From The Editor | September 6, 2012

The Shocking Truth About Patient Engagement

By Ken Congdon, editor in chief, Health IT Outcomes
Follow Me On Twitter @KenOnHIT

The final rule for Stage 2 Meaningful Use was handed down by ONC last month, and I, for one, was encouraged to see that the requirements surrounding patient engagement were largely upheld. Patient engagement was the focus of much debate during the Stage 2 commenting period. The AHA (American Hospital Association) was one of the most vocal opponents of the patient access and engagement requirements, arguing that these objectives were contradictory to HIPAA privacy rules and would be extremely difficult for hospitals to achieve. Based on this and other feedback, the ONC compromised a bit on the achievability front by reducing patient engagement measures from 10% to 5% in the final rule. Otherwise, the ONC’s commitment to enhancing patient engagement and patient/provider communication remains at the center of Stage 2 MU.

Patient Engagement Nearly Nonexistent Today

So, why all the fuss about patient engagement? Is this step really that important to fixing our broken healthcare system? The short answer to this question is an undeniable “yes.” In my opinion, no other initiative will have as significant an impact on improving the quality of patient care and cutting healthcare costs as patient engagement.

My opinion isn’t based on a whim, but on some fairly staggering statistics. For example, a recent study by TeleVox and Kelton Research exposes the sorry state of patient engagement in the U.S. According to the study:

  • 83% of Americans don’t follow treatment plans given by their doctors exactly as prescribed
  • 42% of Americans feel they would be more likely to follow their prescribed treatment plans if they received encouragement and coaching from their doctors between visits
  • However, 55% of providers say they don’t communicate with patients between visits and 50% of healthcare professionals believe their job begins and ends during regular office visits   

Patient Engagement Delivers Real, Measurable Benefits

Okay, so patient engagement hasn’t been a priority in our healthcare system. So what? What proof is there that an engaged patient actually results in better patient outcomes and reduced expenses? Well, Leonard Kish provides some compelling data on this subject in his article The Blockbuster Drug Of The Century: An Engaged Patient.

In his article, Kish references a 2009 study by Kaiser Permanente on coordinated cardiac care. This study showed that patients that enrolled in a coordinated cardiac care program within 90 days of a heart attack had an 88% reduced risk of dying from a cardiac-related cause than those that did not. Coordinated cardiac care teams at Kaiser were able to reduce overall mortality rates by implementing proven CAD (coronary artery disease) risk-reduction strategies (e.g. lifestyle modification, medication management, patient education, lab results monitoring, etc.) and ensuring their patients adhered to the program.

Kish also cites the VA’s Coordinated Care and HomeTeleheath program as an example of the power of patient engagement. Through provider coordination and ongoing patient engagement and monitoring, this program was able to achieve the following results for its patients with chronic diseases:

  • 19.74% reduction in hospital admissions
  • 25.31% reduction in bed days of care
  • $1,600 average annual cost per patient versus a $13,121 annual cost per primary care patient not enrolled in the program
  • 20% to 57% reduction in the need for patients to be treated for chronic diseases such as diabetes, COPD, heart failure, and depression

Results like these are hard to come by from any initiative, and are a testament to the importance of patient engagement. As Kish states in his article, if a new drug showed this kind of effectiveness, it would be considered the blockbuster drug of the century and providers would be accused of malpractice if they didn’t use it.

Granted, changing the nature of patient/provider interaction won’t be as easy as popping a pill. In fact, it will likely be a long, and sometimes painful, process. However, the benefits of patient engagement are real and overwhelming. We need to move in this direction as an industry if we truly plan to address the issues that are currently crippling the U.S. healthcare system.