by Daniel J. Morrill, PT, DPT
The definition of “engage,” as described by Merriam-Webster’s dictionary, has seven notations as a transitive verb. Number seven on its list is “to deal with especially at length,” which is a great way to describe modern patient engagement. Patient engagement is all about the interaction with the patient and healthcare providers over time. Although patient engagement is not new to healthcare, Meaningful Use Stage 2 required eligible providers and hospitals to create an improved patient-provider communication model. This model would be built around a secure foundation that would allow secure communication between providers and patients.
While it is true that the requirement for patient engagement originated through the passing of Meaningful Use Stage 2, there are many other benefits of patient engagement besides an improved communication model between patients and providers. A complete patient engagement program that does more than just focus on communication can improve standards of care and the long-term health of a patient.
Today’s technology users can connect to virtually everything. They can communicate in ways that were unimaginable even 15 to 20 years ago. Yes, the HITECH Act was designed to take advantage of technology to improve the delivery of healthcare, but the fast-paced evolution and speed of personal devices and computers have opened a world of connected care that many people are just beginning to comprehend. The rush for engaging the patient is much broader than simply improving patient health; it is transforming the patient care model and delivery of services.
Patient Perspective on Patient Engagement
Adoption rates by patients for patient portals are still relatively low, but according to healthcare software manufacturers, adoption rates are improving with new features and ease of use. Meaningful Use Stage 2 sets the bar at 5% of patient utilization to meet the requirements for the monetary incentive, which points out that regulators thought the most challenging part of patient engagement portals would be getting the patients to actually use them.
Getting patients to buy into the use of portals and other engagement tools requires encouragement from practice staff and providers. One way to get patients to increase their use of practices’ portals is by creating policies and procedures that take advantage of more efficient workflows that save time for both patients and providers. In the context of a typical medical practice, an example of such a policy would be telling patients that medications are refilled within 1 business day if the request is completed within the portal.
A patient will begin to see the value, especially in a day and age where there is a need for instant answers to the health-related questions they may have. Scheduling, communicating, refilling prescriptions, requesting appointments, and reviewing test results or clinical notes are all reasons for patients to consider using patient portals. Patients are looking for time-saving efficiencies, and for a person to take off a day of work to be told his or her blood work is normal is not an efficient use of anyone’s time and money.
A patient is also looking for reliable resources for education and research. Search engines are great, but accurate, up-to-date content coming from providers and hospitals available to the public can help patients make better-informed healthcare decisions.
The Healthcare Provider
Healthcare providers are data gatherers who are trying to find clues to help solve a patient’s problem. It is logical to expect improved diagnosis and treatment of patients if data were more readily available and organized among all the providers participating in a particular patient’s care. Patient engagement should drive the necessary changes to achieve interoperability (the next big word in healthcare) between all providers and the centralized patient.
The other area in which patient engagement is crucial to the healthcare provider is feedback on care and progression of treatment. Surveys and messages are the two primary data-collection tools in use today. Meaningful Use was focused on cost-effectively improving patient outcomes, but patient engagement needs to address the effectiveness and quality of the delivery of service at a given organization. Ease of scheduling, cleanliness of the clinic, helpfulness of staff, and knowledge of a clinician are all equally important to understand as clinicians communicate more effectively with patients. It is widely agreed upon that it is much easier to fix an issue when you are aware of it early than to learn about it after it is too late to make a difference.
Therapy providers need to be in the patient engagement game as well. Recent studies suggesting therapy over surgery or opioid use speaks to the value of care and needs to be communicated. While therapists’ patients may not need clinical notes every visit or test results like a general practitioner, it is vital that healthcare administrators understand therapists struggle with time constraints and busy schedules. Therefore, having an opportunity to communicate with patients during and after care is essential.
As interoperability between software systems and providers improves and more data is collected via EMRs, outcome tools, and patient engagement, the challenge will be to efficiently manage all that data to make sure healthcare professionals are effectively treating the patient.
The Business Owner or Administration
Defining business performance and success is beyond the scope of this article, but patient engagement can deliver critical data to help identify both weaknesses and strengths within a practice. More importantly, the patient data can be used to help achieve a positive outcome. Supervisors, administrators, and owners typically have metrics revolving around financial performance and referral patterns but quite often are missing the voice of the patient. Patient engagement can begin to supply data points to help drive clinical decisions.
How to Get Started
An excellent place to begin is by conducting a needs assessment and setting goals. At that point, a practice owner or manager should examine the current work processes and understand whether patient engagement implementation will require changes. For example, if online forms are available in a patient portal, patients may need to arrive only 10 minutes before an appointment instead of 30 minutes. Clinic staff will also need to change their workflow from data intake to setting up a portal account for patient use. This is a relatively simple example, but it demonstrates the idea.
Once assessment and goals are complete, evaluate tools that may already be in place. For clinics that want to put together a simple newsletter—which is a great place to test the engagement waters—an email service such as Survey Monkey can be used to launch a small newsletter campaign. You could also consider a commercially available engagement product and determine if it would fit your needs and goals. Remember to always make sure you comply with HIPAA regulations as well as your security policies. It is also a good business practice to request for permission (opt-in) if you are sending out electronic or print information.
The final step is to evaluate success. Questions that clinic owners or managers may want to ask themselves include: Are you getting the information you need to improve the delivery of care for your patients? Are patients satisfied with having more communication with their providers? Do patients see value in the types of engagement you have implemented? If the answers to these questions point to success, congratulations! You have most likely had a very positive impact on your patients, their families, and the community.
Engagement is about empowering patients to work with providers to improve health. Evaluating and implementing the engagement pieces that will make a difference for the practice and improve overall care is what can make a practice stand out in a crowd. RM
Daniel J. Morrill, PT, DPT, is a practicing physical therapist and owner of Hinsdale Sports & Spine Therapy Ltd, Westmont, Ill. He previously worked with the Chicago Institute of Neurosurgery and Neuroresearch, treating a variety of complex spine conditions. Additionally, Morrill has given lectures about spinal topics, including lumbar stenosis, treatment of lower back injuries, marathon training, conservative treatment of the cervical spine injuries, and treatment of the injured athlete. For more information, contact [email protected].
