Can Self-Directed Care Work?
Improving the patient experience has become a mantra across the healthcare industry. As a result, hospitals and other care providers are experimenting with innovative ways to engage patients in their own care. But are we expecting too much from patients when we put care in their own hands?
Just a few years ago, Victor Montori, M.D., director of healthcare delivery research and professor of medicine at Mayo Clinic College of Medicine, said “We have to be very careful not to blame the patients. A lot of the conversation [around patient engagement] has been, how do we get them to do stuff? To me, that’s not engagement.” Certainly, some patients will respond positively to more self-directed care, but healthcare providers need to get the right tools to the right patients to find success.
Tablets Help Put Patients in Charge
Earlier this year, Clinical Innovation + Technology explored pilot programs launched by healthcare providers that aim to leverage mobile technology to improve the patient experience. One of the stand-out programs has been at Northern Westchester Hospital (NWH) in New York.
A year-and-a-half ago, NWH began using bedside tablets in its medical surgical unit to improve access to information for patients and their families. NWH’s vice president of patient advocacy, Maria Hale, said that the driving force behind the program was the hospital’s president and CEO, Joel Seligman, noting that, “instead of being dependent on a care provider to bring their medical information to them, usually at a time that is most convenient to the care provider, he wanted information available to the patients in real-time and when they are ready to receive it.”
But before launching the program, NWH did its homework.
Focus groups and a test lab enabled the hospital to test hardware and software features with patients and clinicians. The result is a tablet that provides access to medical records, lab results and x-rays. Patients can also use the devices to surf the web or listen to music. According to patient feedback, the most popular features include:
- Bios of the care team. The information is updated as the shifts change, so patients and their families know who is responsible for their care at all times.
- Medication lists. Patients appreciate having a single view of all of the medication they are currently taking.
- Lab values for chronic disease management. A stoplight graphic makes it easy for patients and their loved ones to see their health status at a glance. Hale said, “We had one patient whose value was finally in the green and he took a photo to share with his physician. This is what healthcare is about: Getting patient excited to take control of their health.”
Since its inception, the program has been expanded to include the cardiology and pulmonary units as well, and plans are underway to introduce the program in the maternity unit. Not everyone embraces the technology, however. To help older patients who are not as familiar with mobile devices, NWH developed a program called the Patient Activation Volunteer Educators — or PAVERS.
Volunteers visit with patients who are less comfortable with the technology to demonstrate how to use it — even if it means just teaching them how to play a game on the tablet. “It’s about baby steps, ease of use and making sure the tablet brings value,” said Hale.
Driving Adoption of Patient Technologies
Older patients are not the only ones who may not immediately take to new approaches designed for more self-directed care. In order to drive patient engagement and positively impact the patient experience, hospitals must roll out solutions that fit the needs of individual patients. It is one thing to arm patients with tools for self-directed care in a controlled environment like a hospital, but once patients leave this environment, it is a bit more challenging for them to adopt or sustain such behaviors.
The PatientBond Consumer Classifier uses psychographic segmentation to break down patients into five distinct groups based on their unique motivations and attitudes towards health and wellness. Armed with this knowledge, hospitals can identify which segments are more likely to thrive with self-directed care (the Self Achiever and Balance Seeker segments) and which segments are more likely to demand a more hands-on approach from healthcare providers (the Direction Taker, Willful Endurer and Priority Juggler segments). Each segment has its own communication and health management preferences, so the most effective approach is to engage each patient type with the tools and instructions that appeal to their unique motivations.
Ultimately, it is this type of information that will help hospitals develop effective programs that meet the needs of all patients and lead to greater patient satisfaction and better health outcomes.