Over the past several years, the healthcare industry has witnessed a paradigm shift in terms of how patients view their involvement in their care and what the role of the caregiver should be in educating consumers. General industry thinking has been that patients want to take a more active role in their care, giving rise to terms such as "patient engagement," "patient activation," and "healthcare consumerism."
This line of thinking is contrary to the caregiver-centric view, in which the clinician directs the patient's care as well as the outcome, and the patient is a passive recipient. But do patients really want to be engaged in their care, and do care givers know how to promote patient engagement or patient activation successfully? The answer is both "yes" and "no." While patients want to be involved in their healthcare, they also want the medical community to start paying more attention to their needs and wants, instead of being told what to do. Interestingly, the end result of this debate is one that brings patients and caregivers closer together in a more meaningful and productive relationship. This starts with seeing the patient as part of the care team and changing the roles both patients and providers play as part of that team. To begin:
Know the Patient First
The definition of patient activism is "the understanding of one's own role in the healthcare process and having the knowledge, skill and confidence to carry it out."
Many translate this into "teaching the patient" versus asking the patient what they need. The first step, is for physicians and caregivers to take the time to know their patients; understand what's important to them; determine their personal health goals and treatment preferences, and how these goals and preferences support the healthcare system's desire for high-quality and cost-effective care.
Technology plays a crucial role in the discovery process. In a recent survey from WebMD, 84 percent of patients say they should be able to use technology to help their physicians make a diagnosis. A majority of physicians surveyed concur. The opportunity lies in using technology to aid in the discovery of the mutual needs of both the patient and the care provider. By integrating actual clinical and patient-derived data with clinical decision support, a clinical profile can be created that can:
Better inform the patient about their healthcare, and;
Direct the system into asking questions that help identify patient goals, preferences and issues to help providers more effectively dialog with the individual about their healthcare preferences rather than simply telling a patient what they should do to manage their health.
Make the Information Actionable
A 2013 ONC survey revealed that, of those patients that did not access their health records, 74 percent did not do so because they didn't use the information offered. Most likely, the information was not framed in a way that was relevant to a decision or action they needed to take in their life.
A person's interest in their care varies, based on factors such as age, lifestyle, education and their specific disease or condition. Their involvement is greatly influenced by how clinical information is presented. Making that information specific, actionable and relevant, as well as easy to understand and digest, will most likely generate more involvement by the individual in terms of how they collaborate with their healthcare provider.
Provide the Right Tools
Successfully engaging patients in their healthcare is measured by two things:
Making an informed decision and,
Encouraging their on-going interaction and collaboration throughout their lives.
While it is important to continually engage patients through dialog and education, each interaction must be tailored to their specific needs and goals. Patient engagement is not a one-time deal but rather, a set of repeated actions that over time, build trust and continuity between patient and provider. This repeated interaction can be facilitated through the use of technology -- such as technology that enables electronic access to an individual's health information and provides intelligent tools to help them navigate a plethora of data. Incorporating technology with on-going patient dialogue offers a tailored, individualized approach to the most appropriate actions and behaviors.
Even with the right technology-enabled tools and open, honest dialogue between patient and provider, it is important to note that one size does not fit all. Instead, an approach that is tailored to the specific needs and preferences of the individual will help guide the right course of action toward the best clinical outcomes.
We in the health care industry in the healthcare community have to remind ourselves that patients do want to be engaged in their health care, but are also interested in engaging us in their lives and teaching us what it means to be true collaborators in their health. We just have to be willing to be engaged along with them.
Nita Stella is head of product strategy, Mana Health.