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.
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.
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.
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:
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?
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.”
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.
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.