My Dad told me once that the most cared for he ever felt was sitting in the back seat of the family car during a long road trip. In the front seat, his dad — my grandfather — took complete care of getting my dad from one place to another in warmth, peace and safety.
What does this have to do with patient engagement?
When I think about the current focus on patient engagement in healthcare, I can’t help feeling that we as patients have been led by physicians but — more importantly — have led ourselves into thinking of ourselves as that sleeping child in the backseat while our “trusted physician” takes us on a uneventful trip from sick to well. I go in to see Dr. Marcus Welby, tell him of my ailment, sit back, open my mouth in a baby-bird fashion and wait for him to “fix me.”
Folks, I’m not sure this was ever the case, but I know it’s not the case anymore. Ideally, I would assist Dr. Welby in the above mentioned endeavor:
• I can maintain my own diet and exercise
• I can monitor my own health indicators such as pulse and blood pressure
• I can read about my diagnosis and understand what it means
• I can take ownership of my recovery steps
• I can report my own findings as a member of the team
• I can suggest other things I can do to avoid this problem
I wouldn’t be an inert participant. I would be a team member.
This is what patient engagement is all about. Healthcare as an industry is being aggressively pressed to engage patients by the following influencers:
• HITECH act: Of 24 Stage 1 and 22 Stage 2 measures, patient engagement is directly impacted in 9 and 8 measures respectively. This goes UP in Stage 3.
• Accountable Care Organizations are premised on the idea that patients are encouraged at every stage of their care and the ACOs are rewarded for that engagement.
• Readmission Reduction program penalizes hospitals for patients who are readmitted for conditions often avoidable if patients are involved in their recovery.
• Hospital Value-Based Purchasing Program rewards hospitals on patient experience scores which can be directly tied to how engaged patients feel they are in the team.
Engaging patients involves the same three foundational elements of any member on any team:
• Education: I have to be educated on my role in the team and on the conditions I face.
• Ownership: I must own those steps in the process assigned to me as part of the team.
• Execution: I must act when it’s time to do so, and do so in an effective manner.
The goal of patient engagement is providing processes and tools to enable patients in these three areas. This will not be a simple process. Patients are expected to “get engaged” at the very time they are weakest: when they are sick or otherwise physically compromised. It will require a great deal of change on both sides of the treatment equation.
This blog is all about patient engagement, what it means, tools and processes for driving it up and the ramifications (positive and negative) that such change will have on healthcare as a whole.