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Part 1: Top 3 Reasons Healthcare Organizations Are Investing in Patient Engagement

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The Top 3 Reasons Healthcare Organizations Are Investing in Patient Engagement

Part 1: Paving the Way for Value-Based Care 
Read Part 2: Cost Savings through Efficiency

Read Part 3: Marketing and Customer Retention

Recently, I participated in the Healthcare Leadership Conference at InterSystems Global Summit in Palm Desert, California. The Healthcare Leadership Conference brought together InterSystems customers from around the globe to share experiences, ideas, and plenty of (mostly healthy) food and drink.

At the conference, I moderated discussions on personalized care and patient engagement. While I am convinced of the potential value of patient engagement in healthcare, there is a significant gap between today’s reality and what I hope to see five to 10 years from now: a more patient and family-centric approach to care with a stronger emphasis on prevention and wellness. I was curious to learn from this diverse group of attendees who are on the front lines of healthcare in a variety of countries, including the US, UK, Canada, Australia, and China. Is patient engagement just a trendy feel-good concept, or are they actually putting their money behind it, and if so, why?

What is Patient Engagement, Anyway?

As a starting point for discussion, InterSystems put forward a definition of patient engagement:

An organization’s strategy to get patients involved in:

  • actively and knowledgeably managing their own health and wellness, and
  • the health of family members and others for whom they have responsibility.

This includes:

  • reviewing and managing care records
  • learning about conditions
  • adopting healthy behaviors
  • making informed healthcare purchases
  • interacting with care providers as a partner

The conference included participants from health care organizations and Health Information Exchanges (HIEs). For them, patient engagement encompassed everything from enabling bare bones compliance with federal “ meaningful use” requirements in the US, to a more holistic vision of patient-centric information collection, flow, and services. The latter included more comprehensive health records data from multiple sources, data from wearable sensors and the home environment, and personalized care, supported by telehealth and mobile apps.

As participant Ken Riley, Director of Patient and Population Health Technologies at Baystate Health, put it, boosting patient engagement, “isn’t a journey with clear start and end points, it’s an ongoing evolution.” When it came to the business case for investing in patient engagement, the most often-cited business objective that emerged during the conference revolved around succeeding in the new world of value-based care.

Paving the Way for Value-Based Care

In the US, despite ongoing political upheaval related to the repeal and replacement (or not) of the Affordable Care Act (ACA), part of which addresses healthcare payment reform, there is general agreement that we are moving from a fee-for-service to a value-based payment model, though the details of how and when we get there remain uncertain. Numerous other countries, including Australia and the UK, are also taking steps in that direction.

Given that roughly five percent of the population is responsible for half of annual medical spending in the US, many health industry players—including providers and payers—are embracing population health management supported by data analytics and artificial intelligence. The goal is to provide early and high-touch interventions to the highest-risk proportion of the patient population. Because the bulk of health status depends on factors outside of the traditional healthcare system, such as behavioral patterns, genetic predisposition, and social services, patient engagement informed by population-level data and analytics makes logical sense.

Image source:  The Advisory Board Company

pyramid graph showing percentage of high- rising- and low-risk patient populations

According to Erik Milham, Senior Director of Enterprise IT Operations and Infrastructure at Prime Healthcare Services accountable care organization (ACO), reaching out to patients in between visits saves money, regardless of where they fall on the risk pyramid: “If you can get them to see their doctor for a wellness visit, you are one step ahead of critical/acute care requiring that emergency room visit, which pays off in the long run.”

Gary James, Chief Officer of Lincolnshire East Clinical Commissioning Group of the National Health Service (NHS) in the UK, voiced a similar perspective, also underscoring the importance of leadership. According to Gary, a commitment from the highest level of an organization is critical, particularly because the shift toward meaningful patient engagement depends on a cultural change. Traditionally, healthcare has been relatively hierarchical, with an assumption that the provider knows best and that the patient’s primary job is to follow instructions. Successful patient engagement, in contrast, relies on a more egalitarian, collaborative model in which both providers and patients make contributions to and take responsibility for improving and maintaining the patient’s health.

Early proof-of-concept has been demonstrated by systems such as Ochsner Health System, which, in partnership with Apple, provided patients with interactive watches to track activity and blood pressure levels during everyday activities. Among participants with uncontrolled blood pressure, two out of three had their blood pressure under control within 90 days of enrolling in the program. Many conference participants had plans in the works for programs that engage patients in ways that reach far beyond the clinical encounter.

For example, Dr. Wayne Fellmeth, CMIO of Hunterdon Healthcare System, is developing a program that provides patients easy access to their medical records and entices them to engage in healthy behaviors through partnerships with community sponsors such as gyms and pharmacies that provide discounts for classes or flu shots.

Ken Riley of Baystate Health acknowledged that patients may have many reasons to want to see and share their digital medical records beyond the health system. As he said, “My mother would have loved to have seen the ultrasound of our baby – it’s a disservice to the patient to limit records-sharing to medical consults.”

Erick Peters, CTO of Cognosante, said he can’t predict which uses of health information will be the most popular. In his opinion, a crowd-sourced model of app development supported by application programming interfaces (APIs) and the flexible Fast Healthcare Interoperability Resource (FHIR) standard will lead to a logarithmic explosion of growth in highly-tailored apps. For example, a FHIR-based app could pull from population-level data to provide a clinigraphic assessment of a particular child’s risk profile for Type II Diabetes, which could be useful for providers and parents alike.

In my next post in this series, we’ll review the second leading rationale healthcare organizations are using to invest in patient engagement: cost savings through efficiency.
Read Part 2: Cost Savings through Efficiency

Read Part 3: Marketing and Customer Retention

About the Author

Lygeia Ricciardi (@Lygeia)

Lygeia Ricciardi is an expert in digital health and patient engagement. She is the president of Clear Voice Consulting, LLC. Previously, she established and led the Office of Consumer eHealth at ONC at the US Department of Health & Human Services.

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