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February 11, 2015 Readers Write 1 Comment

Innovative Examples of Patient Engagement Programs
By Zach Watson

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For providers looking to increase patient engagement, it can be difficult to distinguish the abstract from the actionable. Patient engagement has become a veritable pillar of new reimbursement models, new government programs, and in some measure, the quality of a physician’s practice.

But will better patient engagement truly reduce the use of medical services? If so, who is finding success, and how?

Patient engagement falls into three broad categories: changing the role of the patient and the patient’s family in the care team, using technology to retrieve information from the patient, and fundamentally altering the environment and manner in which patients receive care.

Let’s examine each of these categories in greater detail.

Patients as Care Managers

At this point, saying the healthcare system is fragmented is a truism. Efforts are underway to improve care coordination through information exchange via electronic health records and other medical software, but many of these initiatives are invisible to patients. Which is to say, they can’t engage with what they can’t use.

Consequently, one of the most effective ways to engage patients is to reposition them as a member of the care team. Instead of the patient playing a passive role in the care she receives, this new model depends on an egalitarian relationship between the providers and patients.

Patients have a large role in the decision making process, and with better information exchange, they can act as the manager of their care plan rather than merely the recipient.

The San Diego-based Sharp Rees-Stealy Medical Centers expertly executed this model in 2013. Following MCG Chronic Care guidelines, the medical group created a multi-disciplinary team that identified high-risk patients for heart failure during their early interactions with the healthcare system and then provided personalized care.

The patients have greater control of the way their care is administered and they don’t have to repeat their diagnosis to different physicians as they move across the continuum of care. The result? A 49 percent reduction in 30-day heart failure readmission rates.

Technology for Collaboration

Patients with chronic diseases consume a disproportionate amount of healthcare resources, but managing these patients can be difficult without adequate technology. That’s why initiatives like the Collaborative Care Network were founded: to help physicians and patients better control the use of acute services.

Founded by a widespread group of pediatric gastroenterologists, the Collaborative Care Network used to be a patient registry where physicians shared treatment strategies and data with patients suffering from rare inflammatory diseases. The network improved remission rates by 25 percent, but the physicians took the program a step further and encouraged patients to contribute ideas for treatment and research they’d like to have done.

Now patients actively share vital sign data and keep their medication doses recorded so physicians can closely monitor outcomes. As of 2012, the CCN boasted roughly a quarter of the US’s pediatric gastroenterologists, and the response rate of patients who received daily messages on their phones was 94 percent.

Care Direct to the Patient

It’s no coincidence that the stress of juggling Meaningful Use and clinical quality measures criteria while keeping a business afloat makes it more difficult for independent physicians to spend the optimal amount of time with their patients. With that in mind, it shouldn’t come as a surprise that a number of physicians — roughly 10 percent — are entertaining a concierge model.

By reserving insurance payments for only acute episodes of care, physicians can charge patients a monthly or annual fee to have access to their services around the clock. What better way to engage patients than by visiting them in their own homes and making sure all their questions are answered before the appointment is over?

The concierge model takes other forms beyond the “doctor at your door” service. The Mayo Clinic recently entered the digital concierge market with its mobile app Better. For about $50 a month, patients have access to video chats with nurses, a symptom-check list that takes into account the patient’s health history, and other healthcare services.

At times patient engagement may seem esoteric, but the truth is that it applies to any instance where the patient can be more empowered in their care. To truly reduce healthcare costs, the system will need to reduce the rate of use. That means trusting patients with greater management of their own care while providing a more unified set of services when patients do need comprehensive medical attention.

Zach Watson is the content manager at TechnologyAdvice.

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Currently there is "1 comment" on this Article:

  1. Interesting read Zach.

    I am always trying to build parallels between new concepts like patient engagement and scenarios that already exist.

    In this case we are asking the consumer to take on a more active role in their care. The first scenario that came to mind was car repair. In this population you have individuals that will take an active role, i.e. try to fix it themselves, get a second opinion, read up on the repair required. Others in this group are perfectly happy to accept the word of experts. I suppose the variable in this correlation is the severity of issue. If I needed a new engine/heart I certainly would be intimately involved in the details, but if you think I am not getting enough oil/vitamin D I am ok with following your advice.

    I can’t think of a situation where we have asked the consumer to take an active role and the majority of the people stepped up to the plate. Am I wrong? If anyone is reading this I would love a better parallel.

    Also, do we really think we are going to achieve real interoperability between providers if we continue to build one to one channels? So I have built an exchange with my rival hospital down the street for pediatric care, but what happens when that child sees someone else where I have no pre-knowledge of the provider? We either need a distribution model that relies on the patients as the source of data or develop national health banks where data is centrally stored and accessible. If we can rely on the patient to be part of their care team, can’t we rely on them to be the holders of their own health data? National health data banks are also intriguing, as they could offer additional services based upon deep data mining.

    NPI anyone?







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