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How healthcare can fix patient engagement

Brian Eastwood | June 18, 2014
The healthcare industry frequently discusses how to use technology to improve patient engagement, but it's just one step in a complex process that, done right, contributes to the much more formative process of patient empowerment.

Nor is it easy for caregivers - the estimated 93 million friends and family who look after sick loved ones. Providers don't engage with caregivers, in part because they aren't certain what HIPAA regulations allow them to disclose, leaving caregivers to comprehend medical terminology and treatment plans on their own. To hear Danny van Leeuwan, vice president of quality management for Advocates Inc., "Healthcare is a Tower of Babel."

There's innovative patient portal functionality out there - letting patients do their own research, say, or presenting patient-reported outcomes as prompts within an EHR system - but two roadblocks stand in the way. First, there's a stark contrast between what patients want and what EHR vendors are willing to give, says Barbara Bartley, system director for clinical decision support and quality with The Health Care Authority for Baptist Health. Second, as a result, rolling out a patient portal, she says, is "like herding cats."

Mere deployment isn't enough, either. A recent panel at the Institute for Health Technology Transformation's Health IT Summit in Chicago discussed the difficulties of patient engagement in stage 2 of meaningful use.

To meet the requirement that 5 percent of an organization's patients send an electronic message to a physician, Dr. Stephen Beck estimates that Catholic Health Partners, where he's the chief medical informatics officer, will need to get 50 percent of patients to sign up. What's more, the reporting period lasts only 90 days - many young, healthy, technophile patients will have no reason to get in touch over those three months.

On top of all that, a recent Mayo Clinic study concluded that more online messaging doesn't equal fewer office visits. It's not too surprising, then, to hear some suggest that it might be time to stifle some innovation and get back to the basics of care.

Bringing Humanity Back to Medicine

This falls on the shoulders of both patients and providers, Goren says. Most physicians provide excellent care, but mistakes are made, and it's often because patients don't understand their role in actively engaging in their own care. Younger patients are changing this, Goren says, as they are "assertive" and "more used to pulling instead of pushing" - but they're often not the ones who need care the most.

Physicians, for their part, need to remember why they practice medicine in the first place. Many of Goren's training sessions with hospital leaders recommend bringing physicians back to that seminal moment from childhood when they decided to enter the field. "When you bring people back to that place, it brings the humanity back," she says.

Beyond that exercise, organizations simply need to understand how the strains they put on physicians can make them seem uncompassionate to patients. There's clinical quality metrics, the looming threat of litigation and, from a technical standpoint, electronic health records. After implementation, Goren says, organizations need to invest heavily in EHR training - not just in using the system itself but also in knowing when to rely on their intuition and training instead of the algorithms.


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