What Role Is Most Critical in Ensuring Patient Engagement?
Experts universally agree that one of the keys to effective healthcare reform lies in patient engagement. Where they don’t always agree is the method for achieving that much sought after engagement and who should be leading the charge. Rather than identifying a single solution, hospitals must focus on developing a strategic plan of action and a combination of technologies – all supported by a range of individuals across the healthcare landscape from the hospital C-suite to clinicians to those beyond hospital walls. Important to recognize, though, that patient engagement is a means, not an end; effective patient engagement should lead to patient activation, where health behaviors are triggered and sustained.
Why Does Engagement Matter?
Last fall, the Brookings Institute hosted a forum, “The State of Accountable Care: Evidence to Date and Next Steps.” During the forum, patient engagement quickly became a recurring theme as healthcare experts discussed the best ways to reduce the costs of care and improve health outcomes.
It’s no secret that more engaged patients are likely to follow treatment advice, leading to fewer re-hospitalizations and better management of chronic conditions — two things that have the net effect lowering costs and improving outcomes.
The discussions also recognized that patient engagement can positively impact the patient experience. A Brookings blog following the event suggested that, “shared decision making and patient activation are proven strategies for engaging patients at the direct care level. These approaches help providers and patients to recognize that a clinical decision is necessary, understand the evidence on best available interventions, and ensure patient preferences are built into treatment decisions and plans.”
The results are a more satisfied patients and correspondingly high HCAHPS scores. What else can help to increase patient engagement?
What’s Working in Patient Engagement Efforts?
During the keynote address at the Brookings Institute forum, Sean Cavanaugh, deputy administrator and director of the Center for Medicare at CMS, noted that, “on controlling costs, the news is historically good … unprecedented performance on reducing the growth and cost per capita of care.” Likewise, hospitals and other providers are enjoying success in efforts to improve outcomes.
- Health Coaching Program. Using tools like a personal health coach, patient action lists, care coordination and pre- and post-visit assessments, participating patients in Mercy Clinics’ health coaching program are scoring in the 90th percentile for managing blood pressure and blood sugar levels. Moreover, Taylor reported that for every dollar spent on the health coaching program was offset by four dollars in revenue. Certainly a win-win when it comes to expectations for patient engagement.
- Web- or Mobile-based Tools. At Beth Israel Deaconess Medical Center an interactive web-based portal — patientsite.org — allows patients to access their records and verify the accuracy of the health data recorded there. It also serves as a decision aid for patients. A study of 30,000 patients revealed that those with the lowest activation scores incurred costs ranging from 8 percent to 21 percent higher than their more engaged counterparts.
Of course, the big challenge is engaging those patients with the lowest activation and highest healthcare costs, and maximizing resource investment to get the highest Return on Engagement.
As Jan Oldenburg, senior manager in the advisory services practice of EY (formerly Ernst & Young), told Becker’s Hospital Review,“Disengaged consumers are more than twice as likely to experience a medical error. Engaged consumers actually cost less. They pick less expensive treatment options, are more thoughtful about what's really important and tend to have fewer readmissions.” According to Oldenburg’s research, healthcare providers must do a better job than simply building patient portals or offering phone and email.
Just as best-in-class retailers like Amazon provide unique consumer experiences based on personal preferences, hospitals and other healthcare providers need insights into the consumers they want to influence — insights that go beyond typical demographics to understand individual motivations and attitudes towards health and wellness.
Who Else Needs to Engage to Make Patient Engagement Work?
The real question is, “Who doesn’t?”
Across the board, patient engagement strategies will only work if there is top down engagement. The CIO, CXO and CMO need to collaborate to bring the right technology and right messaging together. Physicians, nurses and other clinical staff have a well-documented impact on driving engagement if given the right tools. And now, more than ever, healthcare providers need to collaborate with other organizations in the community, business leaders and payers to encourage engagement. Keep in mind that patient engagement isn’t about talking to patients and simply throwing information at them; it’s about talking with patients, and having a two-way dialogue where the provider educates and patients provide insights into their experiences and motivations.
While there is still work to be done, it is clear that with the right strategies, technologies and insights into patients, the engagement level will continue to rise — and with it — so, too, will the benefits.