Slotting the patient into the continuum of care is one of the emerging challenges in healthcare reform. In Stage 2 Meaningful Use, eligible providers are required to engage patients. The same is true of healthcare organizations and providers participating in forms of accountable care. But what role does the provider play in patient engagement and how does that differ from patient empowerment?
According to Blair Butterfield, North American President of VitalHealth Software, the move from paper records to EHRs is accompanied by a similar change in the way patients are expected to partake in the healthcare process:
The whole pendulum has shifted away from the early years of PHRs, which was all about what I would call patient empowerment — putting the data in the hands of that patient and giving them control of their destiny and their selective sharing of data with whom they want to see it. It shifted from that to what I would say now is patient engagement. That’s really the buzz word that everybody uses.
And this current trend is putting the onus on the provider to be the hub of patient-centered care rather than patient. “Engagement implies that someone is engaging them and in this case it’s providers. It’s really still a provider-driven process; it’s not really a patient-driven process. The patient is a participant, but they are no longer viewed as really the owner and driver of the process. That’s for a specific reason,” Butterfield observes.
“Many organizations that have experimented with PHRs and so on,” he continues, “have realized that patients left to their own devices typically don’t choose to empower themselves unless there are certain subsets like the chronically ill that do because they’re very active in their care but the other population doesn’t.”
Although the term is bandied about quite frequently, patient engagement is simply another word for something consumers experience in other aspects of their lives. “It’s really just extensive customer service in a sense. It’s what we expect in every other industry that we participate in,” adds Butterfield.
While it may be a simple concept to grasp, it’s a much harder one for healthcare organizations and providers to implement.
“The main thing is the labor-intensiveness,” Butterfield explains. “They have to put a nurse on the phone, to dial and actually reach the patient, and the patient has to be willing to talk to them. So there’s a certain amount of dropout from that and the hit rate is not as necessarily high as they would like. That’s probably a key challenge.”
And the key to meeting this challenge centers on automating these processes to save time as well as money, something which proves difficult for large and small organizations alike. Even the most sophisticated of health organizations, such as the Mayo Clinic (which co-founded VitalHealth along with the Noaber Foundation in 2006), struggle with it.
The solution to the problem is likely to come in the form of “smart” technology that targets patients based on their diagnoses and demographics and engages them in an easily accessible way, online.
While the term patient engagement may put emphasis on the patient in name and action, the responsibility for making it happen is beginning (if it hasn’t already) to fall squarely on the shoulders of providers and giving new meaning to the term primary care.