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At iHT2-Chicago, Patient Engagement Presents a Broader Set of Issues to Providers

October 9, 2015
by Mark Hagland
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As industry leaders noted at iHT2-Chicago this week, tuning into the concept of patient engagement necessarily triggers a host of issues and activities, organization-wide

As it turns out, when the leaders of patient care organizations strive for patient engagement, a host of issues becomes triggered. That certainly has been the case at the organizations represented by discussants in a panel held Oct. 7 during the Health IT Summit in Chicago, held at the Intercontinental Hotel in downtown Chicago this week, and sponsored by the Institute for Health Technology Transformation (iHT2, a sister organization to Healthcare Informatics, under our corporate umbrella, the Vendome Group LLC).

The discussion session, entitled “Tools and Strategies to Engage Your Patient Population,” covered a wide range of issues, from how to fully activate patients, to connecting patients to meaningful care management and other processes.

The panel was moderated by Cynthia Burghard, research director at the Framington, Mass.-based IDC Insights. She was joined  by Krishna Ramachandran, chief administrative officer at the DuPage Medical Group, a 500-physician, 70-location multispecialty group based in the Chicago suburb of Downers Grove; Tom Scaletta, M.D., chair of Emergency Medicine at Edward Hospital, in the Chicago suburb of Naperville; and David Kaelber, M.D., Ph.D., M.P.H., chief medical informatics officer at MetroHealth System, Cleveland.

Burghard noted that, “Historically, we have said, if we build health information exchange, they will come. But is that theory really going to apply here? In fact,” she said, “The paradigm is shifting to go to where the patients are.”

Kaelber stated, “The more we can go to where the consumer is, the more effective we will be. There are so many people who can benefit from the interaction, and how do you focus on what they need?” He recounted the story of an actual patient being cared for by a MetroHealth primary care physician. “This was a male patient who had not been compliant in taking his medications,” Kaelber noted. “They tried everything, and finally they ended up having  a physician call this patient every morning at 9 a.m. to see whether he had taken his medication. That worked. They asked him why and he said, ‘Well, Henry calls every morning, and I can’t disappoint him!’ So what do we mean by patient engagement?” Kaelber asked. “It’s one of those questions where you ask five people, you get 10 different answers.”

Scaletta said, “I’d like to also differentiate patient experience from patient engagement. Patient experience is a sort of end-to-end thing. Every way in which we interact with patients is shaped by the culture of your organization, and affects the relationship with the patient. Engagement to me is about relationships; and the end goal is to get the patient activated, so that they’re motivated to learn and become active in their health.”

At DuPage Medical Group, “We also see the experience and the engagement as separate,” Ramachandran said. “Engagement, we slice into three buckets: we have the healthy patients; we just need make sure they’re OK and healthy; we have the rising-risk patients; and the high-utilizing patients. And we need to apply a high-touch form of engagement with them.”

“Patient engagement becomes very tactical, and happens in five or ten different places in an organization,” Burghard noted. “In other industries, there are chief customer [experience] officers, but they are different from healthcare. Is your organization thinking about this?” she asked her fellow panelists.

“We’re interested in both patient experience and patient engagement,” Kaelber offered. “This is something that the healthcare system needs to move into. We’re trying to take a very strategic approach; but there are not a lot of models out there for us to follow. It’s one thing to ask, don’t we want to engage patients more? And everyone says yes,” he said. “But then you have to figure out how to make it happen tactically, and so we have this big vision, but it’s being executed in little tactical pockets. On the technology side, we have our personal health record portal and direct patient messaging,” he noted. “And then we have the people side of this. And you only want to throw resource-intensive operations and programs at patients who are already resource-intensive.”

“And you certainly have a specific population, with some rather frail patients,” Burghard said, referring to the demographics of MetroHealth’s market in Cleveland. “And so everyone has to make it work in their own market. And who’s responsible for patient engagement? Is it the care managers in the physician office, the office staff, the physicians? Or everyone?” she asked.

“Strategy without tactics doesn’t go anywhere, either,” Ramachandran asserted. “So we have a director of patient experience who pulls the program together, with support from the board and CEO, but then with tactics to make sure we’re operationalizing this within our workflow. And we have MyChart within Epic, and our CEO made it a goal to get patients active on MyChart, and a whole bunch of tactics came out of that. And about 50 percent of our patients are active on MyChart now. So that’s an example of how tactics formed out of strategy are operationalized in the organization.”