The Provider's Role In Patient Engagement

Compiled by Scott Westcott, Contributing Writer

Two forward-thinking providers share how new technology and engagement tactics are helping their patients play more active roles in their own health.

Patient engagement is emerging as a clear competitive edge in the healthcare space. With the Affordable Care Act instituting measures of “quality of care” and “patient satisfaction,” and patients seeking more active roles in their own healthcare, providers are accelerating efforts to drive deeper engagement. A key to that effort is implementing technology such as patient portals that provide patients unprecedented access to their information while also creating new efficiencies for physicians and healthcare providers.

Yet the path to deeper engagement holds considerable challenges, from back office IT issues to encouraging more adoption by both medical professionals and patients. Maleigha Amyx, IT director, Rockcastle Regional Hospital and Respiratory Care Center, and Allen Weiss, M.D., CEO & president, NCH Healthcare System, shared insights on their organizations’ roles in increasing patient engagement.

Q: What technology investments have you made to meet the patient engagement requirements outlined in Stage 2 MU? How effective have these investments been?

Amyx: We invested in a cloud-based solution from MEDHOST called YourCareCommunity. This solution is a patient-engagement platform that connects everyone on a patient’s care team, including the patient, with the goal of improving care and the patient experience by sharing information online in an easy-to-use system. We have received quite good responses from our patients. Because deploying a patient portal is a multifaceted effort, we focused resources on supporting the product internally and ensuring there were people available to educate patients and assist with sign-up and accessing their medical records via the patient portal. It was important to us that we have staff on hand to really walk patients through the portal and help them understand how they can benefit from regularly accessing their health information online. This, of course, also helps drive patient engagement, which not only aligns with Meaningful Use efforts, but helps with patient satisfaction.

Weiss: NCH has been investing heavily in IT since the early 1990s. IT is the backbone of our organization, which is necessary, but not sufficient to provide value in terms of quality and cost for those we serve. We’re currently at HIMSS Level 6 and have aspirations to reach Level 7 by the end of the year. As such, we feel strongly that we have received return on investment. We were an early recipient for Stage 1 and are on track for MU Stage 2. Our strategy has been effective by outsourcing to experts while concentrating on what we do best — patient care. We are among the top 50 healthcare systems for cardiology, top 10 percent for cardiac care, among the 10 busiest systems for total joint replacements for Medicare patients, and have been awarded Pathways Designation among other accolades. IT is core to these accomplishments.

Q: Beyond technology, what changes have you made to encourage and document patient engagement?

Amyx: In addition to raising awareness among staff, clinicians, and patients, we changed processes. One of the key initiatives we established was working with registration clerks to give patients information about our patient portal during registration. This introduces the portal right at the beginning of a patient’s care experience. It’s important to note that work related to a patient portal and engaging patients is an ongoing effort. It is most effective for hospitals when it’s part of their overall population health management strategy, which, of course, has patient engagement at its core.

Weiss: We have a patient portal, which is maturing and will be shared more extensively in the future. We’ve also partnered with Stericycle Communication Solutions to implement a high-touch patient communication strategy by sharing comments of recently discharged patients with their caregivers. By sharing information quickly we have been able to understand other folks’ points of view. By combining effective communication technology with a human touch element, we are able to communicate with our patients in ways in which they are most comfortable, thereby increasing overall engagement. Additionally, physicians have access to “Ask Mayo Expert” at their fingertips, as we are members of the Mayo Affiliate Network and UpToDate (an evidencebased, physician-authored clinical decision support resource). As we continue to harness the power of being digital, we can create and embrace evidence-based medicine. Through leveraging Big Data, we can work toward understanding the efficacy of various treatments in a multitude of situations. “Super Crunchers,” by Ian Ayres, makes the point effectively that healthcare is just now taking advantage of past experience to predict the future for patients.

Q: What have been the biggest challenges in your patient engagement journey?

Amyx: Getting inpatients accustomed to having a portal — and using it — has been the biggest challenge. This should be expected when anything new is introduced, whether it’s getting clinicians to adopt a new EHR, or with something patient-facing like a kiosk or patient portal. Many times, communication is the key to growing adoption, so we are working on applying some marketing to raise awareness of the portal among staff, clinicians, and patients.

Another big challenge I believe any hospital will have when introducing a patient portal is working with older patients who might not be as comfortable with computers, the Internet, and new applications. Demystifying patient portals, while at the same time showing patients and their representatives (especially in the case of geriatric patients) the many benefits of using our patient engagement platform, will help drive adoption of the portal. As a result, patient satisfaction grows because patients have online access to information about their own care, which encourages them to be more proactive in their care plan and work to stay healthier.

Weiss: Change management is difficult. Old habits die hard, and embracing disruptive technology that shifts the focus from a physician to empowering a patient as information asymmetry vanishes is a tough pill to swallow. Little by little, as new, young physicians join the team, we are changing and continuing to improve our engagement strategies. It is a slow and arduous process, but perseverance counts, and if you do the right thing often enough, you get the right result.

Q: What patient engagement success stories can you share?

Amyx: Patients love that they can get online and quickly and easily access their medical records to see things like lab results. The portal gives them ready access to information they previously had to ask for, so there’s definitely value in that. And, as with anything, value drives patient satisfaction. Having a portal makes it so much easier for patients to take a more proactive role in their care plans and ongoing health, long after they’ve been seen at our facility. They feel more informed and more empowered, and that’s important to us and to them.

Weiss: Patients are drawn to systems that are competent, though this can be hard for a patient to judge. As we’ve become more transparent with our patients, we have seen increased engagement. Soon we will be involved with Telehealth starting with chronic congestive heart failure and acute stroke care.

Q: What advice would you provide other providers striving to improve patient engagement?

Amyx: Introducing something like a patient portal takes extra resources, so make sure you have all of the resources you need going into the project and even after the portal is up and running. We were very surprised at how engaged the outpatient community has been, so it’s clear that patients truly desire access to their health information. This is why it’s critical to have resources available to not only ensure a smooth rollout, but also help grow adoption and manage patient needs in the long term.

It’s also important to engage patients early in the process, especially while they’re still receiving care in your facility. For example, having staff talk with patients and their representatives about how to engage via the patient portal gets them thinking about using the portal. Also, it’s a huge benefit if your facility has marketing people who can develop a brief pamphlet or brochure about the portal that addresses the value and importance of patient engagement overall. It’s a cliché, but it’s true — information is power. In today’s world of healthcare reform, everyone in the hospital, from clinicians to IT staff, needs to be focused on what we can do to help engage with patients to take a proactive role in their own care plans.

Weiss: My advice is don’t underestimate the cost and time it takes to become facile with IT. I had a famous neurosurgeon at Columbia Presbyterian tell me, “You don’t go to the OR to save time, and you don’t go on vacation to save money.” IT costs in time, energy, and money — don’t skimp, or you will be sorry. Staying persistent and engaged always takes longer, costs more, and sometimes fails the first few times, but hang in there, because you can’t do without IT.