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Prepared by:
     Chukwuma Onyeije, M.D.
  Atlanta Perinatal Associates
Morehouse School of Medicine
CMS Health Care
    Innovation Challenge
           Grant.

             Sponsored by:



LINK: http://www.innovations.cms.gov/initiatives/innovation-challenge/
An Overview of American Health Care in 2011


• Greatest Acute Care in the World:
  – People come from around the world to be treated
• HOWEVER
  – 46 million Americans lack coverage
• OTHER PROBLEMS WITH CARE DELIVERY:
  • Uncoordinated –
     •   Fragmented delivery systems
     •   Variable quality
  • Unsupportive – of patients and health care practicioners
  • Unsustainable – Costs rising at twice the inflation rate

                                                               2
Components of a BETTER System


• Affordable
• Accessible – to care and to information
• Seamless & Coordinated
• High Quality – timely, equitable, safe
• Person and Family-Centered
• Supportive of Providers in serving their patients’ needs
• Engaged with the community and fulfilling its population’s
  unique needs
                                                               3
What is the Role of the CMS Innovation Center?




  Better care
  and better
   health at
reduced costs
   through
improvement.


LINK: http://innovations.cms.gov/                    4
How will the CMS Innovation Center Improve Care?

• Better health care:
  – Improving all aspects of patient care, (as defined by
    the Institute of Medicine).
• Better health:
  – Encouraging healthier lifestyles in the entire
    population, including increased physical activity,
    better nutrition, avoidance of behavioral risks, and
    wider use of preventative care.
• Reduced costs:
  – Promoting preventative medicine, better record
    keeping, and improved coordination of health care
    services,
  – Reducing waste, inefficiency, and miscommunication.

                                                            5
Measures of Success


Better health care - Improve individual patient
experiences of care along the IOM 6 domains of
quality: Safety, Effectiveness, Patient-Centeredness,
Timeliness, Efficiency, and Equity

Better health - Focus on the overall health
outcomes of populations by addressing underlying
causes of poor health, such as: physical inactivity,
behavioral risk factors, lack of preventive care, and
poor nutrition

Reduced costs - Lower the total cost of care for
Medicare, Medicaid and CHIP beneficiaries by
improving quality of care and patient experience



                                                        6
Transforming Health Care


INNOVATORS across the country are developing NEW
  & EFFECTIVE care delivery and payment models


 •These innovations offer us pathways to building a future
 health system that is more effective than the current
 system at improving health care, health, and lowering costs.




                                                                7
What is the Health Care Innovation Challenge?

• The Innovation Center has received over 500 suggestions and
  ideas from across the country.

• This initiative is an open solicitation to innovators across the
  country to identify and test innovative service
  delivery/payment models including infrastructure support.

• This Challenge will strengthen the Innovation Center’s current
  menu of options and will address unique needs of
  communities and populations across the country.



                                                                     8
Objectives of the Health Care
         Innovation Challenge

Engage a broad set of innovation partners to identify and
test new care delivery and payment models that originate
in the field and improve quality while lowering the total
cost of care.
Support innovators that can rapidly deploy care
improvement models within six months of the award
through new ventures or expansion of existing efforts.
Identify new models of workforce development, training
and deployment that support new models either directly or
through new infrastructure activities.

                                                            9
Nature of Innovation Challenge Grant Funding


$1 billion to fund innovative service delivery and payment models
                 to support those innovative models
Successful proposals will
    •Define and test a clear pathway to sustainability (higher quality
    and lower total system cost)
    •Demonstrate care improvement within 6 months of award
    •Support care transformation with enhanced infrastructure activity
    •Rapidly develop and deploy a health care workforce

Proposals are encouraged to focus on high-cost/high-risk populations
    •Including those with multiple chronic conditions, mental health or
    substance abuse issues, poor health status due to socioeconomic
    and environmental factors, or the frail elderly

                                                                          10
Nature of Innovation Challenge Grant Funding

• Priority will be given to projects that rapidly hire,
  train, and deploy new types of health care
  workers
• Focus on improved care coordination,
  prevention, and care process re-engineering,
• Serving high-risk individuals with complex health
  care needs using infrastructure such as
  electronic health records, telemedicine, and
  medication reconciliation systems.


                                                          11
Nature of Innovation Challenge Grant Funding

• Awards will range from $1 million to $30
  million over three years.
• No non-federal “matching” requirement.
• Each approved project will execute a
  cooperative agreement with CMS, will be
  subject to monitoring of quality and costs
  based on a standard minimum data set of
  performance indicators, and must cooperate
  with independent evaluators to be contracted
  by CMS

                                                 12
OUR PROPOSAL
OBJECTIVES


• Quantifiably reduce morbidity due to major
  drivers of adverse perinatal outcome in low
  income women over a three year period.
• Utilize cutting edge technology to enhance
  patient education
• Introduce the concepts of self tracking,
  participatory medicine and community
  support to low income women.
• Enhance health literacy.
                                                14
OBJECTIVES

• Use quantifiable data to drive care decisions
  and improve outcomes.
• Allow patients to use emerging social
  technology to improve communication about
  health and build lasting communities for
  continued care in a non-medical context
• Reduce cost by improving outcome via the
  use of inexpensive and readily available
  technology

                                                  15
OUR AREAS OF INTEREST:




      GESTATIONAL DIABETES
   OBESITY AND POSTPARTUM WEIGHT LOSS
 PATIENT EDUCATION AND ENGAGEMENT
Gestational
           Diabetes




          UP-
OBESITY
          CIP
  &                     EDUCATION/
WEIGHT                  ENGAGEMENT

 LOSS
Gestational
 Diabetes
GESTATIONAL DIABETES:

• Background
  – http://prezi.com/z89fo9gxmwka/gestational-diabetes/
• Scope of the problem
  – Affects up to 4% of pregnancies.
  – Increased risk for perinatal complications
  – More common in African-American, Hispanic and Low
    income patients.
  – 45 percent risk of recurrence with the next pregnancy
  – 63 percent risk of developing type 2 diabetes later in
    life.



                                                             19
GESTATIONAL DIABETES: What can be done?

• Introduce a mobile health component to
  current care protocols
• Allow patients to record values for instant /
  ongoing interaction with care givers.
• Allow patients to interact with similar
  patients.




                                                  20
GESTATIONAL DIABETES: What can be done?

• Provide clinicians with tools to rapidly
  assess glucose control and institute timely
  interventions.
• Reduce delays in care seen in current
  care plans
• Reduce cost of current care plans
• Reduce hospitalization for diabetes.


                                                21
A Template for
   Success:




For details see: http://mobihealthnews.com/15116/medicaid-patients-reduce-hospitalizations-with-welldoc/
GESTATIONAL DIABETES:
Our Proposal:
•   Provide patients with smart phones equipped with diabetes management
    software.
•   Phones can be rented to patients or subsidized via grant funding.
•   Software solutions will track blood sugar, dietary choices, maternal weight,
    mood and subjective assessment of compliance.
•   Tracked values and parameters will provide input for patients to self-adjust
    their care
•   Software will allow for patients to share useful practices and concerns with
    clinicians and other patients
•   Software will automatically track and provide clinicians with summaries and
    detailed information of outlying values.
•   Similar programs have reduced the need for hospitalization in patients with
    diabetes.
•   Intensive care of diabetes has been shown to reduce perinatal
    complications and health care cost
•   Economies of scale and new technology make this management feasible
    and afordable



                                                                                   23
GESTATIONAL DIABETES:
Our Proposal:

• Software solutions are already available
  for FREE.




                                             24
INNOVATION: How our proposal changes the paradigm for
Gestational Diabetes Care for Patients?



• Emphasis on ongoing education
• Greater emphasis on patient participation
• Use of readily available technology




                                                        25
INNOVATION: How our proposal changes the
paradigm for Gestational Diabetes Care for
Providers?
• Access to empirical data to quantify and
  monitor effectiveness of intervention in
  real-time
• Open Source communication across the
  country to similar programs
• Rapid iteration and change in protocol
  based on input from all stake holders


                                             26
COST SAVINGS: How our proposal assures
affordable innovation for Gestational Diabetes

• Reduced need for hospitalization
• Reduction in utilization of outpatient acute
  care resources
• Re-useable technology
• Techniques to allow patients to sustain
  techniques after pregnancy is completed
• Program is reproducible in a variety of
  clinical settings.

                                                 27
OBESITY
  &
WEIGHT
 LOSS
Obesity and Postpartum Weight Loss

• Background
  – http://prezi.com/v9fgrfherwtr/obesity-during-
    pregnancy-a-teachable-moment/
  – Identification of Obesity during pregnancy
    represents a “Teachable Moment”
  – Effective interventions for postpartum weight
    loss can reduce the burden of chronic illness




                                                    29
Obesity and Postpartum Weight Loss

• Scope of the problem
  – Obesity is America’s newest and fastest-
    growing epidemic
  – Obesity fuels a multitude of other diseases
  – Children of obese parents have a strong
    tendency toward obesity and a multitude of
    resultant complications.
  – Preventive measures are straightforward and
    simple but have not been implemented widely
    or effectively.

                                                  30
Obesity and Postpartum Weight Loss:
               What can be done?

• Incorporate cost effective and proven
  methods of prolonged fat loss into prenatal
  care.
  – Weight watchers, Quantified self, ----
• Provide patients with methods to track weight
  loss and tools to self assess personally
  effective strategies
• Utilize incentives to facilitate compliance
• Allow patients to record values for instant /
  ongoing interaction with care givers.

                                                  31
Obesity and Postpartum Weight Loss:
What can be done?

• Allow patients to interact with similar patients.
• Use low cost readily available technology to
  allow clinicians to monitor progress
  BETWEEN clinical visits
• Reduce delays in care seen in current care
  plans
• Reduce cost of current dietary interventions
  for weight loss.
• Provide early identification of patients with
  problematic weight loss profiles.


                                                      32
Obesity and Postpartum Weight Loss:
           OUR APPROACH:

       Quantified Self Strategies
                    +
         The Hawthorne Effect
                    +
       Education / Accountability
                    =
Effective Interventions and Sustainable
         Postpartum Weight Loss

                                          33
What is the
Quantified Self?

A community of
   individuals
 who share self
   knowledge
  through self-
    tracking.



For more information: http://www.guardian.co.uk/science/2011/dec/02/psychology-human-biology
The Hawthorne Effect: Observation Changes
  Behavior




Observation
Changes
Behavior




                                              35
Obesity and Postpartum Weight Loss:
Our Proposal:

• A 6 month intensive, physician guided,
  educational program modeled after
  successful nutritional strategies for
  sustained weight loss
• Offered to low income women following
  pregnancy.
• Identify patients while still pregnant
• Hit the ground running on day of delivery.

                                               36
Obesity and Postpartum Weight Loss:
Our Proposal:

• Incorporate weight loss as a part of
  ongoing neonatal and postpartum care.
• Classroom instruction,
  Telephone/Telemedicine consultation,
  Online Educational resources




                                          37
Obesity and Postpartum Weight Loss:
Our Proposal:

• Connect educational resources to patient’s
  chosen social media
  – (Facebook, Twitter, Google+)
• Emphasis on increased activity (walking),
  dietary modification and self-tracking.




                                               38
Obesity and Postpartum Weight Loss:
Available Tools:




              Internet enabled
              scale
                                 Weight management &
                                 Food tracking software




                                             Internet enabled
                                             pedometer
    Portable sleep monitor


                                                                39
Obesity and Postpartum Weight Loss:
Our Proposal:

• Provide patients with tracking tools at low
  cost or no cost defrayed by grant funding.
• Instruct patients regarding self tracking
• Monitor with “Multiple Eyes” to exploit the
  Hawthorne Effect
  –   Patient
  –   Family members
  –   Fellow patients
  –   Health care providers
• Make individual adjustments in care based on
  data obtained.

                                                 40
INNOVATION: How our proposal changes the
paradigm for Postpartum Weight Loss

• Patient empowerment
• Low cost tools
• Intensive education and monitoring
• Exploit the “Teachable Moment” and the
  Hawthorne Effect
• Constant contact between clinical
  encounters


                                           41
COST SAVINGS: How our proposal assures
affordable innovation for Postpartum Weight Loss

• Sustainable interventions
• Small changes compounded by repeated
  execution
• Tracking of effective interventions with rich
  data
• Publish success and build evidenc for
  what works


                                                   42
EDUCATION/
ENGAGEMENT
EDUCATION AND ENGAGEMENT:

• Background:
  – Improved compliance with medical care can
    be achieved with improved health literacy
• Scope of the Problem:
  – Health literacy is a barrier to optimal care in
    low income communities.
  – Health literacy affects all aspects of clinical
    care
  – Few studies documenting methods to improve
    health literacy in low income women.

                                                      44
CMS Health Care Innovation Challenge Grant - Preliminary Proposal
EDUCATION AND ENGAGEMENT:
What can be done?

• Encourage participation
• Use multiple methods to address
  comprehension
• Leverage low cost technology
• Enlist churches, community and civic
  organizations



                                         46
EDUCATION AND ENGAGEMENT:
Our Proposal

• Utilize the previously described
  interventions
• Document effectiveness prospectively
• Publish results
• Obtain insights to develop testable
  hypotheses.



                                         47
CMS Health Care Innovation Challenge Grant - Preliminary Proposal
NEXT STEPS:

• Letter of intent to CMS is due: December
  19th, 2011 at 11:59 PM
• Discussion and modification of this proposal
• Identification of resources and support staff
• Creation of final protocol
• Cost analysis
• Final grant proposal due: January 27, 2012
• Purchasing / Staffing / Implementation upon
  selection

                                                  49
Interested?

• Contact me by email: onyeije@gmail.com
• Indicate availability for further discussion /
  planning
• Next CMS Webinar:
  – Monday, December 19 , 2011 2-3pm EST
• CMS Resources:
  http://www.innovations.cms.gov/initiatives/i
  nnovation-challenge/

                                                   50

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CMS Health Care Innovation Challenge Grant - Preliminary Proposal

  • 1. Prepared by: Chukwuma Onyeije, M.D. Atlanta Perinatal Associates Morehouse School of Medicine
  • 2. CMS Health Care Innovation Challenge Grant. Sponsored by: LINK: http://www.innovations.cms.gov/initiatives/innovation-challenge/
  • 3. An Overview of American Health Care in 2011 • Greatest Acute Care in the World: – People come from around the world to be treated • HOWEVER – 46 million Americans lack coverage • OTHER PROBLEMS WITH CARE DELIVERY: • Uncoordinated – • Fragmented delivery systems • Variable quality • Unsupportive – of patients and health care practicioners • Unsustainable – Costs rising at twice the inflation rate 2
  • 4. Components of a BETTER System • Affordable • Accessible – to care and to information • Seamless & Coordinated • High Quality – timely, equitable, safe • Person and Family-Centered • Supportive of Providers in serving their patients’ needs • Engaged with the community and fulfilling its population’s unique needs 3
  • 5. What is the Role of the CMS Innovation Center? Better care and better health at reduced costs through improvement. LINK: http://innovations.cms.gov/ 4
  • 6. How will the CMS Innovation Center Improve Care? • Better health care: – Improving all aspects of patient care, (as defined by the Institute of Medicine). • Better health: – Encouraging healthier lifestyles in the entire population, including increased physical activity, better nutrition, avoidance of behavioral risks, and wider use of preventative care. • Reduced costs: – Promoting preventative medicine, better record keeping, and improved coordination of health care services, – Reducing waste, inefficiency, and miscommunication. 5
  • 7. Measures of Success Better health care - Improve individual patient experiences of care along the IOM 6 domains of quality: Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity Better health - Focus on the overall health outcomes of populations by addressing underlying causes of poor health, such as: physical inactivity, behavioral risk factors, lack of preventive care, and poor nutrition Reduced costs - Lower the total cost of care for Medicare, Medicaid and CHIP beneficiaries by improving quality of care and patient experience 6
  • 8. Transforming Health Care INNOVATORS across the country are developing NEW & EFFECTIVE care delivery and payment models •These innovations offer us pathways to building a future health system that is more effective than the current system at improving health care, health, and lowering costs. 7
  • 9. What is the Health Care Innovation Challenge? • The Innovation Center has received over 500 suggestions and ideas from across the country. • This initiative is an open solicitation to innovators across the country to identify and test innovative service delivery/payment models including infrastructure support. • This Challenge will strengthen the Innovation Center’s current menu of options and will address unique needs of communities and populations across the country. 8
  • 10. Objectives of the Health Care Innovation Challenge Engage a broad set of innovation partners to identify and test new care delivery and payment models that originate in the field and improve quality while lowering the total cost of care. Support innovators that can rapidly deploy care improvement models within six months of the award through new ventures or expansion of existing efforts. Identify new models of workforce development, training and deployment that support new models either directly or through new infrastructure activities. 9
  • 11. Nature of Innovation Challenge Grant Funding $1 billion to fund innovative service delivery and payment models to support those innovative models Successful proposals will •Define and test a clear pathway to sustainability (higher quality and lower total system cost) •Demonstrate care improvement within 6 months of award •Support care transformation with enhanced infrastructure activity •Rapidly develop and deploy a health care workforce Proposals are encouraged to focus on high-cost/high-risk populations •Including those with multiple chronic conditions, mental health or substance abuse issues, poor health status due to socioeconomic and environmental factors, or the frail elderly 10
  • 12. Nature of Innovation Challenge Grant Funding • Priority will be given to projects that rapidly hire, train, and deploy new types of health care workers • Focus on improved care coordination, prevention, and care process re-engineering, • Serving high-risk individuals with complex health care needs using infrastructure such as electronic health records, telemedicine, and medication reconciliation systems. 11
  • 13. Nature of Innovation Challenge Grant Funding • Awards will range from $1 million to $30 million over three years. • No non-federal “matching” requirement. • Each approved project will execute a cooperative agreement with CMS, will be subject to monitoring of quality and costs based on a standard minimum data set of performance indicators, and must cooperate with independent evaluators to be contracted by CMS 12
  • 15. OBJECTIVES • Quantifiably reduce morbidity due to major drivers of adverse perinatal outcome in low income women over a three year period. • Utilize cutting edge technology to enhance patient education • Introduce the concepts of self tracking, participatory medicine and community support to low income women. • Enhance health literacy. 14
  • 16. OBJECTIVES • Use quantifiable data to drive care decisions and improve outcomes. • Allow patients to use emerging social technology to improve communication about health and build lasting communities for continued care in a non-medical context • Reduce cost by improving outcome via the use of inexpensive and readily available technology 15
  • 17. OUR AREAS OF INTEREST: GESTATIONAL DIABETES OBESITY AND POSTPARTUM WEIGHT LOSS PATIENT EDUCATION AND ENGAGEMENT
  • 18. Gestational Diabetes UP- OBESITY CIP & EDUCATION/ WEIGHT ENGAGEMENT LOSS
  • 20. GESTATIONAL DIABETES: • Background – http://prezi.com/z89fo9gxmwka/gestational-diabetes/ • Scope of the problem – Affects up to 4% of pregnancies. – Increased risk for perinatal complications – More common in African-American, Hispanic and Low income patients. – 45 percent risk of recurrence with the next pregnancy – 63 percent risk of developing type 2 diabetes later in life. 19
  • 21. GESTATIONAL DIABETES: What can be done? • Introduce a mobile health component to current care protocols • Allow patients to record values for instant / ongoing interaction with care givers. • Allow patients to interact with similar patients. 20
  • 22. GESTATIONAL DIABETES: What can be done? • Provide clinicians with tools to rapidly assess glucose control and institute timely interventions. • Reduce delays in care seen in current care plans • Reduce cost of current care plans • Reduce hospitalization for diabetes. 21
  • 23. A Template for Success: For details see: http://mobihealthnews.com/15116/medicaid-patients-reduce-hospitalizations-with-welldoc/
  • 24. GESTATIONAL DIABETES: Our Proposal: • Provide patients with smart phones equipped with diabetes management software. • Phones can be rented to patients or subsidized via grant funding. • Software solutions will track blood sugar, dietary choices, maternal weight, mood and subjective assessment of compliance. • Tracked values and parameters will provide input for patients to self-adjust their care • Software will allow for patients to share useful practices and concerns with clinicians and other patients • Software will automatically track and provide clinicians with summaries and detailed information of outlying values. • Similar programs have reduced the need for hospitalization in patients with diabetes. • Intensive care of diabetes has been shown to reduce perinatal complications and health care cost • Economies of scale and new technology make this management feasible and afordable 23
  • 25. GESTATIONAL DIABETES: Our Proposal: • Software solutions are already available for FREE. 24
  • 26. INNOVATION: How our proposal changes the paradigm for Gestational Diabetes Care for Patients? • Emphasis on ongoing education • Greater emphasis on patient participation • Use of readily available technology 25
  • 27. INNOVATION: How our proposal changes the paradigm for Gestational Diabetes Care for Providers? • Access to empirical data to quantify and monitor effectiveness of intervention in real-time • Open Source communication across the country to similar programs • Rapid iteration and change in protocol based on input from all stake holders 26
  • 28. COST SAVINGS: How our proposal assures affordable innovation for Gestational Diabetes • Reduced need for hospitalization • Reduction in utilization of outpatient acute care resources • Re-useable technology • Techniques to allow patients to sustain techniques after pregnancy is completed • Program is reproducible in a variety of clinical settings. 27
  • 30. Obesity and Postpartum Weight Loss • Background – http://prezi.com/v9fgrfherwtr/obesity-during- pregnancy-a-teachable-moment/ – Identification of Obesity during pregnancy represents a “Teachable Moment” – Effective interventions for postpartum weight loss can reduce the burden of chronic illness 29
  • 31. Obesity and Postpartum Weight Loss • Scope of the problem – Obesity is America’s newest and fastest- growing epidemic – Obesity fuels a multitude of other diseases – Children of obese parents have a strong tendency toward obesity and a multitude of resultant complications. – Preventive measures are straightforward and simple but have not been implemented widely or effectively. 30
  • 32. Obesity and Postpartum Weight Loss: What can be done? • Incorporate cost effective and proven methods of prolonged fat loss into prenatal care. – Weight watchers, Quantified self, ---- • Provide patients with methods to track weight loss and tools to self assess personally effective strategies • Utilize incentives to facilitate compliance • Allow patients to record values for instant / ongoing interaction with care givers. 31
  • 33. Obesity and Postpartum Weight Loss: What can be done? • Allow patients to interact with similar patients. • Use low cost readily available technology to allow clinicians to monitor progress BETWEEN clinical visits • Reduce delays in care seen in current care plans • Reduce cost of current dietary interventions for weight loss. • Provide early identification of patients with problematic weight loss profiles. 32
  • 34. Obesity and Postpartum Weight Loss: OUR APPROACH: Quantified Self Strategies + The Hawthorne Effect + Education / Accountability = Effective Interventions and Sustainable Postpartum Weight Loss 33
  • 35. What is the Quantified Self? A community of individuals who share self knowledge through self- tracking. For more information: http://www.guardian.co.uk/science/2011/dec/02/psychology-human-biology
  • 36. The Hawthorne Effect: Observation Changes Behavior Observation Changes Behavior 35
  • 37. Obesity and Postpartum Weight Loss: Our Proposal: • A 6 month intensive, physician guided, educational program modeled after successful nutritional strategies for sustained weight loss • Offered to low income women following pregnancy. • Identify patients while still pregnant • Hit the ground running on day of delivery. 36
  • 38. Obesity and Postpartum Weight Loss: Our Proposal: • Incorporate weight loss as a part of ongoing neonatal and postpartum care. • Classroom instruction, Telephone/Telemedicine consultation, Online Educational resources 37
  • 39. Obesity and Postpartum Weight Loss: Our Proposal: • Connect educational resources to patient’s chosen social media – (Facebook, Twitter, Google+) • Emphasis on increased activity (walking), dietary modification and self-tracking. 38
  • 40. Obesity and Postpartum Weight Loss: Available Tools: Internet enabled scale Weight management & Food tracking software Internet enabled pedometer Portable sleep monitor 39
  • 41. Obesity and Postpartum Weight Loss: Our Proposal: • Provide patients with tracking tools at low cost or no cost defrayed by grant funding. • Instruct patients regarding self tracking • Monitor with “Multiple Eyes” to exploit the Hawthorne Effect – Patient – Family members – Fellow patients – Health care providers • Make individual adjustments in care based on data obtained. 40
  • 42. INNOVATION: How our proposal changes the paradigm for Postpartum Weight Loss • Patient empowerment • Low cost tools • Intensive education and monitoring • Exploit the “Teachable Moment” and the Hawthorne Effect • Constant contact between clinical encounters 41
  • 43. COST SAVINGS: How our proposal assures affordable innovation for Postpartum Weight Loss • Sustainable interventions • Small changes compounded by repeated execution • Tracking of effective interventions with rich data • Publish success and build evidenc for what works 42
  • 45. EDUCATION AND ENGAGEMENT: • Background: – Improved compliance with medical care can be achieved with improved health literacy • Scope of the Problem: – Health literacy is a barrier to optimal care in low income communities. – Health literacy affects all aspects of clinical care – Few studies documenting methods to improve health literacy in low income women. 44
  • 47. EDUCATION AND ENGAGEMENT: What can be done? • Encourage participation • Use multiple methods to address comprehension • Leverage low cost technology • Enlist churches, community and civic organizations 46
  • 48. EDUCATION AND ENGAGEMENT: Our Proposal • Utilize the previously described interventions • Document effectiveness prospectively • Publish results • Obtain insights to develop testable hypotheses. 47
  • 50. NEXT STEPS: • Letter of intent to CMS is due: December 19th, 2011 at 11:59 PM • Discussion and modification of this proposal • Identification of resources and support staff • Creation of final protocol • Cost analysis • Final grant proposal due: January 27, 2012 • Purchasing / Staffing / Implementation upon selection 49
  • 51. Interested? • Contact me by email: onyeije@gmail.com • Indicate availability for further discussion / planning • Next CMS Webinar: – Monday, December 19 , 2011 2-3pm EST • CMS Resources: http://www.innovations.cms.gov/initiatives/i nnovation-challenge/ 50