How patient engagement technology can improve health equity

Health disparities across gender, geography, socioeconomic status, race and ethnicity lines have an outsized impact on health outcomes. As providers and payers look to bridge gaps in care caused by such disparities, patient engagement can be an effective tactic.

During a November Becker's Hospital Review webinar sponsored by Health Catalyst, three healthcare leaders discussed how digital patient engagement technology is used at their organizations and what went into adopting and implementing it. Panelists were: 

  • Matthew Hoffman, MD, chair, Department of Obstetrics & Gynecology and director, Center for Women's & Children's Health Research, ChristianaCare (Wilmington, Del.)
  • Suzanne Quillen, RN, NP, vice president healthcare innovation, Ernest Health (Mechanicsburg, Penn.)
  • Emily Webber, MD, vice president & chief medical information officer, Indiana University Health (Indianapolis)

Three key takeaways were:

  1. Letting go of historic assumptions can be a powerful driver for engagement. One common assumption that may cause providers to give up on digital engagement before they have even tried it is that older patients are not interested in or capable of dealing with technology. Another assumption is not to view or treat individuals as patients until they have been seen in a brick-and-mortar location. The COVID-19 pandemic upended such assumptions and pushed organizations to leverage engagement tools despite previous long-held beliefs.

    "We had to address patients that didn't have established relationships with us and who we didn't know had access to broadband and other desktop technologies," Dr. Webber said. By providing reliable access to care, through whatever technology users had available, IU Health generated engagement, nonetheless.

    "There were many surprises, [including] the ability and skill level at which this population responded to the platform appropriately," Ms. Quillen said, referring to Twistle, a patient communication platform acquired by Health Catalyst. Ernest Health, which provides post-acute care to older patients, piloted the platform in 2020 with the aim of improving patients' ability to care for themselves after discharge.

  2. Informal caregivers must be envisioned and included in engagement approaches. Patient engagement includes all of the people involved in a patient's care, including spouses, children and parents. That means that communication and engagement strategies must be designed with all of these caregivers in mind.

    Dr. Webber, who is a pediatrician, said IU Health's engagement metrics show that children's caregivers usually open text messages within an hour of receiving them. "The metrics tell us we've designed something that is valuable and meaningful to them," she said, adding that providers should aim for platforms that report on engagement rates, so they can quickly make adjustments if they see users "falling away."

  3. To build the business case for investing in patient engagement technology, advocates should make an economic argument that the C-suite cares about. One metric that is particularly powerful to the C-suite is the cost of readmissions, which can be greatly reduced through effective patient engagement. "Just our hypertension program saves about $300,000 a month," Dr. Hoffman said.

    Once an investment has been made, it is necessary to have a human touch associated with such programs, such as a dedicated nurse reaching out to and following up with patients. "Technology makes us efficient in that we're reacting to abnormal [signals] and patients are reassured," Dr. Hoffman said. "But you need to make sure that someone who cares about driving the program is part of your journey, as you're not simply putting people into pathways and not thinking about them."

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