Patient Engagement: Informing and Sharing When the Consumer’s Well-Being is At Stake

By Jane Moffett, RN, CCRN
VP, Product Management – Therapy, Net Health

Consumer habits have changed drastically over the last several decades, so much so that the way consumers previously interacted with a vendor is almost unrecognizable. Many of these differences are the result of technology, which has molded our consumers into quite a savvy group.

They want to be informed, there’s a high expectation of self-service, and they desire contactless interaction with 24-hour access.

When the consumer is a patient, he or she has even higher expectations. They are not just purchasing an item. Their well-being, independence and very lives may be at stake.

This is where the importance of high patient engagement comes into play.

What is Patient Engagement?

Patient engagement (PE) is described as the desire and capability to actively choose to participate in care in a way uniquely appropriate to the individual – in cooperation with a healthcare provider or institution – for the purposes of maximizing outcomes or improving experiences of care.¹

One of the first steps in understanding the effectiveness of PE is defining the different kinds of engagement. This involves asking the following questions:

• Are there positive outcomes related to high engagement with these kinds of consumers?
• Is the effort that the healthcare provider makes to engage patients worth their time and investment?
• What kinds of engagement are needed for different kinds of patient relationships?

There are several different patient engagement frameworks that have been created by various health quality initiatives.

For example, Ontario‘s PE Framework identifies four degrees: share, consult, deliberate and collaborate. The International Association of Public Participation Spectrum comprises of five degrees: inform, consult, involve, collaborate and partner.

And, the National eHealth Collaborative outlines five steps or phases that make up their patient engagement framework: inform me, engage me, empower me, partner with me, and support my e-community.²

It’s fair to say that the PE framework represents a journey and there are levels of engagement that practices can adopt. In this, my first post in a series of blog posts, I will explore that journey.

Strategies for each step will be discussed along with the impact that each step can have on a practice and its reputation in the community of healthcare consumers and providers.

‘Inform and Share’ for Consumer Well-Being

The first and basic phase of patient engagement is aptly titled “Inform and Share.” In this step, it’s all about attracting new patients, sharing information about what’s expected for an upcoming appointment and informing patients about their past encounters.

Attracting Patients

Attracting new patients starts with being known in the community.

Can you be found? Do you have a way of communicating to the community that you are a provider who cares and can make a difference?

There are several ways to enhance your presence in the community. One way is to establish relationships with your local healthcare referring partners.

Leaving business cards or flyers with physicians in your area is a great way to start and can lead to participation in physician networks. Standing up a booth at local events and passing out business cards might seem traditional but, depending on the age group of your audience, can be extremely effective.

Another way to be seen is by utilizing a reputation management system. This kind of system allows patients to provide feedback about their visit and facilitates the posting of this feedback into local internet searches.

A recent study indicated that in 2008, 61.2% of the population sought health information online first for their most recent search, while in 2017, the percentage had reached 74.4%.³

You have a presence in internet searches whether you like it or not. Taking charge of that experience provides high value and promotes credibility with consumers that use the internet to find providers.

Upcoming Encounter Information

The important second part of the “Inform and Share” step is making sure that patients with upcoming encounters know where to go and what to expect. One of the best models with the most data that we are able to track is the Southern California Kaiser Permanente model.

For nearly 50 of its 75 years in business, this organization has had active contact with all patients who had an upcoming appointment scheduled.

Prior to the internet, all patients received appointment reminders in the mail. If the encounter was a more expensive appointment, like a radiology appointment or an appointment with a specialist, a phone call was made to the patient.

And, if the upcoming appointment was a specialized test, the patient received explicit instructions in the mail and a phone call.

Kaiser as an organization was able to reduce costs and improve outcomes and its reputation by transforming this process to digital communication.⁴

Historically, this process was labor-intensive. Now, there are tools at our fingertips for this kind of engagement.

Appointment reminders can be automated with standard messages that include the provider’s address, directions, and pre-appointment instructions or considerations. These have become relatively easy to set up and can be tailored to the types of appointments.

Practices that use appointment reminder systems have been found to reduce their no-show rate by up to 38%.⁵ Multiply that by your average revenue per visit, and it’s easy to justify the investment.

After-Encounter Summary

The last piece of the “Inform and Share” step is to provide information about what happened during the encounter.

A study out of Brown University’s School of Public Health found that patients forgot or never learned about half the essential information from talks with healthcare providers, though prompting helped recall another 36 percent of it.⁶

In addition, about 15 percent of the information was remembered erroneously or not at all.⁷

There are tools that organizations can use to provide information about the encounter and what the patient should expect after their session. This can be as simple as standardized leaflets for typical visits or patient-specific instructions delivered via email or a portal.

Helping patients understand what happened, what’s next and where they are in their healthcare journeys increases their personal investments in the patient-caregiver relationship.

Using an after-visit engagement process also provides an opportunity to get immediate feedback from patients about how their previous visits went and whether or not their expectations were met. These same tools are then used to promote reputation management and the practice’s presence in internet searches … which is where we started.

The ROI of Patient Engagement Strategies

Establishing a repeatable process for informing patients can dramatically improve patient experiences while providing a notable return on investment by lowering labor and operational costs and improving staff productivity.

This first step in the patient engagement journey is one that has a tangible and measurable impact on a practice and its place in the healthcare community.

In my next PE blog post, I will move on to take a closer look at the second phase of patient engagement: “Consult and Engage Me.”

REFERENCES:
¹ National Library of Medicine, “Unraveling the Meaning of Patient Engagement: A Concept Analysis,” Sept. 3, 2016
² National Library of Medicine, “Clarifying the Degrees, Modes, and Muddles of ‘Meaningful’ Patient Engagement in Health Services Planning and Designing,” April 21, 2019
³ National Library of Medicine, “Online Health Information Seeking Among US Adults: Measuring Progress Toward a Healthy People 2020 Objective,” Sept. 12, 2019
⁴ Marketing Dive, “Kaiser Permanente Cuts Patient Communication Costs with SMS,” 2017
⁵ National Library of Medicine, “Effectiveness of Mobile-Phone Short Message Services (SMS) Reminders for Ophthalmology Outpatient Appointments: Observational Study,” May 31, 2008
^{6 7} National Library of Medicine, “Factors Associated with Patient Recall of Key Information in Ambulatory Specialty Visits: Results of an Innovative Methodology,” Feb. 1, 2018