Patient engagement: The hospital leader's 3-step roadmap

This is an opportunity for healthcare to catch up to consumers who are already accustomed to interacting with technology in a variety of ways while also strengthening the relationship between the patient and the care team.

 [The following content is sponsored by athenahealth.]

Patient engagement is often framed as an extra step hospitals and health systems must take to help patients become active participants in healthcare decision-making, treatment and wellness.

But rather than an extra step, there is another way to look at engagement: It is healthcare's chance to catch up to what consumers already expect.

Patients are accustomed to technology as part of everyday life. They use mobile devices, texting and email to stay in touch, and technology platforms let them complete a range of interactions every day. The ability to purchase airfare, make dinner reservations, check bank statements and complete educational courses online has made life easier, more convenient and more delightful for many.   

Now people expect to interact with their care teams the same way, an option that was cumbersome if not unthinkable for years. What is called "patient engagement" is really the industry catching up to patients' expectations and standards. When you look at it this way, hospitals and health systems are just getting started, and many leaders are unsure about how best to proceed.

First step: Define the vision
There is no "one-size-fits-all" approach to patient engagement. The first step leaders must take is customizing what patient engagement will look like in their organization. Defining this vision will ensure the organization pursues the new patient relationship with a focused, granular understanding of what it entails.

Patient engagement requires buy-in from every facet of a hospital. It involves the entire care team, family, administration and staff. Each aspect is critical to a successful patient engagement strategy.  

Individuals and families should be encouraged and treated as active participants in their care and decision-making. But healthcare is local and personal, and one engaged patient may look different from the next. Here are some characteristics and behaviors that may define an "engaged" patient:

·    The patient participates in shared decision-making with his or her care team.
·    The patient accesses their personal health records online.
·    The patient engages in wellness activities and preventive care.
·    The patient adheres to treatment plans and medication regimes.
·    The patient seeks health information and knowledge.

Secondly, the healthcare team should be prepared and supported to collaborate with patients, families and other members of the care team. When a hospital's leadership, staff and providers are involved in creating the patient engagement vision, they are more likely to be enthusiastic about implementing it. Rely on policies and procedures when moving forward with patient engagement. Share the benefits of patient engagement with staff and providers often so they understand the reasons for every change implemented.  

Finally, the organization should encourage collaboration, maintain accountability and integrate the patient and family perspective into all parts of strategic planning. Leaders should consider input from physicians, nurses, medical assistants, administrators and staff when selecting the tools and resources they will use to meet their engagement targets.    

Second step: Fuse technology into the culture to support patient engagement  
Where does technology come in? Patient portals are a staple in any patient engagement strategy. They lay the foundation for this relationship. Portals also let hospitals and health systems tap into the consumer expectation for technological access to healthcare information and secure messaging capabilities. As hospitals establish patient engagement strategies with a balance of online, live and automated services, patient portals are a critical element and provide user-friendly features like online bill pay, patient registration, appointment scheduling and lab results.

But portals are not silver bullets. For a technology platform to work, leaders must first establish cultures of engagement within their organizations. Make sure staff is on board with the relationships they are expected to build with patients and families. Support from physicians, nurses, medical assistants, administrators and staff is critical to patient engagement, so ensure they are comfortable with the tasks they must complete and how a portal may change their daily workload.

Help your teams understand how patient engagement will actually decrease the amount of monotonous or zero-value-added tasks staff face daily. This will let them focus more of their time and energy on more important work or time at the patient bedside. Technology can put action back in the hands of patients, letting caregivers and staff focus on tasks of higher priority for the organization.

There may also be concerns that patient messaging will take up clinical time. But studies have shown secure messaging actually improves workflow for clinicians. A 2013 report from the Ponemon Institute found the average clinician wasted more than 45 minutes per day due to outdated communication technology. The inefficiency of pagers and email and lack of texting capabilities were top reasons cited for this wasted time. Deficiencies in communication also slow down patient discharge, which can exceed 100 minutes on average.

When a hospital has achieved a culture that supports patient engagement, staff, physicians, nurses and other care team members encourage patients to use the portal. Here are a few tips for how best to do so, depending on patients' preferences.

·    Promote the portal to existing patients and with new patients as they come on board. Make the benefits of using the portal clear, and provide incentives for patients to use it.
·    Ask providers to talk with patients about how the portal can improve their experience.
·    If necessary, walk patients through registering for the portal, and show them how to do tasks they do regularly.
·    When someone calls to do a task that they could do on the portal, walk them through it using the patient portal and encourage them to try it next time.
·    Try to understand and address any hesitancy or concerns with using the portal.
·    Rely on the patient portal for as much of your communication to patients as you can. The more you use it, the more they will too.
·    Accept that some patients will not use the portal. Make sure it is consistently an option so they have opportunities to change their mind.

Third step: Measure success and prepare for change
Use your patient engagement vision to set achievable targets and ways to measure progress. Patient portal adoption and patient satisfaction rates are two other basic, yet incredibly important, measures for hospitals and health systems to track and monitor on an ongoing basis. Depending on your vision, your practice may also want to track metrics such as patients' understanding of how an intervention will help with health goals, how patients are using technology to progress toward health goals and any changes in confidence in managing their own health.  

At the very least, leaders should consider monitoring how many patients have signed up to use the patient portal, how many email addresses have been collected, or how often patients connect with providers and staff through the portal. To encourage continued success, establish a rewards or recognition system to celebrate providers and staff when goals are reached.

It may take time to see outcomes in patient engagement. Patients who have adopted the patient portal may not have another interaction with the office for some time after they sign up. You will probably first see a time savings from reporting lab results on the patient portal and answering messages instead of patient calls. Check in with everyone in the practice to review the adoption results and talk through what processes from your original plan are working and which are not. Ask for suggestions on how to improve the processes, and then integrate into your plan any new procedures that might be effective as well as adjusting any that are not working.

Finally, make sure the patient engagement strategy and technology solutions are flexible enough to accommodate inevitable change and practical for maintenance across an integrated system. Cloud-based solutions can roll out changes and updates to everyone on the network simultaneously. Consider working with vendors that prioritize service, innovation, connectivity and partnerships, so the hospital benefits from both cutting-edge tools and long-term expertise in patient engagement solutions.

Patient engagement is a continuous process of collaboration between patients and providers that is essential to achieving the triple aim of healthcare. This is an opportunity for healthcare to catch up to consumers who are already accustomed to interacting with technology in a variety of ways while also strengthening the relationship between the patient and the care team. Hospital leaders must define their vision for engagement, build a culture that supports engagement, fuse technology tools and support systems into that culture, then measure success and prepare for adaptation. Rather than seeing this as an extra step, hospitals and health systems must view patient engagement as the new normal.

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