Once patients leave a hospital, how do doctors and nurses ensure they keep up with their prescriptions? How do they ensure knee-replacement patients do their exercises at home? That cardiac patients take their blood-pressure medicine?
One of the biggest challenges a hospital faces is patient compliance. Non-compliance is estimated to be the cause of 125,000 deaths and 3.5 million hospital re-admissions each year in the US alone, according to the 2007 booklet "Overview Medication Adherence - Where Are We Today?," by the American Society on Aging and the American Society of Consultant Pharmacists Foundation, and the "Schering Report IX The Forgetful Patient: The High Cost of Improper Patient Compliance."
That’s the problem addressed by ExitCare, whose patient education products are designed to support clinicians, empower patients and help providers meet patients’ educational needs.[caption id="attachment_15664" width="138" align="alignright"]
“The business we’re in is helping patients comply with the information medical professionals have given them,” explained Roger Jacobi, president of ExitCare.
The company, based in Minnesota, was acquired by Elsevier in September and is part of the company’s Clinical Decision Support (CDS) portfolio, which provides information that health care professionals can use to improve patient care.
Elsevier’s CDS products and services are used by hospitals, private practices, pharmacies, government agencies and insurance plans. These solutions use technology to deliver evidence-based, “actionable” information clinicians can use to make decisions. For example, they alert health-care providers to potential complications and help practitioners find the answers they need, whether they’re treating patients, learning a medical procedure or reviewing the latest evidence to support a treatment plan.
Making expert advice easy to understand
ExitCare provides patient-education content that can be delivered via ExitCare’s standalone software system or integrated into an electronic health record.
ExitCare also has multimedia products. ExitCare OnScreen is a video-delivery system and content library that aims to take patient education to the next level. Accessed through kiosks in the hospital, bedside computers, or in the home, the system comprises video, interactive questions and animated graphics designed to keep people informed.
“Think about a patient with a total knee replacement,” he said. “You can give them a piece of paper with some exercises on it, but watching a video of someone doing it is going to be able to be much more effective for them to be able to do it properly.”
Video is not just a simple demonstration tool either; it allows for more persuasive storytelling when it comes to explaining why medication is necessary. Jacobi uses the example of blood pressure medicine, where people often don’t take their medication because it doesn’t make them feel any different. ExitCare can now use video to demonstrate what the risks of high blood pressure are, what it does to vessel walls, and why it’s in the patient’s interest.
Integrating ExitCare with CDS
ExitCare is also being integrated with CDS products. For example, Mosby’s Nursing Consult, the Gold Standard drug database and Clinical Pharmacology now incorporate ExitCare’s patient education materials. ExitCare is also partnering with Elsevier CPM Resource Center to deliver patient education as part of their interdisciplinary care planning and documentation solution for health care providers.
“No one has ever tied care plans to patient education,” said Jacobi, “So we’re going to be the first ones in the marketplace to make that connection.” As a result, the guidelines, advice and strategies that Elsevier’s CPM Resource Center provides to health-care practitioners now extend beyond the boundaries of the hospital.
Working with the experts
Part of ExitCare’s role is to take information aimed at clinicians and turn into something the average patient can understand. With studies revealing that 50 percent of patients cannot understand basic health-care information, ExitCare’s role in providing easy-to-read documents is ever more crucial.
To this end the company works with 80 medical professionals and its own “health literacy experts,” whose job is to take that medical terminology and create patient-friendly documents in 12 languages. However with changing technology, the opportunities for providing more accurate, more comprehensible information are increasing.
Because the company is now integrated into Elsevier, it has access to an extensive library of material. With this in mind, Jacobi reflected on what the future holds.
“Our goal is to become the major resource for a patient, supporting them throughout the whole process,” he said. In the future, ExitCare will be there to help patients understand their ailments, what their options are, what their procedure will be and to communicate with them and their family once the patient has been discharged.
“We want to engage with patients from start to finish,” he said. “We’re going to work with the other CDS businesses to provide something that will meet both the patient and clinician needs throughout the whole journey.”