Patient Engagement

Definition

Patient Engagement is a patient-centric initiative in which patients are regarded as partners in care, are well-informed and actively participate in health-related activities, share in decision-making, and work together with caregivers and their health care team members to maintain and improve their health and wellness.

Patient Engagement covers a whole range of activities. It can take on many forms, from patients accessing their clinical data via patient portals to discuss their treatment with their physicians through secure electronic messaging to monitoring their health activities using wearable tracking devices, among others.

Patient Engagement has become imperative for healthcare providers in today’s rapidly evolving healthcare landscape.  The U.S. government has decided that this is so vitally important that it is mandated by law.  Within the Advancing Care Information category of MIPS, the required base score asks for reporting in the following areas, each of which may be supported by using a certified EHR technology:

• Security risk analysis
• E-prescribing
• Provide patient access
• Send a summary of care
• Request/accept a summary of care

The ‘provide patients access’ to their health information measure under MIPS is critical to increasing patient engagement, and to allowing patients access to their personal health data in order to improve health, provide transparency and drive patient engagement.

 

While technology is a powerful tool for patient engagement, it should not be the only means, nor should it be an end in itself.  True patient engagement strategy goes beyond just setting up the tech infrastructure and includes the following elements:

• Mindset and cultural shifts that accept and encourage patient engagement as a natural and valid component of healthcare
• “Patient activation” defined as a patient’s knowledge, skills, ability, and willingness to manage their healthcare
• Systems and processes that support the collaboration among providers, patients, and the healthcare team. This relationship includes assessing the use of technology as it affects your practice’s workflows and integrating technology in such a way that it supports the efficient and effective delivery of care.

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Patient Engagement provides immense benefits to patients and practices alike - better communication, better care, and better outcomes. It helps achieve the triple aim of healthcare delivery: improving the patient experience of care, population health, and reducing the per capita cost.

Enhanced communication

Patients and providers can communicate and collaborate more quickly and easily with the use of technology. These innovative tools facilitate the sharing of updates on both sides and provide a means for shared decision-making to happen. Enhanced communication leads to better care, improved outcomes, and increased patient satisfaction.

Better care and improved outcomes

When patients and caregivers are given access to their health and clinical data, treatment information, and decision-making tools, their understanding increases. They are better prepared to participate in their care. This participation gives providers more information about the patient’s condition and helps them make better decisions. Health outcomes are improved by increasing the ability to monitor patients’ health conditions, alerting them to early warning signals, enabling early intervention, and possibly lowering the incidence of emergency room visits and hospitalizations.

Increased patient satisfaction

Easy access to their health and clinical information and the ability to interact with their physicians and healthcare team members give patients a sense of empowerment and more control over their lives. These factors help increase their overall satisfaction with the care provided and the outcomes of such care, a major component of value-based reimbursement.

Lower costs and other financial benefits

Patients save time and money by scheduling appointments using the patient portal. Appointment reminders increase patient satisfaction and reduce cancellations and no-shows. Increased patient satisfaction results in the practice being able to maintain and grow its patient base. Evidence shows that patients who use the portal are nearly 2.6 times more likely to remain patients.

 

According to research done by the Advisory Board, the most common patient engagement initiatives are:

1. Patient portals
2. Secure email
3. Online/mobile scheduling including reminders
4. Patient-generated data
5. Social networks

Other tools and techniques recommended by the Office of the National Coordinator for Health Information Technology (ONC) include:

6. New patient pre-registration
7. Team-based care
8. Daily team huddles
9. Pre-visit planning
10. Patient and Family Advisory Councils

Champion and facilitate an organizational mindset and culture that supports and celebrates patient engagement.

 

Acknowledging and understanding that patients and their families are active partners in their own care is the foundation of success for patient engagement initiatives. This may require significant changes for some organizations or individuals.  To facilitate a smoother transition, consider the following activities:

• Communicate the benefits of patient engagement clearly and consistently.
• Involve stakeholders in the discussions about patient engagement and the possible changes that this may entail in terms of processes and practices. Assure all participants that their concerns and contributions are important and valued.
• Collaborate with staff and leadership in creating a set of policies and procedures that clearly outlines the goals and expectations in terms of patient engagement.

Have a clearly-defined organizational definition, vision, and plan for patient engagement.

Before embarking on a patient engagement campaign, it is important that the entire organization, from the front office staff to physicians, nurses, and other support staff and leadership, understand and share the same vision and objectives. This cohesiveness will help the healthcare team members convey a consistent message and attitude when communicating and working with patients and their families.   This plan should include training and equipping all the healthcare team members to clearly articulate the vision and strategies that will be undertaken on both an organizational and personal level.

Actively support patients’ involvement and participation in their care.

When a culture, vision, and plan are in place that supports patient engagement, it will be much easier for the healthcare team to identify and implement ways to support patient participation and collaboration in their care. This could include encouraging patients to sign up for and access the patient portal, consistently communicating with the care team about their condition, and being open to the patient’s plans and activities to improve their health.

The Office of the National Coordinator for Health Information Technology (ONC) identifies eleven key touchpoints during a clinic visit when the healthcare team can connect with the patient and encourage their use of patient engagement tools and modalities.  These touchpoints include the receptionist at check-in and check-out encouraging patients to discuss and demonstrate the value of portal use, various clinicians interacting with the patient and educating them about what they can do on the portal (check test results, request prescription refills, etc.), and providers encouraging the use of the secure messaging system to better monitor patients’ health conditions.

The key thing to note is that the entire organization, not just the technological tool, works cohesively and consistently toward connecting and engaging with the patient.  This sense of “working together towards a common goal” is the heart of patient engagement.

Determine how technology can best be integrated effectively in the practice’s workflows.

Before implementing new technology, analyze current workflows and assess how new technology may impact these existing processes.  Effective technology enables organizations to streamline and optimize workflows.

Patient portals allow patients greater access to their health information and offer enhanced communication with the healthcare team.  They also provide increased flexibility and efficiency by allowing patients to request new appointments, review upcoming appointments, and request prescription refills, all in one location. 

Patient portals can improve the healthcare team’s workflows and decrease repetitive tasks, such as manually calling patients with appointment reminders or printing and mailing various test results.  This frees up the team’s time to focus on the patient’s care.

The Office of the National Coordinator for Health Information Technology (ONC) envisions patient engagement as a continuum, whose end-goal is making the patient a part of the healthcare team.  This continuum starts with encouraging portal access as a foundational tool in patient engagement.

While a patient portal is not the end-goal of patient access, it paves the way for greater engagement and participation.  Carefully select a patient portal with robust features that fulfill the needs of patients and staff and help the practice meet regulatory requirements.  When selecting a portal, consider its seamless integration with your EMR system and its ability to connect securely from any device (tablets, Smartphones, PCs, and Macs) that can connect to the internet.

Commit to the process and be willing to learn along the way.

Patient engagement does not happen overnight or by simply turning on a new system.  It may take time for practices, providers, patients, and families to fully embrace the new partnership and the new tools.  Challenges and change will be part of the process.  It is important that with this realization comes a commitment to the vision and the end-goal. 

Patient Engagement should be one of the top priorities of any organization or practice to meet regulatory requirements and stay responsive and competitive in today’s healthcare world.

A survey conducted by Black Book Market Research reported that 92% of its 650 respondents said that improving customer experience should be the top goal when deploying digital health tools. The respondents, almost half of which identified themselves as millennials, have high expectations of the technology offerings from their healthcare providers, such as:

• Engage them with digital provider tools (93%)
• Offer a variety of virtual access points (85%)
• Online scheduling (97%)
• Online payment options (92%)
• Provide price transparency (94%)

Organizations need to pay attention to these expectations. The consumer survey also showed that 90% of the respondents feel no obligation to stay with a provider who does not offer a satisfactory digital experience.

Here are five steps that you can implement to start on the path to true Patient Engagement:

1. Begin facilitating an organizational mindset and culture that supports patient engagement by initiating discussions about it with various stakeholders.
2. Engage your team in creating a clear vision and plan for patient engagement.
3. Solicit input from your existing patients and staff, so patient engagement policies and procedures are created in partnership with them.
4. Consider technology solutions that can be used to support and streamline your processes to help transition your organization more smoothly to a more patient-centric and patient-engaged model. A seamlessly integrated portal that comes as part of your EMR package may remove much of the friction brought about by change. An easy transition helps patients and staff adjust more easily to new workflows.
5. Demonstrate and model a commitment to increasingly involving and partnering with patients in their care and work with the healthcare team and patients in identifying and celebrating milestones along the way to your goal.

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