Getting Engaged

Elaine Waples

We hear inspiring things about patient engagement.  The very concept has a hearty, spirited, “do-right” sound to it.

I spent many years in human resources. I remember the conversations we had around employee engagement as we searched for a practical approach. We realized that it is the employees’ belief that the company is moving in the right direction; that the work they do is meaningful and that they are committed to it; that the trust index of respect, credibility and fairness is high; and that employees are willing to work hard to help it get there.

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Patient Engagement and Medical Homes – Core Drivers of a High-Performing Health System

Jane Sarasohn-Kahn

Posted 3/30/12 on Health Populi

It was Dr. Charles Safran who said, “Patients are the most under-utilized resource in the U.S. health system,” which he testified to Congress in 2004. Seven years later, patients are still under-utilized, not just in the U.S. but around the world.

Yet, “when patients have an active role in their own health care, the quality of their care, and of their care experience improves,” assert researchers from The Commonwealth Fund in their analysis of 2011 global health consumer survey data published in the April/June 2010 issue of the Journal of Ambulatory Care Management. This analysis is summarized inInternational Perspectives on Patient Engagement: Results from the 2011 Commonwealth Fund Survey, published on The Commonwealth Fund’s website on March 29, 2012.

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Consumer Engagement in Health: Greater Cost-Consciousness and Demand for Cost/Quality Information

Jane Sarasohn-Kahn

Posted 12/14/11 on Health Populi

People enrolled in consumer-directed health plans (CDHPs) are more likely than enrollees in traditional health insurance products to be cost-conscious. In particular, CDHP members check prices before they receive health care services, ask for generic drugs versus branded Rx’s, talk to doctors about treatment options and their costs, and use online cost-tracking tools.

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Physician Executives Should Support Patient Engagement/Activation

Kent Bottles

Posted 10/18/11 on Kent Bottles MD Private Views

The doctor/patient relationship is certainly changing and evolving. A term I hear a lot today is:“patient engagement/activation.” Why is this concept so important and what does it mean? What can physician executives do to make it easier for our patients to become engaged and activated?

Judith Hibbard has pioneered the study of patient engagement, and she noted that one needs knowledge, skills, and emotional support to actively engage in one’s health care. She identified four behaviors associated with engagement and activation:

  1. Self management
  2. Collaboration with provider
  3. Maintaining function/preventing declines
  4. Access to appropriate and high quality care

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ACO’s: Missing Accountability from a Very Critical Stakeholder

Wendy Lynch

First published 3/10/11 on the Altarum Institute Blog

Imagine you decided to run an Accountable Car-Care Organization.  The government announced you would no longer be paid on repairs alone, but for keeping cars on the road and out of the garage. You might contract with qualified teams of mechanical providers, from oil-change garages for preventive maintenance, tow-truck drivers for emergencies, to specialist mechanics for very technical repairs.  Next, you assemble secure, integrated information technology to track the care each automobile receives across providers and assign each license plate number to a vehicle-centered mechanical home. Finally, you determine specific outcomes and standards of practice to keep engines running better. Under ACCO rules, you are ready to start earning performance bonuses.  Right?

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Putting Patients Into Meaningful Use: Regulators and Providers are Catching Up with e-Patients

David Harlow

First published 3/1/11 on HealthBlawg

The Health Research Institute at PricewaterhouseCoopers released a report last week entitled Putting patients into “meaningful use.” It begins with the anecdote I’ve blogged about previously regarding a diagnosis by Facebook in lieu of a PHR, which some have highlighted as a great success for social media in health care. I am much less sanguine on that front. The PwC report, of course, has much more than that story in it; here are the key takeaways, backed up with some survey data and interviews:

  1. Engaging external constituents may postpone achievement of “meaningful use.”
  2. Patient awareness of and access to available health IT tools is low; social, expectation, and education hurdles also exist.
  3. Patient engagement in “meaningful use” is still low, despite consumer interest.
  4. “Meaningful use” has yet to explicitly call for measuring the level of patient engagement.
  5. Health systems will need to compete for consumers in the PHR market.

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Dave and Danny on the Big Screen

Paul Levy

First published 2/22/11 on [Not] Running A Hospital

Regular readers may recall that I wrote about a grand rounds presentation by Dr. Danny Sands and e-Patient Dave deBronkart. It was an impressive and moving exposition about the power of patient involvement in the delivery of health care.

Dave and Danny did a reprise of this session at the IHI Annual Forum in December, and IHI has generously made it available for public viewing. I offer it here for you. It is about an hour long, but well worth your time. (You can play it in the background while you catch up on the long weekend’s emails today!)

Danny and Dave are now both active in the Society for Participatory Medicine, spreading the word and publishing research in support of “a cooperative model of health care that encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care.”

IHI Forum 2010 Session A1: How Patient-Provider Engagement Can Transform Healthcare from e-Patient Dave deBronkart on Vimeo.

Patient Engagement: It’s Not What You Tell Them, But How You Tell Them

Pat Salber

First published 2/16/11 on The Doctor Weighs In

Once you take a look at this video, you will see what a huge opportunity is missed in health care because of lousy communication techniques. It’s not that we don’t know what works – turn on the TV and watch some direct-to-consumer drug ads – they work all too well. Then watch the video for great examples of how we are doing it all wrong – together with some suggestions on how, with a minimum of effort, we could do so much better. BTW, Tom Goetz, the speaker, is the editor of Wired Magazine – a great read.

Measuring Patients’ Experience of Care


First published 2/9/11 on Health Blawg,

There is a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, patient-centeredness are very important.  Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured.

Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date.  (Wearing one of my many hats, I’ve had the opportunity to submit a response to CMS regarding the RFI on these metrics on behalf of the Society for Participatory Medicine.)  These measures go into the Meaningful Use hopper as well, as Meaningful Use Stage 2 metrics are being reviewed.

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