WHAT’S PATIENT ENGAGEMENT REALLY ABOUT?
The interest in patient engagement is because of countless studies and empirical data that have confirmed what our common sense has known for years — when people are empowered and have a voice, you have better outcomes. –Chris Cashwell, Lincor Solutions. Source: Electronic Health Reporter
Patient engagement is more than just a buzzword in modern day healthcare. Want to keep patients around, grow your practice, and — most importantly — truly improve your quality of care? Then you need to work toward better patient engagement. Of course, it’s also linked to Meaningful Use requirements and will be crucial with the growing shift toward value-based care models. When patients are engaged in their care, they have better outcomes. Everyone wins.
But it does take some work to get there. In the past two decades, mass communication has exploded thanks to the Internet, smartphones, and social networking. Today, patients seek information, connection, and collaboration with their healthcare provider. If you really want to get patients engaged, your practice needs to adapt to the current Information Age. Without engagement, you could be stuck in the healthcare Dark Ages—and no one wants that.
A change in perspective
Doctors can’t escape the truth: The fundamentals of how to deliver, organize, measure, and get reimbursed for healthcare are changing. Healthcare is steadily moving away from a traditional supply-driven, fee-for-service system focused on how many tests and procedures doctors do.
Instead, we’re shifting towards a value-based system that prioritizes the value of patient care — that means high-quality care, better outcomes, with a lower price tag. Can you guess one of the top strategies to make this happen? That’s right. Patient engagement. When patients are truly engaged in their care, outcomes improve, costs go down, and value shoots through the roof.
Having a national impact
The increasing focus on patient engagement is, in part, due to reforms laid out by the Affordable Care Act (ACA). The ACA ties Medicare payments to improved productivity, efficiency, and quality metrics, such as patient engagement and care experience.
Maximizing patient engagement is also an objective of major healthcare reform initiatives. Meaningful Use is all about improving care by bolstering providers’ and patients’ valuable exchange of health information. These reform initiatives also include Patient-Centered Medical Homes and Accountable Care Organizations.
The Centers for Medicare & Medicaid Services (CMS) expects this shift to value-centered care to save approximately $85 billion through 2016. These savings are crucial at a time when the country is struggling to contain healthcare costs for patients, doctors, and the government alike.
What is patient engagement, really?
The future of healthcare is being shaped largely by the patient engagement evolution. Patients are front and center, with providers giving them an increasingly active role in in the management of their own care and treatment. – Marty McKenna, VP of Population Health Business Unit, Allscripts. Source: EHR
Basically, patient engagement involves doctor-to-patient communication and education. But effective patient engagement goes beyond the common methods. In other words, you can do a lot more for your patients and staff than just setting up an online patient portal. Healthcare providers need to foster a relationship with a patient that involves:
- Sharing practical information. Not only patients’ understanding of their health, but also their skills, ability, and willingness to manage care for themselves and their families.
- Building a culture of engagement. A healthcare culture that prioritizes and supports patient engagement.
- Valuing collaboration. Active collaboration that enables patients to be partners in their care — involved in the design, management, and outcomes.
Why is patient engagement important?
When done right, patient engagement provides many benefits to both patient and provider:
- Improves outcomes of patients’ care
- Boosts patients’ satisfaction with their experience
- Cuts costs for patients, providers, payers, and our entire health system
- Rewards providers through better patient retention, more referrals, and better reimbursements
What it means for your practice
The challenges you face while implementing effective patient engagement will vary widely from the other practice down the street. Your challenges might be adapting to a new technology or transforming your office workflow, while another practice might have trouble getting their patient population onboard. Whatever the biggest barriers are for your practice, you can get through them. All you need is a solid patient engagement framework.
Let this guide walk you through the steps of how to build a bridge between you and your patients using effective patient engagement.
The impact of patient engagement on the future of healthcare.
- The U.S. Department of Health and Human Services will tie traditional Medicare reimbursements to the quality or value of care at a rate of 85% by 2016 and 90% by 2018.
- 80% of Americans with access to their electronic health records use them.
- Two-thirds of Americans without this access say they want it.
- 41% of Americans would switch doctors to gain access to their electronic medical records.
Building an Effective Patient Engagement Framework: Mastering the 5 Steps
Ready to boost your patient engagement levels? You’re in the right place. What you need is an effective patient engagement framework that’s tailored to your practice. A framework ensures you strategize, stay on task, and can measure your progress for achieving your goals. Let’s walk through the 5 steps to building your practice’s patient engagement framework.
Step 1: Create your vision for patient engagement
You probably already know that before you start any initiative with your practice, you need a clear goal and vision for achieving it. The same goes for improving your patient engagement. For your first step, define your ideal “end state” vision clearly and share it with the people it directly impacts:
- Senior leadership
- Board of directors
To develop this end state vision, ask yourself a series of questions:
What does an engaged patient look like?
How will your patients act when your vision for patient engagement comes to life? What does that look like? Your engaged patient may embody these traits:
- Isn’t afraid to ask specific questions about diagnosis and care
- Stays up-to-date on their health
- Collaborates with you on best strategies for care
- Gets actively involved in his or her own care outside your practice’s doors
- Volunteers feedback about experience at your practice
- Maintains a positive attitude
What is your ideal case scenario?
Once you can visualize your engaged patient, you need to figure out the ideal case scenario you’d like to see your patients experience. That scenario might look something like this:
- Patients schedule office appointments online or engage with virtual appointments using telehealth solutions.
- Patients review their medical records and recent test results before their appointments, and come prepared with questions about their diagnosis and treatment.
- Patients ask what they can do on their own to stay healthy and/or treat their ailments.
- After their appointments, patients leave feedback in person or online and access their prescriptions to fill at their local pharmacy.
- Appointments are more efficient and valuable since patients come prepared.
- After-hours calls go down, since patients already had questions answered at their appointments or know how to seek the right information via their health portal.
Your ideal case scenario may look something like this or be completely different. Consider what you would like to see improve in your practice to make it run more smoothly for you and your patients.
What are your practice goals?
Your vision’s practice goals represent the outcomes you’re working toward with your engagement framework. These goals should be SMART and embody five essential characteristics:
- Be more specific than “Increase patient engagement.” Answer the five “W” questions:
- Who? Your patients in general / targeted specific patients
- What? Lower costs / happier patients
- Where? Your practice / on your website
- When? Starting next month / by the end of the year
- Why? Notice patient morale slipping / Need to meet Meaningful Use requirements / Want to provide better value care
- Use concrete criteria and metrics to record the progress and attainment of your goals.
- Determine smaller, more attainable goals that act as steps toward a bigger goal. For example, set a goal of increasing patient portal visits by 15% in 30 days on the way to 50% by the end of the year.
- Be realistic about not only what you believe you can achieve but also the lengths to which you and your staff are willing to go to achieve your goals.
- Schedule a timeframe to achieve both your smaller and larger goals. Be realistic with this timeframe.
What are the metrics?
Finally, in line with the measurability of your goal, you need to know the metrics to record and analyze your progress toward your vision for patient engagement. These might include:
- % of patients who use your patient portal
- % of patients who initiate secure messaging, or respond to secure messages
- # of patients seen each day
- % of patients who use evisits
- % of patients who attend scheduled appointments, both in office and online
- # of new referral patients
- % of patients adhering treatment plans
- % of patient retention
- # and % of patients in accounts receivable
- $ of specific costs you want to remedy
Think about what data points you need to show you’re meeting your goals. Analyze each metric carefully, and think about how it will allow you to track progress as well.
The importance of feedback
In every stage of achieving your patient engagement vision—planning, execution, analysis—you need feedback from all parties.
- Providers: Would the vision make providers’ jobs easier and their days more productive? Do they think the vision will lead toward better patient engagement?
- Staff: Can the staff handle the changes in responsibilities and workflow? Do they foresee any problems that could arise?
- Patients: Do patients think they’ll benefit from the new strategies? Are you focusing on right things to get them engaged? What do they really want from your practice?
- Senior leadership/Board of Directors: Does the vision fit into the practice’s overall mission? Is the vision financially practical to carry out?
Through careful planning and thorough discussion, you can ensure patient engagement becomes a natural part of your patient relationships and day-to-day operations.
Step 2: Create a culture based on engagement
Employees who are ‘engaged’ have greater psychological commitment to the practice at which they work, often go above and beyond their basic job descriptions, and put more discretionary effort into their work. Engaged employees are also more motivated, productive, and likely to stay with the practice than the average employee. –Bob Levoy, human resource and practice management author, from Physicians Practice.
Once you have your vision in place, your next step is to foster the culture and environment needed to carry out your plans for better patient engagement. Build an engagement-friendly culture with your staff with these five steps:
Before implementing any patient engagement strategy, consult with your staff and have an open discussion with them about your ideas. Invite them to offer their own ideas to work into your plans. Assign internal accountability to keep everyone on task. Encourage enthusiasm and motivation from the get-go.
In addition to discussing your plans, educate your staff on the details and benefits involved in increasing patient engagement. Take the time to provide research and statistics to illustrate your points. Correct any misconceptions, like how it’s impossible to engage older patients with new technology or that new technology will only create more work (this may be true in the beginning, but it will save time in the long-run!).
Create a logical framework for staff to learn and train with any new technologies, workflows, or other strategies. Provide official training meetings conducted either by yourself or by someone knowledgeable in that area. You could even make each staff member a team leader on one aspect of your patient engagement plan, and have them lead the relevant training. Keep in mind that training takes time and resources, and make sure you build that into your schedule and goals.
Encourage feedback and openness both in the beginning and as you go along. Check in with your staff to see how everything is going and if they need follow-up training or support. Consider scheduling a weekly or monthly meeting to measure progress and address staff concerns. Ask about patient interactions to gauge interest, participation, and effectiveness.
When you hit the patient engagement goals you planned in Step 1, celebrate your successes as a team! This step is incredibly important for fostering a culture of engagement in your practice, so take it just as seriously as any other step. Positive reinforcement is crucial for maintaining momentum, attaining higher goals, and boosting staff morale and retention. Remember that meeting your patient engagement goals is impossible without a team effort!
Step 3: Identify Your Engagement Tools & Technology
Our largest struggle is not with the patient who takes their medication regularly, but with the patient who does not engage in their own care. Technology can be the driver that excites a patient with the prospect of wellness. –Stephen Beck, chief medical information officer at Mercy Health (formerly Catholic Health Partners), from Rise of the ePatient Movement.
Busting the myth: Older patients do want to engage with technology.
About 56% of baby boomers who don’t currently use patient portals would be more interested and proactive in their healthcare if a portal was available. This is particularly true if they have chronic conditions. As for preferred use, 70% of this age group would use patient portals for scheduling appointments, followed by reviewing medical records and test results.
With a vision in mind and your staff onboard, it’s now time to determine the tools and technology needed to put that vision for patient engagement into practice.
What’s most important to patients is information about their own health, and educational tools can inform them about your practice as well.
- Placed in the waiting room and offices, brochures provide easy access to valuable healthcare information, such as explanations of treatments and diseases.
- Email campaigns. Patients are more likely to read information about common and seasonal illnesses and other issues when it’s delivered conveniently to their inbox.
- Patient portal. Portals present an opportunity to educate patients with accessible health information through links to useful websites, condition-specific resources, and even recommendations on helpful apps they can use to manage their health.
- Mobile applications. Health and medical mobile apps can help educate patients about their health and provide support when they’re away from the office. For example, PatientPartner gamifies health education to show patients how important it is to stick to a medication schedule. The app iTriage helps patients search for their symptoms to gauge how serious their symptoms are and whether they need to come in to see you. This could save both you and them from several unnecessary appointments!
Using tools to connect with your patients can increase your practice’s accessibility, availability, and convenience. When patients can get the care they need and have their questions answered, they’re more likely to follow treatment plans and feel engaged in their care. Better yet, adding many of our best patient engagement tools to your practice can free up time by making your practice more efficient:
- Patient portals with secure messaging. Secure messaging services offer a direct line between doctor and patient. Funneling patient questions and requests through secure messaging instead of phone calls is a great way to make your practice more efficient. Instead of playing phone tag with patients or being interrupted throughout your day with requests, you can block out specific times of your day to answer secure messages. Patients can also use portals to pay bills, schedule appointments, and refill prescriptions.
- Social media. Social networks provide a fresh way for you to connect with your patients and offer personalized interactions in a place they already frequent. You can also use social media to share informational health articles and educate patients on popular issues.
- Telehealth tools, like eVisit. Adding a telehealth option to your practice lets patients connect with you over webcam and get treatment from anywhere. Providing virtual visits is a great way to give patients urgent care for minor medical issues (like infections) or do quick follow-ups that don’t require patients to travel to the office or deal with long wait times. Patients will love the increased access and convenience. So will you!
Collaboration seals the bond between you and your patients, making the experience more positive and empowering for them.
- Patient feedback and surveys. Patients can communicate their opinions about you, your practice, and their care.
- Remote monitoring and wearable technology. Patients can track their diet, fitness, and pregnancy and share that information directly with you.
- Patient access to medical records. Patients can review their health statistics and test results to stay informed about their own healthcare and ask questions when needed.
- Wellness plan. Whether implemented through discussions, paperwork, or electronically, developing a wellness plan with your patients is key to collaborating and engaging patients with their healthcare.
- Online community and support forums. These tools offer a way for you, patients, their family, friends, caregivers, counseling, and various services to collaborate out of the office.
Online access to medical records drives engagement.
A majority of patients would like online access to their medical records. If they had this access, about 57% of patients who don’t currently use patient portals say they would take interest and be more proactive in their healthcare.
Step 4: Plan your Process
Planning how you will implement your ideas to create an effective patient engagement process grounds your efforts and demystifies the logistics of putting all the changes into place.
- Create a timeline for your goals.
Without a concrete timeline, you’ll likely have trouble measuring your success rate in a given period of time. A timeline keeps you organized! It’s really hard to accomplish goals without those deadlines, as we all know too well.
- Schedule a process for implementing your tools and technology.
After deciding which tools and technology you will use, determine how and when you will begin using those tools in your day-to-day routine. Think about implementing these new tools in stages – it would be impossible to introduce them all at once! Spread new technology out in stages so that you and your staff aren’t overwhelmed by too many new processes beginning all at the same time. Create a seamless transition from one step in the process to the next to keep your staff and patients onboard and cognizant of the changes you make.
- Identify team involvement.
Don’t forget—without your staff, your patient engagement goals can’t get off the ground! Each staff member will have his or her own role, so clearly define and explain that role and how it will affect the practice and daily responsibilities. For example, if you’re going to make medical records accessible to patients through a patient portal, who will be responsible for adding notes to the records, uploading the records, or notifying the patient that their records are available if needed? Who will be responsible for promoting this new feature to patients? Who will track and report on how many patients are accessing their records (if this is one of your metrics)?
Think through the process involved and assign each step or task to the appropriate team member. The staff involved need to know how and when to implement their tasks for the most effective approach.
Step 5: Review and Adapt
Like with any plan you make, you’re likely to hit some snags and roadblocks. You can’t always predict all the hurdles you’ll encounter or how long certain changes will take you. That’s ok! The most important thing is that you continuously track your progress, review your goals, and adapt when you’re not hitting your targets.
- Plan how you will review your progress.
In Step 1, you picked the metrics to measure your progress toward your goals. By now, you’ve also set up a timeline for when you will review these metrics, including how often you will take stock of what you accomplished.
For the next part of the review plan, decide who will track and analyze the metrics to create a clear picture of your progress in that timeframe. Will it be a member of your staff? Will you have a computer program that can track and report on the metrics automatically? Is this feature built in to your current systems or software? Figure out how you will review these metrics, whether it be on your own or in a staff meeting. Without an effective review plan laid out, how will you or your staff know you’re having an impact?
- Conduct patient surveys.
The most important engagement review is from your patients. In addition to metrics, encourage your patients to provide feedback on the new processes and how they feel they are engaged with their healthcare and your practice. The best way to gather this data is through a patient survey, in-person, by phone, or online. Ask patients specific questions about their level of engagement using specific goals from your vision. For instance, if your goal was for % of your patients to actively use the patient portal, ask them how frequently they use the patient portal and how useful they would rate the portal. Encourage just as much openness and honesty as they have in appointments with you—they are your patients, after all!
- Plan what happens when you don’t reach your goals.
When you aren’t hitting your goals, it’s not a sign of failure. [TWEET] Instead, see it as a trial or experiment that gauges certain strategies and teaches you what works and what doesn’t. If you don’t meet your goals, determine how you will decide which strategies to change. Collaborate with any staff involved in performing and measuring your goals to get feedback and collectively find potential solutions.
- Be flexible, and adapt to new changes.
After deciding your next move, don’t wait to put it into action. Retrain your staff in how to carry out your new strategies for patient engagement. Inform your patients of any changes so that they can also adapt and provide feedback on how those changes improved or worsened their healthcare experience.
There you have it – your practice’s very own framework for patient engagement. To make sure you’re getting the most out of your framework, be ready and willing to understand what’s involved and what strategies to apply to your practice. Collaborate with your staff, and explain their role in implementing the new system. Create SMART goals, and plan how you will review them to determine how best to be successful. Above all else, stay in close contact with your patients for feedback and cues that your system is working and engaging them unlike ever before.
If you would like to learn more about patient engagement and the steps you can take to achieve it, please review our additional resources. These patient engagement resources provide further support in helping you create and carry out your goals.
Additional Patient Engagement Resources
Athena Health, “5 Elements of a Successful Patient Engagement Strategy,” http://www.athenahealth.com/whitepapers/patient-engagement-strategies/
Athena Health, “Patient engagement knowledge hub,” http://www.athenahealth.com/knowledge-hub/patient-engagement/framework
eVisit, “Infographic: Engage Patients with Patient Portals,” https://evisit.com/infographic-engage-patients-with-patient-portals/
eVisit, “10 Secrets to Get Patients Using Patient Portals,” https://evisit.com/10-secrets-to-engage-patients-with-patient-portals/
Healthcare Informatics, 5 Steps to Patient Engagement, a NeHC Framework is Created, http://www.healthcare-informatics.com/article/5-steps-patient-engagement-nehc-framework-created
InformationWeek, “Engage Patients: 16 Creative Healthcare Strategies,” http://www.informationweek.com/healthcare/patient-tools/engage-patients-16-creative-healthcare-strategies/d/d-id/1127677
Becker’s Hospital Review, “10 Keys to Designing an Effective Patient Engagement Strategy,” http://www.beckershospitalreview.com/hospital-management-administration/10-keys-to-designing-an-effective-patient-engagement-strategy.html
Top Achievement, “Creating S.M.A.R.T. Goals,” http://topachievement.com/smart.html
Harvard Business Review, “The Strategy That Will Fix Healthcare,” https://hbr.org/2013/10/the-strategy-that-will-fix-health-care/
U.S. Department of Health & Human Services, Press Release, http://www.hhs.gov/news/press/2015pres/01/20150126a.html
Healthcare Information and Management System Society Foundation / National eHealth Collaborative, “Patient Engagement Framework,” http://himss.files.cms-plus.com/HIMSSorg/NEHCLibrary/HIMSS_Foundation_Patient_Engagement_Framework.pdf
Centers for Medicare & Medicaid Services, “The Affordable Care Act: Lowering Medicare Costs by Improving Care,” http://www.cms.gov/apps/files/aca-savings-report-2012.pdf
Healthcare Informatics, “Healthcare Orgs. Still Doing Bare Minimum on Patient Engagement, Report Says,” http://www.healthcare-informatics.com/news-item/healthcare-orgs-still-doing-bare-minimum-patient-engagement-report-says
Physicians Practice, “How to Engage Your Medical Practice Staff,” http://www.physicianspractice.com/staff/how-engage-your-medical-practice-staff
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