The financial case supporting the benefits of patient engagement continues to grow. In 2013, Fairview Health System, a large healthcare delivery system in Minnesota, conducted a study of more than 30,000 patients and found that patients with the lowest activation levels had 21 percent higher costs than patients who actively engaged in their own healthcare.
Similarly, a 2013 policy brief published in Health Affairs and sponsored by the Robert Wood Johnson Foundation, claimed “patients who are more actively involved in their healthcare experience have better health outcomes and incur lower costs.”
Both of these studies illustrate the clinical and financial importance of strategies and tools that enable consumers to take control of health decisions that affect their lives. While patient activation refers to patients’ skills, knowledge and willingness to manage their own health, the overall concept of patient engagement also includes interventions that encourage and support positive patient behavior such as preventive care.
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The challenge for providers pursuing patient engagement programs is patients expect to be able to access their health information and their provider beyond the four walls of the medical facility. By engaging patients through a multifaceted strategy that takes advantage of information technology tools consumers already own and access on a continual basis, providers can improve the likelihood that patient engagement is successful.
To be truly effective, an organization’s patient engagement strategy must incorporate the following five essential elements: mobile access, interoperability, monitoring, context and outreach.
Mobile access: Reach consumers regardless of location
To support engagement, many organizations have implemented a patient portal or similar consumer-facing technology capable of delivering visit summaries or receiving electronic messages—both of which are required under Meaningful Use (MU) Stage 2. However, many portals are only accessible from patients’ computers, which not only limits the opportunity to meet MU requirements, but also results in insufficient consumer engagement. Mobile technology must be taken into account.
Smartphone adoption rates reached 71 percent in the U.S. as of September 2014, according to Nielsen estimates. A 2014 Pew Research study also noted that 34 percent of Americans use their smartphone as their primary method of accessing the Internet.4 Mobile data exchange will only increase as smart watches and other wearable bio-monitoring devices gain traction in the market, which emphasizes the importance of connecting with consumers in a manner optimized for mobile technology.
Interoperability: Combine data from diverse sources
As mobile adoption continues to increase, engaging consumers through personal technology will also be crucial. This will require information systems on the provider side that are capable of efficiently capturing and organizing the onslaught of data collected from each of these sources. For example, an interoperable patient portal that collects a consumer’s self-reported data and also syncs with a personal fitness app or home health-monitoring device would streamline data exchange with providers, thereby enabling more rapid and useful analysis.
Monitoring: Capture and manage data safely and efficiently
As data is automatically aggregated within portals and shared with providers, organizations likely will need to assign clinical support staff members or teams inside their facilities to monitor the incoming information. These clinicians can then decide when to initiate an intervention based on the data. Clinicians can also determine when to contact consumers directly to inquire about the metrics and conditions the data reveals.
Context: Put data into action
Simply monitoring the data influx alone cannot effectively detect or prevent costly illness complications or adverse events among consumers. Rather, through an interoperable portal, an organization’s information systems must be able to interpret and present data to the clinical team in an evidence-based context, allowing the team to make actionable decisions.
For example, let’s say a patient with a smart bodyweight scale wirelessly transmits his weight to his provider daily and begins to exhibit a steady weight gain over several days. The weight gain could be a potentially dangerous side effect of a specific medication. Although the daily updates alone might be overlooked, an intervention could be ordered before an adverse event occurs if a clinical-decision support (CDS) engine automatically accesses the patient’s electronic health record (EHR), filters the updates, and generates a notification for the provider.
Outreach: Engage the highest-risk consumers
Taking the bodyweight example a step further, consider what might happen if the consumer received an automated notification to contact his provider through his smart mobile device. An alert might not be enough motivation to activate the consumer, especially if he is not yet highly engaged. However, in this case, the clinician monitoring the data would simply call the consumer to inquire about the data, answer questions, and connect him directly with his provider, if needed. In a recent study, these calls from a patient’s provider have been associated with higher engagement than automated calls alone.
As government and commercial payers begin to adopt more value-based payment models to shed more of their financial risk, organizations must establish effective patient engagement strategies that not only protect their institutions, but also their patients.
Patients are steadily evolving into healthcare consumers and bearing more financial responsibility themselves. A cost-effective engagement strategy should include mobile—an interoperable technology that streamlines clinical data exchange between providers and consumers so interaction is not location-dependent and episodic, but continual. With effective monitoring and interventions, engagement between providers and consumers will grow—while unnecessary spending declines.
Vern Davenport is CEO of Medfusion.