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Podcast length – 52:39

Patient Engagement in Healthcare – How is it defined, does it have a significant on improving health and reducing the

cost of care, what engagement initiatives are providers using, and what will future engagement look like?

Brad Tritle

Topics Covered in Podcast:

Definition of patient engagement and how it manifested as a Stage 2 Meaningful Use Requirement

Patient engagement federal mandate parameters

The essential elements of a practical and feasible patient engagement initiative beyond patient portals

The relationship between patient centered care and patient engagement

Healthcare provider patient engagement performance and examples of successes and failures

Topics Covered in Podcast (continued):

Healthcare provider patient engagement obstacles

The future of patient engagement

• The industry has yet to agree what the definition of patient engagement is

Patient Engagement Defined & Why It’s a Part of Meaningful Use Stage 2

• The Center for Advancing Health Behaviors provides the best framework:

“Actions individuals must take to obtain the greatest benefit from the healthcare services available to them.” • The patient engagement movement originated from the convergence of

three sources: • #1 - Institute for Healthcare Improvement’s (IHI) “triple aim” which is:

• To improve the health of populations • To decrease the per capita cost of care • To improve the patient experience (which includes satisfaction)

• #2 - National Quality Forum • Established “National Priorities Partnership”

• Provided input into the “National Quality Strategy”

Patient Engagement Defined & Why It’s a Part of Meaningful Use Stage 2 (continued)

• Specifically, “Patients and families need to be involved in their own care.”

• #3 - The Office of the National Coordinator for Health

Information Technology (ONC) • Released a National Health IT Strategic Plan

• Goal #4 states, “Empower individuals through Health IT to improve their health in the healthcare system”

• Ultimately the Congress appointed Federal Advisory Committee established a Health IT Rules Committee that added engagement as part of Meaningful Use Stage 2

• Patient engagement goals requires that patient action will be more than

5% of a practice’s patients sending secure messages to the provider and more than 5% of the patients accessing their health information online

Patient Engagement Defined & Why It’s a Part of Meaningful Use Stage 2 (continued)

• Core objective #7 requires the healthcare provider to provide patients the ability to view online, download and transmit their health information within four business days of the information being available

Did you know? Communication continues to be a basic hindrance to healthcare relationships. – 50% of seniors do not bring a list of questions to cover during appointments with their doctors and more than 60% of seniors do not regularly bring a list of medications to their physician appointments. One-quarter of seniors never bring a list of medications.

Patient Engagement Federal Core Objective Parameters

• Core Objective #7 • Healthcare providers must allow patients to view, download, and

transmit their health information within four days of their visit Measurement: The provider must make the information available to 50% of all the unique patients seen while in turn, more than 5%* of all unique patients seen must view, download, or transmit their health information

• Core Objective #17 • Requires the use of secure electronic messaging to communicate

with patients on relevant health information. This will be measured by more than 5% of unique patients sending secure messages using the messaging function of your Certified EHR.

Measurement: More than 5% of unique patients must send secure messages using the messaging function of your Certified EHR *Originally discussed that the threshold should be 10% before it was changed to 5%

Patient Engagement Federal Core Objective Parameters

• The question becomes: 100% of patients can access their medical information electronically, but how many actually will?

Did you know? Stage 2 of the CMS EHR Incentive Programs will begin in 2014 for those Eligible Professionals (EPs) who have completed two stage 1 reporting periods. Stage 2 includes new objectives to improve patient care through better clinical decision support, care coordination, and patient engagement.

Essential elements of a practical and feasible patient engagement initiative beyond patient portals

• Most people look to patient portals as the first step of engagement • Some providers are offering patients the ability to download their

information and store in in a data repository like Microsoft HealthVault – allows patients to combine health information from multiple providers and medical devices

• Social media provides an interactive platform to engage patients Examples:

• Blogging (knowledge sharing) – gather a list of commonly asked questions by patients and dedicate a blog post to each (e.g. – “The Top 5 health concerns for a 2 year old.”)

• Facebook, Twitter – Establishing a page/tweet stream for healthcare organizations can help build communities and trust through quality engagement

• Videos – developing short clips that answer common patient questions and creating v-logs

(video blogging), a YouTube channel or both!

• Key tip - Healthcare providers unsure of whether social media is relevant should start by identifying where their patients are and then listening before developing a strategy

Essential elements of a practical and feasible patient engagement initiative beyond patient portals (cont.)

Did you know? The Journal of Internet Medical research reports that 60% of adults use the Internet to find desired health information.*

*Social media sites are emerging as a potential source for online health information. However, little is known about how people use social media for such purposes. – via The Journal of Medical Internet Research)

Essential elements of a practical and feasible patient engagement initiative beyond patient portals (cont.)

• As more patients turn to peers for advice about healthcare, social media will become more prominent in provider communications strategy

• Social media is evolving into a competitive advantage for healthcare providers who understand how to effectively use it – it helps attract and retain patients

• Patients will communicate with or without your presence on social media

Did you know? A recent report by Nielsen revealed that 92% of participants recognize that the greatest source of influence comes from the people closest to us.

Relationship Between Patient Centered Care and Patient Engagement

What is patient centered care? • Patient centered care – supports active involvement of patients and

their families in the design of new care models and decision making about individual options for treatment • The Institute of Medicine defines patient centered care as,

“providing care that is respectful and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.”

How does patient centered care work with patient engagement? • In some medical facilities, patient engagement facilitates patient

centered care • There is a definite need to have informed, activated, and engaged

patients

Relationship Between Patient Centered Care and Patient Engagement

• Patient engagement tools help prime active and engaged patients – basic care questions can be answered via tools so physicians can concentrate on deeper issues

• Health Information Exchanges (HIEs) were created for providers but patient has become central steward of information exchange – engagement enhances patient role as information liaison

• In order for patients to take action they need: • To be informed • To have tools

• Patient engagement tools help facilitate collaborative healthcare decisions between provider and patient and fosters a patient centric environment

Patient Engagement Performance and Examples of Successes and Failures

• Meaningful Use Stage 1 saw over 11,000 providers offering patients

timely access to electronic information (e.g. – lab results, allergies, medications) – providing access seems to be a success

• The ability to download, view and transmit data is still a work in progress • Direct transfer of information from a provider to a patient vis a vis an

account like Microsoft HealthVault is on the rise • Secure messaging has proved to be an effective and efficient tool • Medicare experimenting with providing access to personal health records

(PHRs) through patient portals • Traditional PHRs are on the decline because of their inability to store real

clinical data

• Kaiser Health is seen as an healthcare industry patient engagement benchmark – over 2 million patients actively use their portal

Industry Benchmarks

Patient Engagement Performance and Examples of Successes and Failures (continued)

Industry Benchmarks (continued) • Mayo Clinic and their work with patient portals is another example of a

patient engagement industry benchmark provider

• In a Healthcare Information and Management Systems Society (HIMSS) 2013 Leadership survey asking: “What are your priorities for health IT?” • 28% of respondents said Meaningful Use • 20% of respondents said optimizing their current system • 2% said consumer related healthcare issues

• Effective patient engagement is evolving into a tool to attract patients • It is in a healthcare provider’s best interest to make consumer

engagement a priority • Providers can place themselves at a competitive advantage & increase

the quality of their services through patient engagement

Patient Engagement Performance and Examples of Successes and Failures (continued)

• Successful patient engagement is also found to lower accounts receivable

Did you know? 83% of Americans don’t follow treatment plans given by their doctors exactly as prescribed. 42% of Americans feel they would be more likely to follow their prescribed treatment plans if they received encouragement and coaching from their doctors between visits.

Healthcare Provider Patient Engagement Obstacles

• Patient portal costs can be prohibitive • Remaining reactive vs. being proactive • Failure to shift to a more patient centric data model (e.g. – not providing

patients with the opportunity to accumulate data from multiple providers)

• Paradigm shift – failure to evolve into a collaborative patient care model • Reimbursement structure – how engaged can you be with patients in a

fee for service model?

Did you know? Patients who had access to their online records and who may have taken advantage of other features on a patient portal used the healthcare system more than those who didn't participate in the portal, according to a study by researchers at Kaiser Permanente.

New Book on Patient Engagement: Engage! Transforming Healthcare Through Digital

Patient Engagement • Available at HIMSS Web site: http://bit.ly/19V4Czb

• Collaborative effort between several healthcare professionals • Wide range of provider viewpoints represented – from small town

practices to provider behemoths • Contains case studies and recommendations in each chapter that can

implemented by even small, private physicians • Contains information on what Payors, Pharma, and patients themselves

are doing around patient engagement • Possible missing pieces of patient engagement outlined in book:

• A single, longitudinal, interoperable medical record under the patient’s control that crosses providers – in order for providers to make the right decision, they need access to the right information

• Patients should proactively set up their own online medical records that aggregate health data into one single repository (e.g. – Microsoft HealthVault)

The Future of Patient Engagement

• Clinical data flowing to patient personal health platforms will spur growth and use – must be deployed by entities that the public trusts (insurers, providers, etc.)

• We will continue to see healthcare apps flourish as patient engagement shifts to mhealth platforms – apps that physicians prescribe and may be reimbursable under insurance

• Medical monitoring devices will become smaller, cheaper, and more interactive and passive to spur more patient engagement

• More social media functions will be built into medical applications

Thank you to Brad for his time and knowledge for this podcast!

To learn more about Brad’s current project, please visit: www.vitaphone.com

John Trader PR and Marketing Manager M2SYS Healthcare Solutions

1050 Crown Pointe Pkwy. Suite 850

Atlanta, GA 30338 jtrader@m2sys.com

770-821-1734 www.m2sys.com

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