What would it take for consumers to become effective and informed managers of their health and health care? What skills, knowledge, beliefs, and motivations do they need to become “activated” or more effectual health care actors?
The Patient Activation Measure® (PAM) ® is a proven tool to assess the underlying knowledge, skills and confidence integral to managing an individual’s health and healthcare. As the Quality Innovation Network-Quality Improvement Organization, we are making a conscious effort to increase involvement of the patient and family member ‘voice’ in our work. PAM is another tool to help foster engagement in care and in return, improved health outcomes through better understanding and support.
The Patient Activation Measure is a valid, highly reliable, uni-dimensional, probabilistic Guttman-like scale that reflects a developmental model of activation.The PAM survey measures patients on a 0-100 scale and can segment patients into one of four Activation Levels along a continuum:
Level 1: Overwhelmed and disengaged
Level 2: Becoming aware, but still struggling
Level 3: Taking action
Level 4: Maintaining behaviors and pushing further
Each activation level reveals insight into an array of health-related characteristics, including attitudes, motivators, behaviors and outcomes. This predictive guidance helps to identify realistic and achievable opportunities to change behaviors and treatment that can move an individual forward on a journey of increasing activation. Individuals who measure high on the assessment typically understand the importance of taking a pro-active role in managing their health and have the skills and confidence to do so.
This information can assist in identifying which individuals need more support, how to tailor support and information and how to measure performance and to have markers for quality care.
To date, over 200 peer‐reviewed published studies worldwide have documented the importance of activation, PAM’s ability to measure activation and its ability to predict a broad range of health-related behaviors and outcomes.
The Patient Activation Measure is being used in a number of ways to improve the delivery of healthcare, including:
- a metric to assess the degree to which patients are prepared and able to self-manage
- to tailor support and education to help patients increase in activation
- to track the impact of interventions and tailored support on increasing patient activation levels
- to segment an enrolled patient population, and direct more resources to low activated patients
PAM was developed by Judith Hibbard and colleagues at the University of Oregon. The PAM has strong psychometric properties and has been translated into 22 different languages. The measure is currently used to assess patient activation or engagement by researchers and clinicians around the world. PAM is offered to healthcare organizations exclusively by Insignia Health, a company based in Portland, Oregon.
Patient activation is another means to help reduce costs and improve the quality of healthcare. If you are not already aware of the PAM, you can learn more at Insignia Health.