The spotlight shines on three healthcare organizations using technology to bolster patient engagement.
Published in For the Record Magazine on 1/28/13 by Elizabeth Roop
From meaningful use and pay for performance to collaborative care models, the pressure is on healthcare organizations to effectively engage patients in their care. Indeed, under stage 2 meaningful use, technology-enabled patient engagement is required. But technology tools on their own do not create an engaged patient; they are only as good as their adoption rate. And adoption requires that providers understand—and be able to demonstrate and communicate—the value patients can realize from utilizing portals, secure messaging, EHRs, and various other forms of health information exchange.
“A lot of providers are focused on [meaningful use], and certainly patient engagement is one of the hardest parts of what providers are struggling with,” says Kate Berry, CEO of the National eHealth Collaborative, which recently released a five-stage patient engagement framework (see sidebar). “But the biggest issue is that they are under so many pressures and requirements that it’s almost overwhelming. It’s not that there isn’t an interest in patient engagement, but it’s hard for it to make the priority list when there are so many other major issues.”
The challenges to patient engagement are many. For example, there is no common definition of an “engaged patient.” Also, it’s a battle to carve out the necessary resources to design, deploy, and manage effective patient engagement initiatives. But perhaps the greatest hurdle is the cultural change required by patient engagement. Not only is it necessary to counter a prevailing view that patients are disinterested in being active participants in their care, but it also can be an uphill battle to convince providers of the value an engaged patient brings to the process.
“We know the reasons why individuals should be more engaged in their healthcare, [but] healthcare has traditionally been pretty institutionally focused, so it’s an evolution,” Berry says. “To some extent it’s not totally fair to hold the physician accountable, but what gets patients willing to use the tools is when their provider is genuinely supportive.” It can be done. And when it works, technology-enabled patient engagement initiatives can have a profound impact on the care process. This can be seen in the experiences of three healthcare organizations that are currently running highly effective patient engagement initiatives.
West County Health Centers, a federally qualified health center serving 14,000 patients in California’s Sonoma County, viewed its foray into technology-enabled patient engagement as part of a larger transition to a service-oriented approach to healthcare. The goal is to eliminate the “social stressors and underlying barriers to care,” says medical director Jason Cunningham, DO. “The current system is not effective at engaging patients. We needed a different way for them to interact with healthcare so they could take ownership of their wellness.”
The foundation of West County’s initiative is customer service. To reach that goal, it conducted specialized training for frontline staff and appointed a customer relationship manager. A patient portal also has been deployed.However, it is the social element of West County’s initiative that sets it apart, making it a key element in engaging patients to self-manage their chronic conditions. In mid-2012, the center deployed WellFX, a HIPAA-compliant social networking platform that provides patients with a secure and confidential forum for sharing experiences and accessing conditionspecific educational content.
The technology “changes the framework so patients are coming up with solutions vs. providers or staff. It’s an interesting dynamic because patients are engaging with each other in the context of healthcare delivery,” Cunningham says. “We have been doing one-to-one [healthcare], but we’re social beings,” adds WellFX CEO Jock Putney. “The notion that you can connect with people who understand what you’re going through is really powerful. And when you take away the [concept] of a consumer-directed social platform and instead put people in a provider-directed platform … it becomes a great opportunity to engage an entire patient population. It’s like hitting a reset button with them.”
Patient adoption, feedback, and activity levels initially will be used to measure the success of WellFX. As the platform matures, effectiveness will be measured based on tangible outcomes, such as improved hemoglobin levels in diabetes patients and reduced recidivism in addiction patients. Achieving those goals requires a specific focus on change management, in particular working with staff and patients to encourage them to engage in and take ownership of the initiative. On the patient side, that includes establishing a patient advisory board to vet platform features and activities prior to rolling them out to the larger population.
Training and the ability to dedicate sufficient human and financial resources are also important. Finally, West County works closely with WellFX to provide data and feedback on platform improvements “so we can fine-tune content based on what’s working,” Putney says. In doing so, it helps ensure that WellFX and West County continue to meet the unique social needs of a special patient population.
“We’re dealing with very interesting patients who have very difficult psycho-social and complex medical issues that need a drastically different approach to healthcare that is focused on patient engagement,” Cunningham says. “We all need that [and] healthcare needs to be transitioning to that.”