Patient Engagement

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The key to maximizing population health and effective healthcare

The overall goal of patient engagement is to drive consistent, sustainable behavioral changes in patients, family members, caregivers and healthcare providers in order to improve not only healthcare, but health. A strategic priority if the potential of healthcare reform is to be realized, patient engagement must flow through all major care settings, from the traditional (hospitals, outpatient centers, physician offices) to less traditional (imaging centers, pharmacies, rehabilitation centers, skilled nursing facilities) to non-traditional (places of employment, the patient home).

Patient Empowerment

Engagement guides patients to take ownership of their personal health and their healthcare processes by gaining a foundation of knowledge and understanding about preventative health and maintenance of their current health conditions. By providing impactful information at the appropriate educational level, in the appropriate language and with an appreciation for the user’s culture and socio-demographic status, engaged patients are transformed into powerful advocates who champion their own health and the health of friends, family members and the entire population. Ultimately, engaged patients are truly empowered to become their own best providers.

Patient engagement is critical if we are to dramatically, consistently and sustainably elevate the population’s health and the value (quality divided by cost) of our healthcare delivery system. Society as a whole, and the healthcare sector specifically (healthcare systems, hospitals, traditional providers and payers), must recognize the importance of the “patient as provider” role and move towards consensus on an accepted definition of “engagement” and defined outcome goals and metrics.

Appreciation of the importance of patient engagement must also occur within the C-Suite and hospital/IDN board room. In these executive settings, a full-blown patient engagement implementation plan is rarely necessary. Rather, elaborating on several foundational concepts can secure support for engagement activities:

  • An Expanded Definition of “Provider”
    Successful healthcare reform must be based on the “patient as provider.” This patient ownership concept must be accepted not only by patients, but also by traditional providers (physicians, nurses, therapists, etc.) and administrators.
  • Engagement Across Critical Care Settings
    Access to appropriately presented engagement and educational information must be available across both traditional and non-traditional settings.
  • Information at All Stages of Engagement
    Graduated knowledge and information must be available for patients just beginning to engage through those who are passionately engaged.
  • Personalized, Targeted Information
    Information must appear to be personalized based on target user educational level, language skills, culture, and socio-demographics. It must also be customized to address specific healthcare scenarios, such as co-morbidities and risk.
  • Empowerment of the Support Network
    Engagement must expand beyond the patient to include the individual’s support network, including family, friends, caregivers, spiritual advisors, etc.
  • Training the Trainers
    Successful patient engagement demands that those who engage patients are themselves expertly trained in engagement techniques and technology. Adequate resources (money, time) must be allocated to designated engagement nurses, social workers, care managers and others in preparation for (and continued maintenance of) these new responsibilities.

The engagement, education and empowerment of patients is a challenging journey. Success when implementing an engagement strategy is most likely with clearly defined targets and goals. Start by selecting a specific patient population demonstrating a clear suboptimal metric with a definable improvement, such as heart failure patients who have been emergently hospitalized three or more times in the previous year, or children who have visited the emergency department two or more times during the last year suffering from an asthma attack.

Finally, successful patient engagement, education and empowerment requires a balance of human-to-human interaction (for example, nurse-to-patient) and powerful engagement-dedicated health information technology (HIT) solutions. This combination of the personal touch and technology offers the greatest opportunity to improve clinical outcomes and reduce the costs of care in a meaningful and sustainable fashion.

Such an approach is advanced by considering several themes:

  • Sustain a Patient Engagement Culture
    The most challenging theme, and one which requires constant attention, is the creation of a culture in which traditional healthcare providers, administrators and patients themselves accept the critical role of the “patient as provider.”
  • Identify and Commit the Require Resources
    Recognize resource allocation not only includes financial (for HIT solutions, provider training, etc.) but also human resources (nurses, social workers, care managers, etc.). Do not create a strategy and then under-allocate; get it right from the start, and make honest course corrections as the process moves forward.
  • Utilize Validated Instruments to Measure Engagement
    Validated instruments allow for the measurement of both baseline and improvement in patient engagement. In addition, such instruments demonstrate meaningful relationships between engagement levels and clinical outcomes and costs.
  • Select the Right HIT Vendor Partner
    Recognize patient engagement, education and empowerment requires significant expertise. Select an experienced HIT vendor partner who can provide ongoing guidance as you develop and implement your patient engagement strategy.
  • Select the Right HIT Solutions
    Make certain that the solutions you select (with your HIT vendor partner’s help) address your patient sub-populations’ educational, language, cultural, and socio-demographic profiles in order to successfully engage, educate, and empower.
  • Regularly Reassess Your Progress
    Course corrections are expected in order to achieve your patient engagement goals. Regularly hold honest reviews of where you are versus where you wish to go, including a variety of stakeholders (including patients) in these scheduled reassessments.

Patient engagement is a complicated, constant challenge. Yet without successful engagement, truly impactful improvement in the health of our population and in the value (quality, cost) of our healthcare system is not achievable. Successful patient engagement, education and empowerment requires a philosophical realignment towards the role of “patient as provider” and a significant commitment in focus and resources (financial and human). Finally, meaningful, consistent and sustainable patient engagement demands a balance of both human-to-human interaction and dedicated HIT engagement solutions supported by experienced, committed HIT vendor partners.

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About Author

Peter Edelstein, MD, FACS, FASCRS

CMO, Elsevier Clinical Solutions

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