It is a proven fact that when patients that are actively engaged in their own healthcare, they are statistically healthier. As we move into shared savings programs where incentives to providers are based on quality outcomes and healthy patients, it is clear that getting patients to be active in their own health care is critical. CMS has also seen this with their inclusion of a new core measure for providers requiring a minimum of 5% of the provider’s patients actively engaged and recorded in their Meaningful Use Measures. Stage 2 Meaningful Use requires Patient Engagement beginning in 2014 for Stage 2 attestation. Additionally, any coffee shop discussion of rising deductibles and co-pays leads to a changing dynamic where patients are getting engaged in not only their health care but also the cost associated with their health. There is a huge shift occurring in health care and while this has been discussed, planned and argued for many years, it is beginning to be a reality.

As leaders in our health care institutions, we need to endorse and support this shift leveraging our technology enabling healthcare tools and our experiences. We have done a great job setting the foundation with Meaningful Use Compliant Electronic Medical Record systems in our hospitals and physician practices. Additionally, many of us have developed or linked their organizations to Health Information Exchanges.

While the foundation work we have completed is far from finished, we did an good job of putting in a technology foundation that can reach out to our patients. As we are all also patients, we can understand the need for the well-being for ourselves and our families. While some feel this is going to be extremely difficult, I disagree and feel that once our patients get engaged successfully, the momentum to connect this last mile will move fast.

While working with the Regional Extension Center in New Jersey, I have the benefit of interacting with private and group practices on this very topic. Since Meaningful Use Stage 2 is the current hot topic, many are inquiring on the Core Measures specific to engagement. For private practices, this tool will likely be the use of a Stage 2 compliant portal that for the most part will be a module extending from their practice electronic medical record system. Additionally, I have seen several Health Information Exchanges begin to offer this as a service however with the challenge of seamlessly connecting to disparate electronic medical record systems.

In working with practices, my first encounter with a successful use of patient engagement ironically occurred with an OB practice established in a rural area in NJ. The OB patients were heavily providing medical care for a population of Spanish speaking farm workers. This particular physician had the foresight to install the portal at the beginning of his implementation and his patients were able to access the portal via computer or hand held devices. He told me the story of one of his patients who was encountering significant pelvic pain during her pregnancy and was rushed to the local community Emergency Room. The patient and the ED physician were having trouble understanding the request from the ED as to her current medications and medical status. The patient had here phone and logged into the OB practice portal where the ED physician had instant access to her current medications and recent exams.

The above example is one that shows the benefits of utilizing technology in an emergency situation. Patient Engagement provides a significant benefit in taking care of chronic disease conditions. While likely not your typical healthcare consumer, I try to utilize patient engagement myself and for my family. My primary care physician is on the practice’s third generation EMR and has the ability to upload visits, meds, lab results and other pertinent information to my personal health record. For me specifically, this helps me track my management of my inherited conditions of hypertension and high cholesterol. Of course, losing 20 pounds and getting back to my high school weight is a good way to also help, I find myself struggling to get to that goal and need help and tools to measure my conditions.

Medicare has a wonderful program in place called Blue Button which also free access for Medicare patients to their claims information. Now, I am blessed to still have my 81 year old parents living nicely on their own but I also realize that this typically is not a patient population that is going to access their information electronically or download to a personal health record. In talking to my boomer friends, many of us with similar non technically educated parents, are doing this for them.

As a consultant, I also had the opportunity to manage multiple health systems in a project to identify patient engagement solutions. Each member organization had sized up its criteria for reaching patients and getting them engaged in their own health. Examples included one health system that was embarking on Customer Relationship Management (CRM) as one of their patient engagement solutions. Another example was a system using Social Media would be their initial venture with patient engagement. This system focused on the following using social media:

  • Educate patient about Diabete
  •  Conduct virtual classes
  •  Access the outside resources
  • Share personal experiences
  • Opportunity to get second opinion

Finally, we also explored one of the emerging Patient Engagement that provides population health management solutions. This vendor software application included a population registry, predictive analytics and care giver and patient report information.
Is summary, based on my experiences as a healthcare IT executive and a patient, here are my recommendations for you as Patient Engagement technology leaders and applying patient engagement into your organizations.

  1. Get buy-in. Key leaders and clinicians must be committed and buy-in to the initiative
  2.  Identify data requirements based on the highest need, highest risk and highest level of utilization.
  3.  Look for a strong technology foundation with analytics to allow you to manage and measure the benefits you are looking to achieve.
  4. Start with a pilot. Pick an area aligned with your organizational priorities such as mammograms, diabetes or flu reminders.
  5. Start simply and make sure success criteria are clearly defined.

Refine and broaden as you advance patient engagement. Explore the best way to increase “stickiness” and prevent patient leakage and increase patient loyalty. Once you establish the stickiness, explore more robust models with multiple disease states. If possible, try multiple campaigns to compare their effectiveness. Patient Engagement is the last mile to connect and we are at the forefront as health technology leaders to make this happen.