If you ask people involved in Patient Engagement about how hands-on they are in their own health, the most common reply you will get would be something along the lines of, “I try to take care of myself by doing X or Y or Z.”
About 82% of US adults have a regular doctor whom they visit at least once a year with the average number of visits being 3 per year, which, in fact, is double the number of visits made by people with chronic conditions.
Obviously, one would think that this level of patient engagement would be immensely beneficial to physicians, administrators, health IT vendors and others involved. But that wouldn’t be correct. Let us see why.
Physicians, administrators, health IT vendors, etc. each, have their own definition of what patient engagement is. Let us see their definitions and how they measure patient engagement.
1. Physicians/Provider definition of patient engagement:
Maintaining appointments, even though it might be about 6-7 appointments annually, along with abundant self-care, would not count as patient engagement from the physicians’ perspective. Most patients do not do as they are told by their physicians – they are often non-compliant.
As numerous physicians equate patient engagement with patient compliance, the high non-compliance rates (30%-70%) that are seen these days suggest that a large number of patients are far from engaged. What the clinicians fail to realize is that up to 20% of non-compliance is a direct result of poor physician-patient communication and not lack of engagement.
2. Health IT Professionals and Vendors:
Health IT professionals neither consider “showing up” nor the level of compliance of the patient when it comes to defining or measuring patient engagement. The HIMSS (NeHC) Patient Engagement Framework would have you believe that the true patient engagement is all about the use of health information technology and the achievement of Stage 2 Meaningful Use, which means, as long as the patients use the right health IT tools, they are considered engaged.
What Health IT industry often overlooks is the fact that 85% of patient prefer to meet their doctor face-to-face when they feel the need. They are reluctant to let technology get in between them and their doctor.
The challenge however, the physicians and health IT professionals face, is not how to engage more patients, but actually, it’s about how to be more engaging to the majority of the patients who have already been engaged.
The reality is that health care is about everyone but the patient. Most physicians still relate to their patients using a peculiar communication style where they act as the clinicians knows best, does the most talking and makes almost all decisions for the patient. Patients are encouraged to be passive and compliant rather than being engaged.
Health IT treats patients as unwise and unneeded when it comes to engagement. They ignore the fact that 85% of adults want to be able to interact with their physician face-to-face whenever they want, regardless of their showing willingness to use secure email, patient portals or any other such technology. People are not unwise. They realize that Health IT wants to put technology between themselves and their doctor. A number of patients have stated that laptops and computers in the exam room interfere with the doctor-patient relationship. This is clearly not serving patient engagement.
The only certain technique to improve patient engagement is to be more engaging to the patient. Which means being more patient-centered. The patient-centered attitude should reflect in the things being done for the patient, the way physicians talk and listen to them, the way products and services are designed, and how patient engagement is assessed.
This includes obtaining the patient’s story, paying attention to their health beliefs, fears and concerns, comprehending their health information needs and interests, understanding their previous health experiences, and so on.
The patient has the major stake in their own health. This should never be forgotten. Besides, it’s not like they don’t have brains.