Patient Motivation a Must for Accountable Care

Proposed Stage 2 meaningful use criteria seek to ­expand upon these measures and add new measures that are relevant to patient engagement activities, such as providing and ensuring usage of both patient portals and ­secure messaging.

Target efforts to ensure high impact. Healthcare organizations will want to initiate their patient engagement activities-getting patients more ­involved in their own healthcare-in a manner that will ensure the greatest impact. For instance, avoidable hospital readmissions are one area worthy of attention since they are costly and, in the near future, will expose hospitals and healthcare organizations to financial penalties.

Rehospitalization is common among Medicare beneficiaries. Drazen notes that one study found roughly ­one-fifth of Medicare beneficiaries were rehospitalized within 30 days and cost Medicare $17.4 billion in 2004. Pneumonia, heart failure, and acute myocardial infarction are some of the most frequent reasons for readmission.

Starting October 1, 2012, CMS will begin reducing reimbursement for excess readmissions for these conditions and will begin targeting additional conditions in 2014. Hospitals and healthcare organizations stand to lose up to 1% of Medicare payments in the first year and up to 3% by the third year.

"By identifying and engaging hospitalized ­patients with these conditions first, healthcare organizations can establish contact and provide patients with the ­information and tools that they need to successfully manage their care at home and potentially avoid rehospitalization," Drazen and Lorincz write.

Consider logistical components. Physician practices should consider how best to initiate patient engagement activities and deploy ­available health IT tools. One method of launching patient ­engagement activities is to concentrate on point-of-care settings, beginning with the most ­costly setting and ­incrementally expanding to other areas, Drazen says.

Through the use of patient identification tools, ­healthcare organizations can identify hospitalized ­patients and establish contact with them prior to discharge.

Similarly, healthcare organizations can also ­establish contact with other "seen" patients as they attend scheduled office appointments, Drazen says. "­Healthcare organizations can then reach out to ­other ?unseen' patients by sending out educational ­information, reminder notices to schedule wellness visits, and other information."

"This would aid in reestablishing contact ­between ­patients and providers and help better engage ­patients," Drazen and Lorincz write. "Once ­connectivity is ­established with patients, healthcare organizations can then equip them with self-service and self-care tools over time."

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