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The 4 Buckets of Patient Engagement

January 10, 2013
by Gabriel Perna
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How one organization takes on patient engagement

There is proof, in healthcare at least, that bigger is not always better.

At a recent webinar, hosted by the Healthcare Information and Management Systems Society (HIMSS), Denni McColm, CIO of Citizens Memorial Healthcare, the rural-based healthcare network out of Bolivar, Mo., spoke of the four strategies her organization undertakes when it comes to engaging patients. Those strategies have helped Citizens Memorial, which has a 76-bed acute care hospital and 22 physician clinics, become an industry leading organization.

The achievements for Citizens Memorial range from achieving Stage 7 certification of the HIMSS Analytics EMR Adoption Model (EMRAM) in 2010 to the HIMSS Nicholas E. Davies Award of Excellence for Health Care Organizations in 2005. However, it’s the organization’s successful efforts to engage patients that may be the most impressive.

All in all, McColm said Citizens Memorial breaks down the task of engaging patients into four buckets:

  1.          Skills Building for Caregivers
  2.          Programs to Encourage Patient Engagement
  3.          Basic Information Strategies
  4.          Technology Support Patient Engagement

When it comes to skills building for caregivers, McColm pointed to the organization’s training methods with caregivers as an example of where it instills the mindset of connecting with the patient. From the get-go, caregivers are taught to connect with the patient by using the EHR as a bridge rather than having the computer act as the proverbial wall.

In addition, McColm talked of several programs to encourage patient engagement, such as the implementation of a patient engagement events calendar which can be scanned onto someone’s phone with a Quick Response (QR) code. McColm also mentioned the use of care coordinators, who help the organization’s physician clinics reach out to patients, in this category [not sure what category means].

Basic information strategies can be broken down, according to McColm. For one, caregivers are instructed to be consistent with their education and instructions to the patient. She cited the repetition principle, which says that adult learners need something repeated three times in order for it to stick.

The information strategies also include various convenience initiatives such as a patient friendly card that has a barcode, the patient’s picture, and their consent. This, she said, allows them to get treated more quickly. The patient boarding pass is another example of an attempt to streamline the process for patients, which helps them verify information in advance.

Last but not least is Citizens Memorial’s fourth bucket, technology supporting patient engagement. In addition to having a patient portal tethered to its Meditech (Westwood, Mass.) EHR, the organization  allows patients to get their information in the form of an un-tethered personal health record (PHR). The patient portal, which she said meets the meaningful use download, view, and transmit requirements,  allows patients to securely message their provider, pay bills, and see a summary of their last visit.

In addition, the organization has implemented electronic white board displays in the patient room, home health monitoring, and telemedicine. In terms of paying for the telemedicine network, which has been difficult for many rural-based providers, McColm says the organization qualified for reimbursement from the Centers for Medicare & Medicaid Services (CMS). However, McColm dId mention how many of the patients are unable to afford broadband, which makes it hard to not only use telemedicine, but any of these electronic services.

While McColm admitted the benefits from this type of engagement can often be unclear, she pointed to a significant reduction in readmissions rates and high risk behavior among patients as evidence that the programs have worked. In addition, the organization has seen increased immunization rates for those in home health monitoring. Overall, she said patients have expressed interest in being more engaged, and seeing the provider as less of a foreign environment.