Healthcare is fast entering what could be called the ‘Age of Engagement’ — an era intended to transform the patient-doctor relationship while also re-writing the rules on how to successfully run a medical practice. In this post, I speak to people, patients, caregivers, physicians, office staff and all members of the healthcare team. Take time to read the post, make a comment as to how you are helping to improve patient engagement and what challanges you are seeing in your world.

Three reasons for this transformation include;

• The ease people have to healthcare information via the Internet, smartphones, and other technology. As a result, people are far more informed and proactive than previous generations. With this newfound awareness, expectations about the quality of care and their involvement in the care they receive are heightened.
• The second driver of patient engagement was the implementation of the Affordable Care Act (ACA). Although the ACA is in flux, measurement of “quality of care” and the focus on “patient satisfaction” is on the top of minds of payers, providers but most important, the patient. Financial incentives for physicians and healthcare providers are tied to the outcomes they produce specifically in areas of patient satisfaction and quality of care.
• Last, patients are responsible for paying for more and more of the cost of healthcare services. As a result, they are becoming savvy shoppers who want to have a say in their care. They also expect more from the healthcare team in helping to achieve their goals.

The challenge physician’s and other members of the healthcare team face in adapting to this transformation is that ‘most people’ do not have the knowledge needed to make health care decisions. According to the Office of Disease Prevention and Health Promotion, health literacy is a serious concern. Research shows that only a small percentage of adults have proficient health literacy skills, and almost 9 out of 10 adults have difficulty using the everyday health information. In addition, the system is complex and fragmented, so it is hard for the average person to navigate when they are thrust into it. None the less, people realize they have to be involved in their health and healthcare and are looking to YOU for help.

The healthcare team is starting to learn how to meet the patient ‘where they are.’ We know it is vital for all members of the healthcare team (including the patient) to take time to understand each other, effectively communicate, so all are on the same page and to share their goals. The healthcare team must do a better job at educating and empowering their patients to be active participants in their health and healthcare by addressing the limitations and instituting strategies to ensure people can navigate the system to meets THEIR goals.

Empowering people to take an active role in their care is no longer an option for the healthcare team, it’s a necessity. And while engaging and empowering people to participate in their care may seem complicated and time-consuming, tools and best practices are emerging to help achieve these milestones. Tools like Shared Decision Making, the Patient Activation Measures, and Telemedicine are developing strategies to assist physicians and patients in improving patient engagement.

As the retail giant, Sy Syms said, ‘An educated consumer is our best customer.’ Taking the time to educate and empower patients will improve the experience for both physicians and their patients.

So what is Patient Engagement? Engagement can mean different things to medical professionals and the patient. At its core, engagement aims to make every patient feel as if he or she is the only patient and their care is top in the minds of all who care for them. Most people assume the healthcare system has their interests in mind at all times. In reality, the system is set up for the health care system and not for the patients who use it. So how can physicians improve the system and manage the expectations of their patients?  Here are some tips to consider:

1. Keep the information simple. Patients are people. They come from all walks of life. They are not medical professionals and we should not expect them to know what we know. Learn to share information in ‘plain language.’ Plain language is one tool to help combat health literacy barriers. The principles of plain language focus on communication that is clear, concise, and logically organized. Plain language is not “dumbing down” content. Instead, it is using language that people can easily understand and apply written and verbal techniques that support comprehensions, such as visual aids and the teach-back/repeat-back method. Here are some websites that you and your team can use to understand how to implement plain language techniques into your practice.

• PlainLanguage.gov
• Plain Language (NIH)
• Toolkit for Making Written Material Clear and Effective (CMS)

3. Be as specific as possible: As healthcare professionals, we often tell patients to do things but do not tell them how. Providing vague instructions such as “stop smoking” or “you should lose 30 pounds” is like telling someone to drive to an unknown destination without providing a map or a GPS system. Finding ways to deliver useful information in written, audio, or video formats, either in-person or online, can supply the “how.” Understanding what will motivate a person to make a change in their behavior is key. Implementing the concepts of motivational interviewing is an important competency all healthcare professionals should work to improve. A good book to learn about Motivational Interviewing is Motivational Interviewing for Healthcare professionals: A Sensible Approach. Two Motivational Interviewing experts wrote the book. They are Drs. Bruce A. Berger and William A. Villaume.
4. Get patients involved in setting goals: The more concrete and personal the goals are, the more likely the patient will be to follow the plan of care to achieve them. The Center for Healthcare Communication has some good information on setting goals and measuring success that can help your team get started.
5.  Ensure everyone is on the same page. Don’t make assumptions that your patient and their caregivers understand what you say. Ask probing questions to ensure that when you’re saying “X,” your patients are hearing “X” and not “Y.” Incorporating the Ask Me-3 education approach is an excellent way to gain information from your patients, so you know if they understand your directions and their plan of care
6. Make information shareable: Patient portals are great places to share goals, action items, reminders, and information, with patients. The availability of a single access point for obtaining information enables patients to determine how they want to consume the data and share it with you and their other providers as needed.
7. Create accountability: helping patients to be accountable is an integral part of patient engagement. Ask your patients to keep a diary to detail how they are doing with meeting their goals. Have them chart their progress, their challenges and what steps they took to stay on track. Take time to read the information and use this tool as part of your education and empowerment strategies.

According to the Health Program-Health Project, engaging patients more fully in their health and health care not only improves the experience of care for patients and their families, but it also enhances the quality and cost-effectiveness of care. Research shows that more engaged patients have better outcomes concerning both cost and quality, which is why consumer engagement is such an essential element of the new delivery system and payment reforms emerging to address the significant challenges facing the U.S. healthcare system.

The industry is moving to create tools and channels that will help providers improve patient engagement and the outcomes. Anna Kang, Project Manager with Kareo, agreed, she said; “Allowing for channels to easily communicate and share information we improve the end-to-end patient experience. Not only will the patient-provider relationship improve, but allowing for patients to easily find a provider, schedule an appointment, setup telemedicine visits, submit intake forms electronically, make payments, and ask any follow-up questions will result in an improved experience overall with the practice, leading to happier patients and, in turn, a happier office staff.”

In closing, I hope this article provides the information you, your team and your patients can use to add patient engagement into your workflow to improve outcomes.