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Scaling Patient Engagement To Improve Health Outcomes

Patient engagement is the measure of how patients engage with all the resources their health system makes available to them. It requires them to be actively engaged in leveraging the services and resources that can help resolve their conditions and optimize their wellbeing. When they do so, they help promote patient-centered care, effective patient-provider relationships, and improved health outcomes.

The rise of patient-centered care and patient engagement

Patient engagement as the cornerstone of patient-centered care became a popular industry model in 2011, shortly after the Patient Protection and Affordable Care Act (PPACA) was passed in 2010. Since then, scores of studies like those published in Sage Journals and the Patient-Centered Outcomes Institute have demonstrated that patient engagement, when practiced consistently, leads to improved health outcomes. That’s because actively engaged patients monitor and manage their conditions and their health information via regular patient-provider communications and the use of their patient portal to track care plan progress and schedule appointments.

According to BMC Health Services Journal, patient-centered care can help develop actively engaged patients through effective communication, partnership, and health promotion. These 3 core elements allow clinicians to select a patient-centered approach that aligns best with each patient’s needs. Another study conducted by the BMC Health Services Journal found that patient engagement makes patients feel like supported, respected collaborators in their care, which motivates them to adhere to treatment protocols.

Now that patient-centered care and patient engagement have been associated with improved health outcomes, health tech companies are developing platforms that can enable and streamline it.

How patient engagement improves safety

Patients are increasingly expecting their health systems to be more responsive and transparent. They also expect their clinicians to engage them in decision-making. Finally, they’re more likely than ever to research and inquire about safety standards.

The World Health Organization (WHO) has published evidence demonstrating that patient engagement is one of the key strategies for improving patient safety in primary care. Clinicians’ competing priorities — organizational, reputational, financial — may leave them with no time to focus on an individual patient’s safety. Actively engaged patients, however, naturally prioritize their safety and well-being. The WHO also found that patient engagement can promote mutual accountability and understanding between the patients and clinicians.

The organization has long recognized that patient engagement drives patient-centered care, as actively engaged patients are able to make more highly informed decisions about their diagnoses, treatments, and safety considerations. Aligning with patients’ priorities also enables health systems to use resources more efficiently and avoid unnecessary expenditures. As Health Affairs confirms, “Patient engagement is one strategy to achieve the ‘triple aim’ of improved health outcomes, better patient care, and lower costs.”

How to scale patient engagement

Health systems and clinicians in all specialties excel at patient engagement and build long-lasting relationships with patients when they have their health system’s support to achieve the following:

Understand what drives patient engagement

There are many factors that can support or deter patients from being willing and able to participate actively in improving patient safety or reducing harm.

The World Health Organization has found that these factors affect patient engagement:

  • Patients: their demographic, medical literacy level, and desire to engage
  • Health conditions: the type and severity and immediacy required to manage illness
  • Clinicians: their level of specialized knowledge and attitude about patient engagement
  • Healthcare tasks: whether a required patient safety behavior challenges clinicians’ clinical abilities
  • Healthcare setting: primary care, specialist care, long-term care, or emergency care

A patient’s perception of their subordinate role to clinicians or distrust of clinicians may hinder patient engagement. Those who fear they’ll be considered “difficult” may not actively express their concerns for their safety. Such challenges can be overcome by improving communication and educating both patients and healthcare providers to view healthcare as a partnership.

Provide education on patient engagement

HealthIT.gov underscores the importance of getting meaningful consent from patients to share their health information. Robust and compassionate education and easily accessible health information can inspire patient engagement and build trust.

When you provide user-friendly formats inside an easily accessible patient portal, you’ll enable patients to understand exactly who accesses their health information, what parts of their health information you may be sharing with other healthcare professionals, and why. They will understand how their health information is protected.

Patients must also be made aware that they can choose not to share their information at all. Education and engagement are crucial to helping patients understand their consent options and the impact of their choices.

Healthcare providers can lower the potential risks associated with limited patient health literacy by avoiding medical jargon, responding clearly and slowly to patient questions, and explaining complex forms. They can also decrease mistrust by showing genuine interest in the patients who have high health literacy and enjoy keeping up with the latest research published in medical journals. Education leads to shared decision-making, and thus, shared responsibility for health outcomes.

Inspiring self-management also goes a long way. Clinical trials reviewed by The National Institutes of Health have demonstrated the benefits of patient engagement in achieving positive outcomes for a range of conditions like diabetes, coronary heart disease, heart failure, and rheumatoid arthritis. Robust patient engagement can inspire self-efficacy — the motivating belief in patients’ ability to accomplish the goals they helped their provider define and structure.

Collect feedback to improve patient engagement

AHRQ suggests implementing patient feedback to discover which features of your practice may be causing patient engagement resistance and help you identify areas for improvement in one of these ways:

  • Shadow patients to understand how they experience your practice workflow, procedures, and communication style.
  • Ask permission to observe how patients use your portal; this will help you understand where changes in appearance, wording, organization, or navigation of the portal may be needed.
  • At the end of a visit, ask your patient for feedback on how understandable your written materials are to follow and act on.
  • Use a suggestion box to encourage patients to suggest ways your practice can improve communication.
  • Administer a survey like CAHPS and analyze the data to make improvements in patient engagement.

Your insights should lead you to set new goals and track changes with additional periodic feedback loops. The Picker Institute has determined that patient engagement can be inspired by providing accessible, clear, and reliable health information. Patients also respond well to effective treatment delivered by trusted professionals, shared decision-making, respect for patient preferences, fulfillment of physical and emotional needs (including support for family members), and effective continuity of care.

The future of patient engagement

Effective communication

There can be no patient engagement without honest and open communication. The Journal of Graduate Medical Education has concluded that communication skills are critical to clinician competence. Enhancing communication skills training in medical school likely will require significant changes at undergraduate and graduate levels, as well as improvements in communication assessments.

Online training portals are also becoming popular in healthcare systems as they are available 24/7 and allow clinicians to learn at their own pace. Science Daily even reports how virtual humans help aspiring clinicians learn empathy for patients.

Partnership

The Patient Experience Journal examined the “patient-as-partner” paradigm and found that clinicians’ continuous participation improved care quality and led to a better understanding of patients’ expectations, highlighting the interdependence of care team members. Patients were much more motivated to follow instructions after sharing their vision and seeing it integrated into their care plans.

Colleaga breaks down how assisting patients in behavior change is an important component of healthcare engagement. Helping patients make healthier life choices improves population health. A prominent behavior modification theory — the Transtheoretical Model of Behaviour Change — recommends clinicians follow these stages: pre-contemplation, contemplation, preparation, action, maintenance, and termination to inspire the patient engagement that makes everyone’s journey easier.

Colleaga research also found that after other family members, clinicians are the most trusted people in most patients’ lives. A short chat with a clinician can increase smoking cessation rates by up to 10%. Effective interventions use messaging that addresses economic, educational, and social determinants of health, as well as each patient’s engagement ability.

Health promotion via patient engagement

Health Promotion International lays out 5 key action areas for health promotion:

  1. Reorient health services to improve the health of entire populations and provide health resources to all — even before they become ill.
  2. Create supportive surroundings to foster an environment that physically and socially assists in health success and eliminates harmful practices.
  3. Develop personal skills to teach patients pertinent health information so they understand what could cause illness and proactively work to decrease their risk.
  4. Strengthen community to bond and inspire patients to advocate for policy changes and the development of new programs.
  5. Develop public policy to increase awareness, provide resources, and educate people to take control of their health.

According to Hospital News, it is nursing professionals who most directly promote patient engagement for preventative care. Nurses are qualified to talk to patients about a range of health-related topics, from nutrition and exercise to disease prevention in a casual, personal way.

They can choose to host informational sessions or provide brochures and links to online resources. Nurses can use patient visits as an opportunity to initiate preventative health discussions. If a patient comes in with joint pain, a nurse can explain how excess weight can exacerbate it and suggest gradual weight management strategies. If a young patient comes in with a chronic cough, a nurse can discuss the benefits of smoking cessation. Nurses have more time and more direct, personal contact with patients — and they use it strategically.

Ready to enjoy the benefits of patient engagement?

You’ve likely enjoyed instances of patient engagement success during your career, but implementing it at scale requires some assistance and planning with your care team to get each clinician on board and motivated to learn. To start developing your own customized patient engagement strategy, read our guide to patient-centered care.

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