The Secret to Patient Engagement: More Engaging Physicians and Health IT

May 25, 2014
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patient engagement

I was the keynote speaker recently at a national Patient Engagement Symposium. I opened my presentation by asking the audience how many considered themselves to be engaged in their health. You know…just a show of hands. Everyone in the room appeared to put their hand up….and no one admitted to not being engaged in their own health.

patient engagement

I was the keynote speaker recently at a national Patient Engagement Symposium. I opened my presentation by asking the audience how many considered themselves to be engaged in their health. You know…just a show of hands. Everyone in the room appeared to put their hand up….and no one admitted to not being engaged in their own health.

When asked how to describe “how they are engaged in their health”, true to form most people responded by saying they “I try to take care of myself” by doing X, Y and Z.

The evidence bears this out. 82% of U.S. adults have a regular doctor who their visit at least once a year with the average number of doctor visits being 3/year – double that for people with chronic conditions.

You would think that this level of patient engagement would be music to the ears of physicians, administrators and health IT vendors everywhere…but you would be wrong.

Why?

You would be wrong because physicians, administrators, health IT vendors and the like each have their own definition as to what constitutes patient engagement.

Here’s how these groups tend to define and measure patient engagement.

Physicians/Providers Definition Of Engagement

Simply “showing up” for their appointment, even if it is 6-7 times a year, interspersed with copious amounts of self-care, does not constitute patient engagement from the physicians’ perspective. After all, patients often don’t do what they are told by physicians – many patients are non-compliant. 

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Since many physicians tend to equate patient engagement with patient compliance today’s high non-compliance rates (30%-70%) suggest to them that most patient are not engaged.  What clinicians are often unaware of is that up to 20% of non-compliance is a function of poor physician-patient communications (disengaging communications) not a lack of engagement.

Health IT Professionals and Vendors

Neither “showing up” nor “the patient’s level of compliance” count for much when it comes to how health IT professionals define or measure patient engagement.  The HIMSS (NeHC) Patient Engagement Framework leads you to believe that the true path to patient engagement is all about the use of health information technology and the achievement of Stage 2 Meaningful Use.  As long as patients use the right health IT tools they are engaged. 

What Health IT folks often ignore is the fact that 85% of patients want the ability to meet face-to-face with their doctor when they feel the need..  They don’t want health technology to get in between they and their doctor which is what some health technologist seem to believe is the answer.

The Challenge For Physicians And Health IT Professionals In Not How To Engage More Patients….But Rather How To Be More Engaging To Patients Who Are Already Engaged

Let’s face it. Health care is still about everyone except the patient. Most physicians still relate to patients using a paternalistic, physician-directed communication style where the clinician knows best, does most of the talking and makes all the decisions for the patient. Patients are not supposed to be engaged – rather they are supposed to be passive and compliant.

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Health IT tends to treat patients as stupid and superfluous when it comes to engagement. Health IT folks turn a deaf ear to the fact that 85% of adults want to be able to meet with their physician face-to-face when they want despite their “willingness” to use secure email, patient portals, open notes, etc. People aren’t stupid – they know you want to insert technology in between themselves and their doctor. They are already complaining about the introduction of laptops and computers in the exam room and how it is interfering with the doctor-patient relationship. How is that supposed to be engaging to patients?

Patient Engagement Is Not Hard

So what is the secret to improving patient engagement? Try being more engaging to patients. That means being more patient-centered versus you-centered in how you think about what you do to/for patients, how you talk to/listen to patients, design products and services for patients and what you measure when it comes to assessing patient engagement. It means soliciting the patient’s story…their health beliefs, fears and concerns, understanding their health information needs and interests, understanding their previous health experiences and so on. It means giving the patient credit for having a brain as well as already having a stake in their own health.

That’s what I think.  What’s your opinion?

(patient engagement / shutterstock)