Patient Engagement Occurs One Step at a Time

These strategies can involve peer support or learning problem-solving skills. "Provider support makes a very big difference with giving people strategic help in how to learning how to manage conditions and monitoring set goals," she said.

Later on, the patient can becomes more persistent in asking questions when they don't understand something in the medical encounter. "Turns out only the most activated [patients] do that, and sadly it's only the most activated who know where to get quality information and actually use it," she said.

"Many of the things that we are asking consumers to do are actually well beyond many of them," she said. "So, thinking about what is realistic—and helping people break them down into smaller steps—is going to help people to feel that they can actually [become more engaged]."

Activation and engagement are important because they are related to better outcomes, she said. She cited earlier studies where more engaged patients are found to be less likely to be readmitted to hospitals within 30 days of discharge. Patients who are engaged also have been found less likely use emergency rooms for care.

In one Kaiser Permanente study, measuring the activation level among diabetic patients was found to correlate with hospital readmission rates within a two-year period: Higher rates of engagement were related to less hospitalization.

"What we've learned overall is that we can do a better job," she said. "We know that we can help people gain in their confidence and their skills and ability to self-manage, but we have to move away from a one-size-fit-all approach. In doing so we can do a better job."

"And, we don't have to throw people into the deep end of the pool."