What is Patient Engagement?
Patient engagement is not a new concept, but it has only recently gained traction in the healthcare industry and has become a core focus for healthcare providers. It's important to understand what patient engagement means, how it differs from other concepts like patient satisfaction and loyalty, and why it matters for your practice or hospital.
So, what exactly is patient engagement and why is it important?
Patient engagement is a healthcare strategy that encourages patients to participate in shared decision making and take responsibility for their own health, by fostering their engagement, collaboration, and empowerment. This strategy equips patients with sufficient knowledge, skills, and solutions to increase the level of their engagement and leads to improvement in quality and safety of healthcare.
Engaged patients not only experience higher levels of patient satisfaction, the process of engagement also increases patient safety and efficiency of healthcare delivery. Modern patient engagement solutions have transformed the healthcare industry by improving patient outcomes and enhancing the overall patient experience. Patients self-monitor health indicators and utilize patient portals to access and manage health information.
It goes without saying that healthcare organizations will need to use a range of tools and approaches to actively engage patients in their care and improve the overall quality of healthcare services.
Key Ingredients of Patient Engagement
While technology is a powerful tool for engaging patients, 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.
Software Solutions to increase Patient Engagement
Technology has come a long way and there are a number of software tools or platforms designed to facilitate patient interaction with healthcare providers, systems, and data.
They typically includes a combination of tools and services aimed at empowering patients to take an active role in their care, including:
-
Secure access to health information: Patients can access their health information, test results, and medical records through a secure portal or mobile app.
-
Virtual consultations and visits: Patients can use telehealth and virtual visits to communicate with their healthcare providers, including video conferencing, secure messaging, and remote monitoring.
-
Patient education and resources: Patients can access educational materials and resources on health topics, treatments, and lifestyle modifications to support their health and wellness.
-
Scheduling and appointment management: Patients can use the software to schedule appointments, request referrals, and manage their healthcare tasks and goals.
-
Real-time insights and analytics: Healthcare providers can use the software to track and analyze patient engagement, health status, and outcomes, and support continuous improvement initiatives.
The goal of these software solutions is to improve the quality and coordination of care and to empower patients to take an active role in their health and wellness.
According to research done by the Advisory Board, the most common software solutions that promote patient engagement include:
- Patient portals
- Secure email
- Online/mobile scheduling including reminders
- Patient-generated data
- Social networks
Other tools and techniques recommended by the Office of the National Coordinator for Health Information Technology (ONC) include:
- New patient pre-registration
- Team-based care
- Daily team huddles
- Pre-visit planning
- Patient and Family Advisory Councils
10 Best Strategies to increase Patient Engagement
A number of strategies can be used to encourage and empower patients to take an active role in their care and to support communication and collaboration between patients and healthcare providers. These strategies aim to improve the quality and coordination of care and to enhance patient satisfaction and health outcomes.
1. Shared decision making
Encouraging patients to participate in making decisions about their care, such as choosing between treatment options, can increase their engagement in their health. Shared decision making can also improve communication between patients and their healthcare providers and lead to better outcomes, as patients are more likely to adhere to treatment plans when they have a say in the decision-making process.
References:
- Stacey D, Légaré F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;(12):CD001431. doi:10.1002/14651858.CD001431.pub3
- Elwyn G, Frosch D, Thomson R, et al. Shared decision making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 2012;74(5):685-692. doi:10.1016/j.socscimed.2011.12.037
2. Patient education
Providing patients with clear, concise, and accessible information about their health can help them make informed decisions and take an active role in their care. Effective patient education can include the use of multimedia tools, such as videos and interactive quizzes, to engage patients and help them better understand their health conditions.
References:
- Willinger M, Moore J, Zaza S. Patient education for promoting health. In: Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd; 2013. doi:10.1002/14651858.CD003944.pub5
- Haynes B, Mcdonald H, Garg AX, et al. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2018;(5):CD000011. doi:10.1002/14651858.CD000011.pub4
3. Technology-enabled engagement
Utilizing technology, such as patient portals and mobile health apps, to engage patients and provide them with access to their health information can enhance their engagement in their care. These tools can also help patients to track their symptoms and manage their care, as well as provide them with real-time access to health information.
References:
- Chaudhry B, Wang J, Wu S, et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144(10):742-752. doi:10.7326/0003-4819-144-10-200605160-00006
- Kvedar JC, Joyner M. The internet of healthy things. Healthcare. 2016;4(2):70-74. doi:10.1016/j.hjdsi.2016.03.001
4. Team-based care
Involving patients in care teams, such as allowing them to meet with members of their healthcare team, can help to foster engagement and a sense of partnership in their care. This can also help to improve communication between patients and their healthcare providers, as well as increase trust and accountability in the care process.
References:
- Bodenheimer T, Sinsky C. From fragmented to coordinated care. N Engl J Med. 2014;370(16):1483-1486. doi:10.1056/NEJMp1311535
- Doherty J, Hart A, Macdonald H, et al. Interventions for improving the quality of collaborative care for people with mental and physical multimorbidity. Cochrane Database Syst Rev. 2018;(2):CD012508. doi:10.1002/14651858.CD012508.pub2
5. Personalized care plans
Developing care plans tailored to the specific needs and preferences of each patient can help to increase their engagement and improve outcomes. Personalized care plans can take into account the patient's goals, preferences, and cultural background, as well as their specific health conditions, to ensure that they receive the care that best meets their needs.
Reference:
- Bodenheimer T, Lorig K, Holman H, et al. Patient self-management of chronic disease in primary care. JAMA. 2002;288(19):2469-2475. doi:10.1001/jama.288.19.24
6. Patient-provider communication
Improving communication between patients and their healthcare providers, such as through regular check-ins and follow-up calls, can enhance patient engagement and promote better understanding of treatment goals. This can also help to build trust and a strong therapeutic relationship between patients and their healthcare providers.
Reference:
Beach MC, et al. Provider communication and patient satisfaction with care. Health services research. 2006 Apr 1;41(2):431-52.
7. Self-monitoring and self-management
Encouraging patients to self-monitor their health and participate in self-management programs can help to promote engagement and improve health outcomes. Self-monitoring can include tracking symptoms, managing medications, and monitoring vital signs, while self-management programs can help patients to develop the skills and knowledge they need to manage their health conditions effectively.
Reference:
Lorig K, Sobel DS, Ritter P, Laurent D, Hobbs M. Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical care. 2001 Nov 1;39(11):1217-23.
8. Empowering patients
Providing patients with the resources and support they need to take control of their health can increase their engagement in their care. This can include access to health information, support from healthcare providers and peers, and tools and resources to help them manage their health conditions.
Reference:
Heisler M, et al. A review of patient activation measures: availability, properties, and use. Medical care research and review. 2012 Sep 1;69(5):476-95.
9. Community-based approaches
Engaging patients in community-based programs, such as support groups or peer-led programs, can help to increase their engagement and improve health outcomes. Community-based approaches can help patients to connect with others who are facing similar health challenges, share experiences, and learn from one another.
Reference:
Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effectiveness of a self-managed lay led chronic disease self-help program: results of a randomized trial. Medical care. 2001 Nov 1;39(11):1224-30
10. Continuous improvement
Regularly reviewing and refining patient engagement strategies can help to ensure that they remain effective and continue to improve patient outcomes over time. This can include evaluating the effectiveness of specific strategies, gathering feedback from patients and healthcare providers, and making changes as needed to ensure that patient engagement efforts are as effective as possible.
Reference:
Institute for Healthcare Improvement. (2021). Continuous Improvement. https://www.ihi.org/topic/continuous-improvement/
Benefits of Patient Engagement
Your team and the patients you provide care to stand to benefit a lot from the engagement process. 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.
Strategies to Increase Patient Engagement
We list below some strategies to increase engagement level of patients:
1. Champion and facilitate an organizational mindset and culture that supports and celebrates 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 in this regard 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.
2. Have a clearly-defined organizational definition, vision, and plan for patient engagement
Before embarking on a campaign to increase engagement of patients, 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.
3. 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.
4. 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.
5. Commit to the process and be willing to learn along the way.
It 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 patient engagement 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.
Top 5 Steps That Small Practices can take to improve patient experience and stay compliant
Any small practice that desires to meet regulatory requirements and stay responsive and competitive in today’s healthcare world, should think about making patient engagement as one of their top priorities.
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 this path:
- Begin facilitating an organizational mindset and culture that supports patient engagement by initiating discussions about it with various stakeholders.
- Engage your team in creating a clear vision and plan for patient engagement.
- Solicit input from your existing patients and staff, so patient engagement policies and procedures are created in partnership with them.
- 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.
- 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.
