By Barbara Ficarra, RN, BSN, MPA
What is patient engagement?
Patient engagement is a connection between patient, caregiver and health care provider. A trusted relationship forms and mutual respect is fostered. Patients and their families are empowered and they are active in health care decisions. However, patient engagement begins before the initial interaction with health care providers.
When patients and consumers recognize the need to be in charge of their health, patient engagement evolves. Patients and consumers have a choice to be an active participant in their health care. Those patients and consumers who choose to be actively involved and in charge of their health, work together with their health care providers to successfully reach their health goals and needs.
A recent study conducted (pdf link) by the National eHealth Collaborative “2012 NeHC Stakeholder Survey,” found that 64% of stakeholders’ survey described “patient engagement” as: “Patient uses educational material and online resources to learn about better health or their own health conditions.”
It’s interesting that most stakeholders surveyed felt that using educational materials and online resources best reflects the definition of patient engagement.
Obtaining health information online helps begin the conversation between patient and health care practitioners. The internet is a tool to help enhance communication and collaboration. The actual “engagement” is connection, communication, collaboration and respect.
In light of meaningful use and Accountable Care Organizations (ACOs) patient engagement has become the buzz word and hospitals and health systems are clamoring to find ways to partner with patients to make hospital care safer, more reliable, and less costly. Preventing hospital acquired conditions and helping patients heal without complications to avoid re-hospitalization within 30 days of discharge, has “the potential to save up to $35 billion across the health care system, including up to $10 billion in Medicare savings, over the next three years.”
Health IT and Engagement
Healthcare technology plays an instrumental role in helping patients and their families manage their health, and help in the medical decision process.
A report from Deloitte Center for Health Solutions (pdf link), found “two out of three physicians agree that HIT can improve quality of care in the long run.”
Health information technology (HIT) can help move patient engagement forward. Utilizing Electronic Health Records (EHRs), Personal Health Records (PHRs) and communicating with patients using secure messaging systems to email and text are ways to improve quality care.
Mobile technology, PHRs, and EHRs need to be part of the conversation between patient and health care provider.
Health information alone isn’t going to change health habits or maintain good habits; it’s the action that you take to help achieve a healthier life.
Doctors, nurses and other health care providers can help empower patients and caregivers. When patients and caregivers feel empowered they are better able to participate in their health care.
Let’s look at patient engagement in terms of buckets. I feel that there are five buckets that contain essential ingredients for patient engagement to flourish and foster an empowered patient.
5 Buckets to Patient Engagement
- Empathy – With empathy we can connect, engage and empower our patients. Empathy allows us to understand what it is patients are going through. By acknowledging their emotional state and listening attentively, we can engage our patients and empower them to be proactive and in charge of their health care. According to Jodi Halpern, M.D., Ph.D. author of “What is Clinical Empathy?” in the Journal of General Internal Medicine: “Empathy involves being moved by another’s experiences. In contrast, a leading group from the Society for General Internal Medicine defines empathy as “the act of correctly acknowledging the emotional state of another without experiencing that state oneself.”
- Collaboration – Developing a partnership with your health care provider is paramount. Collaboration is not only the sharing of health information; it is the interaction between patient, caregiver and provider. Doctors and other health care providers have the opportunity to discuss the use of technology to promote and maintain health and achieve your health goals. From remote patient monitoring to health apps, health care providers can educate patients and caregivers about useful technology. (Additionally, patient engagement relies on a coordinated and collaborative approach with stakeholders including, consumers, payers, providers, government and academic and research institutions, etc. for good patient outcomes and quality patient care.)
- Listen and Communicate – Listening is an extremely important skill, and understanding patients’ needs are critical. Communicating with patients in simple language is essential. As health care professionals engage their patients with empathy, we can make them feel valued and respected, and by listening and communicating effectively with our patients we can develop a treatment plan specifically around their needs. Patients are the center and the most valuable member of the team. We need to involve them in their care and understand that they are the integral part of the health care team. We need to encourage them to be a proponent of their own health care. We need to let them know that it is okay to ask questions and to take charge of their health. Patients may have some self-doubt about questioning health professionals. They may feel uneasy and perhaps they may have difficulty expressing themselves, but we can offer reassurance and continue to encourage them to be proactive.
- Motivation – Motivation through words and praise can be beneficial. We can also help motivate our patients by understanding that technology has an incredible role in helping patients achieve their health goals and promote or maintain a healthy lifestyle. “Leveraging mobile technology is paramount and widespread adoption may be possible. Simple motivational messages and reminders may help foster a stronger relationship with health care providers and it may allow patients and consumers to take action. Patient engagement is essential for quality health care. Mobile technology may be the link to connect the dots in health care. It may help to transform the lives of patients and provide a stronger partnership with health care providers.”
- Action – Action is needed to achieve your health goals. Gaming allows individuals to become active and engaged in their health. Issues such as medication adherence, chronic disease management, and prenatal care may be a “tap” away. By receiving text messages through a smartphone, patients can become proactive in their health care. There are tools to help empower patients, and the Center for Connected Health offers a variety of ways to help health care providers interact through mobile technology.
To effectively engage patients and caregivers, hospitals and health systems need to clearly define patient engagement and define the role of the patient and caregiver. When a patient or family members asks for a copy of their medical records during hospitalization (or a print out of pertinent data), patients assume they will be given that information immediately. All stakeholders need to be on the same page in order to fully engage. Technology is transforming health care, but one constant needs to remain, and that is the relationship formed between patient and health care provider.
And it’s critical that health care providers engage with empathy. With empathy we connect, we understand, we listen and we can engage and empower our patients to be proactive and in charge of their health. It’s imperative that health care providers bring technology into the conversation and offer valuable information to help guide patients to achieve their health goals.
What’s your definition of patient engagement, and does technology have a role in patient engagement?
We would love you to share your insightful thoughts in the comment section below. As always, thank you for your time.
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Deloitte Center for Health Solutions (Harry Greenspun, MD)
Center for Connected Health (Joseph C. Kvedar, MD – The cHealth Blog)
[This post, 5 Buckets to Patient Engagement and the Role of HIT, is a subsequent post to Patient Engagement and Health IT – Social Media Voices.]
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I have spent a lot of time investigating popular notions like engagement and empowerment, two concepts which you address in your post. With respect to engagement, there are at least 2 ways of looking at engagement:
1) physician/provider perspective wherein engagement is typically conflated with compliance – where patients do what providers think is in their best interest.
2) patient perspective wherein health engagement is something they do all the time. 80% of adults go online to look up health information. 80+% have a personal physician, most people say they watch what they eat.
It is the provider’s perspective of engagement which is currently framing much of the discussion regarding engagement. As a result, providers fail to recognize that patients are already engaged by the time they see them in the office or hospital. After all the patient makes a series of decisions and takes a series of steps before they ever show up at the doctor’s office.
I would argue that much of what transpires in the office visit and hospital, due to structural and delivery issues, tend to diminish or totally extinguish the level of engagement people walk through the front door with. The medical interview, lack of time and poor provider communication are all barriers to effective patient engagement. The solution, as your five buckets, suggest is the adoption by providers of more patient-centered communication style by providers…in contrast to the physician/provider-directed style that used by most providers.
Thank you for sharing your expertise. Your points are well taken. It’s important that both patients and providers share the same meaning of patient engagement. Whether the style as you mention is patient-centered or physician/provider-directed.
Thank you again for your insights.