A Guide To Better Patient Engagement

Patient engagement is a key metric for healthcare providers … and also a hot topic of study and conversation. The big question: How do we better engage our patients in their health?

Unfortunately, despite great efforts from within the community to provide tools for patients to access their healthcare data, recently released research shows that the digital divide is also an issue in the healthcare marketplace, especially for low-income and minority patients.

The study, conducted by researchers at Weill Cornell Medical College and published in a recent issue of the American Journal of Managed Care, shows that patients in “disadvantaged socioeconomic groups were less likely to use health IT to access their health records.” Those surveyed included 900 residents in New York state who were asked questions about their use of patient portals to either access or update health information among other things. 

While the survey showed a great increase in overall use from 2012 to 2015, the proportion of adoption between African American and Hispanic communities was significantly behind the overall average. The study’s authors noted that there appears to be a digital divide based on income and ethnicity. 

“As previously reported, the use of portals/PHRs was also more common among patients who used the Internet more frequently, those with higher education, and those using prescription medications,” they wrote (http://www.healthcare-informatics.com/news-item/patient-engagement/study-socioeconomic-digital-divide-remains-personal-health-record-use).

So, how can adoption be improved across all income levels and ethnicities? 

The study authors recommend several options, including specific efforts to target these groups.

“Measures that should be investigated include making these technologies accessible in multiple languages, designing for usability by individuals with low levels of computer expertise and ensuring access via mobile phone and web browsers,” they wrote.

Meanwhile, at the recent Pop Health Forum, sponsored by the Healthcare Information and Management Systems Society (HIMSS) and held in Chicago, the conversation was about being more efficient in the creation of tools (http://www.healthcareitnews.com/news/we-need-better-patient-engagement-not-just-more-apps-says-cleveland-clinic).

“I just learned the Cleveland Clinic has 22 apps, many of which haven’t been updated for several years,” said Adrienne Boissy, MD, the Chief Experience Officer at the Cleveland Clinic, during her presentation at the event. “That is not a seamless, cohesive digital platform.”

Her primary point — apps in and of themselves are not a strategy. Having separate apps for separate patient action items (i.e. separate apps for billing, way-finding, and appointment scheduling) may not increase engagement at all; in fact, it may drive patients away. And so the Cleveland Clinic has started seeking patient feedback on engagement strategies. 

“Patients define their own engagement,” she said. “It’s kind of ironic that these physicians would decide what’s best for you to keep engaged.”

Frederick Muench, the director of digital health intervention in the Department of Psychiatry at Northwell Health, would agree. In his presentation at the Pop Health Forum, he suggested working backwards in improving patient engagement (http://www.healthcareitnews.com/news/secrets-engagement-start-patient-and-work-backward).

“Patient engagement is whatever the patient thinks it is,” he said. “If we start at that point, work backward by figuring out the barriers and then fitting technology in, we’re able to overcome those barriers and judge success as outcomes.”

The other problem, which Boissy brought to attention, is that not every patient wants to be engaged.

“As a multiple sclerosis physician, I can tell you the vast majority of my patients hate coming to see me,” she said. “They hate to be reminded they have MS. The best thing I can do to engage them is to leave them alone.”

So, there is still a lot of work to be done when it comes to engaging as many patients as possible in an efficient matter. While engagement numbers overall are rising, there are still substantial barriers to overcome.

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