Healthcare systems are using high-tech and high-touch approaches to reach patients where they are and with what they need, but an actively engaged patient remains an elusive partner in care.
This article appears in the July/August 2015 issue of HealthLeaders magazine.
Providing a patient with clinical care that is safe, effective, and costs less all are high-priority issues competing for the attention of leadership at hospitals, health systems, and physician groups. Top organizations are developing new models of care with the patient at the center of this new paradigm, but it is the patient who is a key variable that can sink a system's efforts.
In the April 2014 HealthLeaders Media Intelligence Report, The New Primary Care Model: A Patient-Centered Approach to Care Coordination, 59% of respondents cited patient engagement as one of the most challenging clinical components of primary care redesign. But it can be argued that patient engagement is a sticking point no matter the setting.
At face value, the term patient engagement seems straightforward. For example, patients who come in for their annual wellness exams on time, or patients with a chronic disease like diabetes who are faithfully taking their medication, monitoring their blood sugar, and coming in for regular checkups would be considered engaged patients.
But providers are finding that there is a lot of nuance to defining a truly engaged patient, one who is an active partner in his or her own healthcare. Settling on a definition is difficult, and measuring it is even harder. Those who have successfully engaged patients in their care have done so with a combination of human touch and technology, as well as an understanding that patience is essential when looking for long-term success.
Patient engagement requires a culture of compassion
In 2009, Brenda Jones was 57 years old, weighed nearly 400 pounds, and suspected she had type 2 diabetes. With no insurance, a temporary job in Dallas, and a sick father to take care of, she first turned to the Internet for help because she didn't have a regular primary care doctor—nor the money to see one.
"My urine started smelling sweet," she recalls. "At first it was faint, but then it increasingly got more noticeable, and it was like, 'What is that?' So, I Googled it, and every hit that came up said type 2 diabetes. I went and bought a glucose tester, and my sugar tested 320 mg/dL. I knew a trip to the ER wasn't what I needed. I knew this was going to be long-term care. I needed medicine and guidance."
Jones was like 17% of adults in the United States and 33% of adults living in Dallas at that time: employed without health insurance. But lack of insurance was just one barrier Jones faced. She says her access to affordable and healthy food was limited, she didn't know how to start eating healthier, and making a lifestyle change seemed too hard to do on her own. "It was too much for me to figure out," she says.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.