POCP Blog

By Michael Solomon, PhD, MBA, Practice Lead, eCare Management

Everyone is talking about ways to engage patients in their healthcare. Payers, providers, pharmaceutical manufacturers, and HIT vendors are making major investments in personal health management systems (PHMS). Consumers are embracing mobile health.  This surge of interest begs the question: are these technologies really helping to develop more engaged patients? The healthcare community can’t answer this question without a clear picture of what an “engaged” patient looks like.

An ambitious goal without a robust measure of success

Policy makers at HHS deserve credit for raising awareness of providers’ need to get serious about engaging patients to achieve significant and sustained improvement in health outcomes. To achieve meaningful use, hospitals and healthcare professionals are being held accountable for providing patients with access to their EHRs. Patient satisfaction is a key measure in a growing number of performance programs (e.g., CMS hospital value-based purchasing ).

While engaging patients to improve health outcomes is exactly where the focus should be, a patient who is accessing an EHR and is happy with his or her provider is not necessarily engaged. If healthcare’s leaders want to move the needle on outcomes by developing more engaged patients, the bar must be raised beyond these narrow measures.  An engaged patient is an individual who is actively self-managing his or her health – with the knowledge, skills, and confidence to do so.

System Use + Patient Experience + Patient Activation = An Engaged Patient

Now is the time to step back and establish a measure of successful patient engagement to guide the development of PHMS applications that truly contribute to better health outcomes.  For a PHMS to be effective, it must be used in a meaningful way to help the individual become a more activated patient. Plus, the patient’s overall experience with the system must be positive.  This occurs when the time spent using the application is found to be so convenient, relevant, and so useful that the person eagerly recommends it to others.  Blue Button and its mobile counterpart iBlueButton exemplify the positive patient experience. A patient can use iBlueButton to easily access from anywhere (the convenience factor) his/her personal health information (the relevance factor) and share it with doctors and pharmacists (the useful factor).

The need for taking a multi-faceted approach to engaging patients became clear while I was conducting research at a regional healthcare system. The goal was to help patients become more engaged by using a PHMS.  Here I learned:

• Sustained use of the PHMS did not always result in more activated patients;
• Patients with low activation expressed satisfaction with the PHMS;
• However, patients showing the greatest improvement in activation were frequent users who reported a positive experience.

A PHMS engages patients in a way that will lead to better outcomes when using it is a positive experience that increases a patient’s level of activation and makes the individual use it more, which further enriches the experience, increases activation, and so on.  I call this model health IT for patient engagement effectiveness – HIT-PE² for short.  You can learn more about it in the JHIM Winter 2014 issue. Adoption of HIT-PE² will bring us closer to building PHMSs and mobile health apps that really do engage patients in ways that lead to better health.

From your perspective, what are the factors that determine how well a HIT application helps a patient become more engaged in his/her healthcare? 

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