Patient Engagement: Medicine’s New 'Blockbuster Drug'
Traditional medicine casts doctors as patriarchs and patients as either cooperative or uncooperative. But the second stage of the Affordable Care Act, with its emphasis on patient engagement, aims to change that equation.
It’s a very big deal.
“Patient engagement is the blockbuster drug of the century,” said Dr. Farzad Mostashari, who headed the Office of the National Coordinator for Health Information Technology until stepping down last year.
The new provisions require hospitals to lower hospital readmissions for some conditions or face penalties. Because Medicare and Medicaid payments are now partly based on treatment outcomes, hospitals and clinics are turning to a team-based approach that emphasizes patient contact and patient decision-making. Providers also must make “meaningful use” of electronic health records and show that at least 5 percent of their patients communicate electronically about their care. Stage 2 suggestions for achieving patient engagement include:
- Providing patients with updated online information
- Presenting patient information in a manner that leads to their viewing, downloading or transmitting the information
- Providing educational resources
- Promoting interactions that encourage patients to communicate with their providers electronically
Patients need to be engaged at every step of their care. In the hospital, they need to be made a part of the care team, at the heart of every decision. They need to be given clear information about post-hospital care and provided with tools to accomplish it. This is especially true for patients with chronic conditions, who need a lot of follow-up care in order to avoid another hospital stay.
Healthy patients need to be engaged with wellness and fitness programs to develop behaviors that will keep them out of the hospital in the future.
Patients need to be able to access their health records through secure online portals, where they can also receive important treatment information without visiting the doctor. They should be able to manage prescriptions and appointments remotely. Electronic health records are not just a one-way information flow. They mark the beginning of a new dialog that lets patients ask questions about their care electronically and on a continual basis.
Though some physicians resent being judged by outcomes of their treatment, they are finding the technology behind patient engagement useful. An orthopedic surgeon told U.S. News & World Report that when post-op patients send him photos, he spots problems like blood clots sooner.
Patient engagement is about keeping patients at home, but encouraging them to stay connected to health professionals through monitoring devices and telemedicine. For older patients, such connections can help them pass down savings to their families instead of spending it on expensive nursing homes and assisted care facilities. It’s not just the patient who needs to be engaged. Doctors, nurses, aides, case managers, pharmacists, physical therapists, and family members are all part of the new web of connectivity, providing continuous off-site care.
Monitoring patients’ behavior patterns is just as important as tracking their physical health. Falls and mental health issues are strong predictors of readmission. Identifying patients who need help with psychological issues is hugely important. These patients need extra attention to ensure that they follow up with their treatment plans.
The form the engagement takes depends on the patient. Younger patients are comfortable with texting, which has also been used successfully with pregnant women and HIV/AIDS patients. Many older patients can be equipped with monitoring devices that they can wear at home.
Young or old, patients who are engaged in their medical care have better results. And so do the hospitals and clinics that serve them.