Monday, 20 October 2014 15:58

MHC - Your Role in Getting Quality Care


 Your Role in Getting Quality Care



Quality health care happens when you take an active role in your own care, partnering with your doctor to create a more effective, trusting relationship that helps you stay healthy or determine the right care when you need it.

The choices people make about their health and health care profoundly affect outcomes and cost.

That is why we need to:

  • Understand the behaviors that put them at risk and, for those who do have an illness, understand how they do help manage it.
  • Work with their doctors to understand and make informed choices about treatments.
  • Understand the difference between good care and bad care—and demand good care.
  • Choose doctors, clinics and hospitals based on information about their ability to deliver effective care.

Be Engaged in Your Health Care

“There are some very simple things you can do to begin your journey to become a more informed patient and increase the likelihood of safe and effective care”, says Dr. Michael Parkinson, president of the American College of Preventive Medicine. The role of the doctor is to create your care management plan, tailored to your needs, whether they be preventive or whether they be chronic care. But there are simple things you need to know, do and act upon with your physician. Ask him or her what those are. Be prepared before you go into that very busy visit with a good list of your symptoms, all your medications, including things over-the-counter that you don't even think are medications. And be prepared to make a care management plan. Shared decision-making is key.”

The first step is making it clear to your doctor that you want to be in charge. “One of the most important things you need to understand that it is necessary to ask questions., “suggests Ann Monroe, President of the Community Health Foundation of Western and Central New York. Most physicians, at the end of an 11- or 15-minute appointment, can't be sure that they have given you what you need to have. Write them down before you go in, what do I want to know when I leave this appointment.? Taking someone with you is very important; they can listen and report back to you later things the doctor said that you might not have remembered. Those are two things you can do.” With the help of your doctor, your family and friends you can take charge of your health!

“I think there are a lot of things that we need to keep ourselves healthy, the first of which is to take better care of ourselves,” Ann Monroe adds.

Learn What Drives Poor Health

Long before we talk about seeing the doctor, we need to understand what drives poor health. Health care begins with healthy behaviors. Did you walk 30 minutes today? Are you eating the right types of foods? Are you avoiding tobacco and use of alcohol? Do you have a healthly response to stress?

“We take more medications in this country than any country in the world on a per-capita basis, because we have medicalized things that aren't inherently medical, like lifestyle,” says Dr. Parkinson. The epidemic of chronic diseases like diabetes and heart disease are linked to those behaviors - what you eat, if you exercise, how you handle stress and your use of tobacco and alcohol. The ten leading categories of drugs that Americans take -8 out of the ten of those are lifestyle related. People around the world do not all take statin drugs, they don't all take hypertensive medications and sleeping pills. We've got to get back to the basics we can not prescribe our way out of these problems it starts with behaviors.

And if you're part of the growing number of Americans that have a chronic disease, that's where you really need to know three things. You need to know about your disease. You need to do certain things that are specific to that disease. And you need to act upon information with your doctor.”

Focus on Prevention

We all need preventive care, whether we have a chronic condition or not. Do you know your preventive care needs? Learn more from the Agency for Healthcare Research and Quality (AHRQ) -

Men: Stay Healthy at Any Age (Your checklist for health from AHRQ)

Women: Stay Healthy at Any Age (Your checklist for health from AHRQ)

One of the most powerful forces driving improvement in health care is you - the educated consumer. When you make informed choices and are engaged in your own care you not only experience better outcomes, you also help reward doctors, hospitals and health plans that deliver better care and service.

More on your role of getting quality care on the web:

Agency for Healthcare Research and Quality - Patients & Consumers



Thursday, 16 October 2014 13:51

MHC - Finding Credible Information


 Finding Credible Information


Making health care patient-centered starts with giving consumers accurate information that they can use to make informed choices.

The fastest growing resource of information in our society today is the internet. There is a seemingly endless supply of information about health and just about anything else you can imagine on the internet along with opportunities to interact with people all over the world. Imagine being diagnosed with a rare health condition, and being able to connect with other people who share your diagnosis even though they live hundreds, if not thousands of miles away.

In recent years the growth in technology and new media has created a communications revolution that puts instant and equal access to previously unavailable or difficult-to-find information at your fingertips. Unfortunately the quality of that information can be described as the good, the bad and the ugly. How do you tell the difference? That's an important question when you consider that people rely on this information to make important decisions about their health and healthcare.

The internet has virtually no controls over who is posting information or whether the information is correct, or even safe.

We have a tough job. Having a critical eye is our responsibility. We must decide which information is good based on common sense, sound judgment and some general guidelines. Approach the information with skepticism and caution and you'll be able to navigate to the highest quality information.

The National Library of Medicine has put together a tutorial to help you Evaluate Internet Health Information.

What to look for. . .

Many reliable websites have a seal of certification from a trusted accrediting organization like URAC and the Health on the Net Foundation . This “seal of approval” tells users the information on a particular site is reliable. To earn a seal, the web site has to meet certain conditions. Health and medical site owners seek this accreditation on their own. There are plenty of sites without these seals that contain good health information.

Use a specialized search engine.

There are specialized search engines that look only at reputable sites that have been vetted by health professionals. Dirline, run by the National Library of Medicine, is one such engine, as are and searches for information on government health Web sites.

Check the source.

Who is responsible for the content? At the end of the web site's URL (the web address, starting with http://), you will usually see .com, .edu, .gov, or .org if the web site originates in the United States . Good sources of health information include:

  • “dot govs” are from governmental agencies like the National Institutes of Health or the U.S. Department of Health and Human Services. A college or university like Johns Hopkins University Medicine will have a “dot edu”.
  • “dot orgs” are non profit organizations. Look for groups whose focus is research and teaching the public about specific diseases or conditions, such as the American Diabetes Association, the American Cancer Society, and the American Heart Association. Hospitals and other health care facility sites like the Mayo Clinic and Cleveland Clinic are “dot orgs.” Medical and science journals like the New England Journal of Medicine and the Journal of the American Medical Association are also “dot orgs” and are a credible source of information although they may be difficult to understand as they aren't written for consumers.
  • “dot com” indicates a commercial website. These web sites are trying to sell you a product or service, or sell advertising space. This doesn't mean the information isn't good; there are many commercial sites that provide trustworthy information.

Here are some questions you can ask yourself as you are looking for health information on the Web:

  • Check out the source of the information. Be wary of Web sites that (1) do not list the origin of the information, (2) are trying to sell a product or service, or (3) are promoting only one point of view. The most objective sites are government agencies such as the Centers for Disease Control and Prevention, the National Institutes of Health, the National Library of Medicine, or your local department of health. One question you could ask yourself: Does the author have anything to gain from having only one viewpoint on the topic?
  • Know the purpose of the site. Many sites have an “About This Site” or “About Us” link. Click on it to see what the purpose of the site is. It will help you to find out if the information is reliable. Know who is paying for the site. The source of funding for the site can affect what content is on it. Is the site paid for by advertising or by sponsorship from a drug company? The answer should be clearly stated or easy to find.
  • Find out when the site was last updated. Health and medical information is constantly changing and needs to be current. If the information is old, it could be less reliable. If the Web site is rarely updated, it probably is not as accurate as a site that posts information regularly. Always know when the site was first created and when it was last revised.
  • Is the information reviewed by experts? Having a review system in place will help ensure that the information is reliable.
  • Be aware of what information the site is collecting. If you have to be a member or sign up on the site, chances are that information will be used for something other than identification. Any site that requests your name, address, credit card, or other information should tell you exactly what they will do -- and not do -- with this data.
  • The site should have a way to contact the organization or webmaster. Look for a “Contact Us” link.
  • Get a second opinion. Compare the information with that of other sources.

Most important of all: No health information on the Web should take the place of information provided by your physician or healthcare provider. Health information on the Internet is meant to supplement the information your physician gives you, not replace it. Ask your doctor what he or she knows about the topic or finding and what sources they would regard as reliable.


More on finding credible information on the web:


Evaluating Internet Health InformationWatch a tutorial from the National Library of Medicine that teaches you how to evaluate health information.

MedlinePlus Guide to Healthy Web Surfing

Finding Credible, Reliable Objective Health Information on the Internet - Guidelines and best practices for internet health and medical research (from by Trisha Torrey)



Thursday, 16 October 2014 13:17

MHC - Finding Resources & Support


 Finding Resources & Support


People can improve their care by learning more about their doctors and their own conditions—asking questions, sharing their medical history, making sure they understand their doctor's recommendations, and taking the necessary steps to feel better sooner.

Knowing when you need help and how to find help is critical when it comes to managing your health. It can be a challenge. Without a detailed map, where do you start?

Your doctor's office is a great place to begin. Talk with your doctor and ask them for suggestions on finding additional resources or information. Don't forget about other members of your healthcare team—nurses, dieticians, insurance specialists—who can help you to.

Oftentimes, one of the first community resources your doctor will suggest are voluntary health organizations, places like the American Diabetes Association or the American Cancer Society. There's a whole branch of these organizations that can provide personalized, one-on-one support for people who have been diagnosed with a particular health condition. Finding what you need may be a simple as looking in the phone book, making some calls or going online. Medline Plus has put together a list of these organizations you can access grouped by health topic or listed in alphabetical order.

The telephone book can lead you to some of those organizations too. Look for “information and referral” in your county or city government listings. Other agencies listed in the phone book like the United Way , the local chapter of AARP and your local senior service agency can also be helpful with referrals.

Hospitals and health care organizations may also offer some services. Call you local hospital, health insurance plan or clinic and ask for the social services department.

Another community resource is the public library. Be sure to enlist the help of the reference librarian to make sure you don't overlook anything. There are also other specialized health libraries. They are oftentimes offered through non-profit organizations or hospitals. Sometimes they will charge a small fee. Use this link from Medline Plus to find a medical library in your area.

You may also want to reach out to support groups, message boards and forums online. Connecting with other patients and sharing with others can be very empowering.


More on finding resources & support on the web:

Next Steps After Your Diagnosis: Finding Information and Support - from the Agency for Healthcare Research and Quality

Find Services & Information - from Medline Plus

Interactive Health Tutorials - tutorials are interactive health education resources from the Patient Education Institute. Using animated graphics each tutorial explains a procedure or condition in easy-to-read language. You can also listen to the tutorial. (From Medline Plus)

Patient Friendly References for Health and Medical Research - Master list of types of resources and links to get you there too. (from by Trisha Torrey)




Thursday, 16 October 2014 13:03

MHC - Learn Problem Solving Steps


 Learn Problem Solving Steps



Like most things, self-management is rarely a smooth process. Chances are you will run into a few roadblocks along the way. When it seems like you're getting a little worse or hit a plateau, keep in mind that ups and downs are unavoidable. If your plan doesn't work, don't give up! As we saw in “Ann's Story” there are specific steps that can help you tackle the barriers that get in your way.

Kate Lorig at Stanford University has developed a very successful program called the Chronic Disease Self Management Program . The following steps are adapted from this program:

Identify the problem. This is the first and most important step, but it is usually also the most difficult step, it may take some work to identify the root of the problem.

List ideas to solve the problem. Once you have your list it may be helpful to consult with your “self-management support team”—friends, family, your doctor or community resources.

Select one method to try. New activities can be difficult, so make sure you give your selection a fair chance before deciding that it doesn't work.

Assess the results. If you've solved the problem great! If not it's time to substitute another idea from the list.

Reach out for additional resources. If you still don't have the solution it's time to reach out once again to your “self-management support team” for more ideas.

Accept that the problem may not be solvable at this moment. Just because that problem isn't immediately solvable, doesn't mean it won't be solvable later. Don't give up.

Don't dwell on what you can't do. Start working on another goal you'd like to accomplish.




Wednesday, 15 October 2014 18:38

MHC - Goals & Action Planning


 Goals & Action Planning


Getting peace of mind about health care begins largely with finding the right doctor—one who values relationships based on openness and trust and provides high-quality care. Regardless of what kind of relationship they have with their doctor, there is a lot people can do to manage their own health, like watching what they eat, getting exercise, and limiting stress.

Once you've decided to take an active role in your health, one of the first steps is to set a goal for yourself. This is something you and your doctor or other members of your healthcare team should do together. It's part of your treatment plan—allowing you to extend your care beyond the exam room walls and into your everyday life.

Pick a problem. Talk to your doctor and take an honest look at the unhealthy aspects of your lifestyle. It's your turn to zero in on a particular behavior that you'd like to change to help prevent future illnesses, to have better control of conditions you already have and to prevent complications. For example, you might decide that you want to make healthier food choices, increase your physical activity or take your medications as your doctor has prescribed. Write down your goal and date it. Share it with your doctor and other people you trust and ask for their help.

Look for ways to accomplish your goal. There are many ways to reach any specific goal. If your goal is to lose weight you could start an exercise program, decide not to eat between meals or decide to cut out cola of other sweetened beverages from your diet. Sometimes what keeps us from reaching our goal is the failure to see alternatives, so you'll want to list all the options. Share your goal with family, friends and your healthcare team and ask them to help you add to your list.

Turning your Goals into Action Plans. When you think about reaching that goal it can be overwhelming. Generally, goals are too big to work on all at once. If your thinking about losing a significant amount of weight, say 50 pounds, it's not something you can achieve in one week, or even one month. You'll need to break down those goals into smaller achievable steps—this is action planning.

To be successful action plans need to:

  • Come from YOU. The action plans should be something you want to do or accomplish. Don't choose something to please your doctor or your loved ones.
  • Be Reasonable. It should be something that you can accomplish within a week. Remember, it's the combination of successful actions plans that will help you achieve your goal.
  • Be Specific. The more specific your goal is, the more likely you are to succeed. For example, instead of saying, “I'm going to exercise more,” decide what kind of exercise you'll do. Be specific about what days of the week you'll exercise and what times you'll exercise on those days. Your new goal might be: “After dinner on Mondays, Wednesdays and Fridays, I'm going to walk 1 mile in through the neighborhood, with my dog.” Try to answer the questions what, how much, when and how often.
  • Be Realistic. Go or the real, not the ideal. The ideal might be walking 10,000 steps a day, but if you're currently walking only 500 to 1,000 steps a day, going for 10,000 may be too much. A more realistic goal may be 1,200 to 2,000 steps. When you do that, add a few more.
  • Be Behavior Specific. Think behavior, not results. For example instead of saying, “I'm going to eat healthier,” decide to add one serving of vegetables to your dinner at least five days this week and switch from drinking Coke to water at lunchtime.

Plan ahead. Try to think of things that could go wrong and plan how you'll deal with them. For example, if it rains and you can't walk in the park as planned, where will you go to walk? Is there an indoor track nearby, or could you go to the mall? If you plan how to handle problems in advance, they won't prevent you from following through with your action plan.

Check your confidence level. Ask yourself, “How confident am I that I'll be able to meet this goal?” Calculate your confidence level on a scale o 1-10 with 1 being not sure at all and 10 being totally sure. If the answer is below 7, you may need look at your action plan and either plan or foreseeable problems or change your plan so you are more confident of success.

Keep track of results. Once you are confident of your action plan write it down and post it where you will see it every day. It's a good idea to keep track of how you are doing each day. Check off accomplishments and list any problems you encounter. Ask family and friends to check in with you to see how you are doing—they can be good motivators. At the end of the week, see if you've accomplished your action plan and if you're made progress toward your goal. If you are struggling with your plan it's time to problem solve.

One of the most important things to remember is that you can change your behavior. Even though chronic conditions can make you feel helpless at times, if you work with your doctor to set goals and you take responsibility for following through with them, you can make changes that will lead to better health and decrease the advancement of disease.

Ready to start . . . Make a Plan for Your Health!

Make a plan resources:


My Health Counts! Action Plan

My Health Counts! Living Well with Diabetes Guide

CDC Healthy Living - Healthy Living



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