Patient engagement: Compliance requires more than a carrot

Only a small percentage of humanity is quick to alter their daily habits upon learning of a better, healthier lifestyle.

The majority of us are a bit too engrossed in our life patterns to be willing to change. Though certain consumer decisions can be influenced by incentives alone, most of our lifestyle choices are more engrained and require more than a coupon or happy face emoji to draw us out of the entrenched ruts of our lives. The truth is, and always has been, if you want to actually modify the behavior of a person, an organization, or a population in a lasting way, there must be a clear incentive to go in a new direction and an equally clear incentive not to turn back.

We can see evidence of this within the healthcare industry in the Centers for Medicare & Medicaid Services' efforts to transform patient engagement and payment models. Though some forward-thinking health organizations were early adopters of CMS's initiatives to improve the patient experience and outcomes while reducing costs, it required CMS tying reimbursements to quality and outcomes and potential fines to high rates of readmissions in order to move the industry forward. For providers to experience success and therefore bring about lasting change, however, it will require that the patient become an aligned partner in this evolution as well.

Similar to CMS's "carrot and stick" model of driving change on the institutional level, it will require the same type of engagement with patients: incentives for patients to become active and aligned partners in their own episodes of care and even clearer incentives to not return to a dependent posture of waiting to be told what to do and when to do it. Though many doubt that patients would be willing to take on responsibility for their own care, this perspective lacks understanding of the deeper needs of humanity. The reality is that humans both love and need some sense of control. In fact, a feeling of awareness and control ("safety") hovers right above Maslow's baseline of physiological needs.

Thus, the incentive forward requires a robust body of education and actionable guidance prior to and throughout a patient's episode in order to satisfy this need and empower them to be a partner in their care. By proactively engaging the patient to manage their expectations and encourage them towards an active role, it enhances the patient's experience, their level of satisfaction with their physician and healthcare provider, increases their confidence and improves their outcomes.

However, in order for the provider and payer to gain the full benefit of improved patient satisfaction, cost reduction and risk mitigation that arise from the proactive patient, it needs to be a standard upheld by a majority of the patient population. In order to achieve this, the "carrot" needs to be supplemented with a "guiding staff" of actionable supervision and accountability in order to address those patients that may revert to former patterns of disengagement and inactivity. Rather than being treated as a "free resource available to patients," an effective program will be prescribed and communicated as a mandatory pathway. Additionally, the patient needs to know that their clinical team has a clear window into their compliance characteristics throughout their episode of care and that their activity, from education and coordination tasks to symptomatic and progress observations are being tracked and reported within a closed-loop notification system.

Though there are many claims of technology solutions that engage patients for the improvement of outcomes, authentic engagement that impacts the patient experience and outcomes requires very robust platform capabilities that proactively support the patient as described above. In determining the efficacy of such solutions, a high bar should be used to measure the integrity of the platform capabilities and resulting benefits. With the right balance of "carrot" and "guiding staff," all stakeholders stand to benefit.

David Brown is the chief executive officer and founder of VOX Telehealth, a leader in the development of procedure-specific, patient engagement solutions. David brings more than 20 years of entrepreneurial experience across several industries, including behavioral healthcare, technology, banking, and retail. David has a deep appreciation and understanding of engaging patients effectively having previously spent a decade overseeing patient engagement for a multi-state behavioral healthcare practice.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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