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Patient Engagement’s Time is Clearly Now - Part 2

September 24, 2012
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Not to harp on, but the patient engagement train continues to roll forward at an impressive speed. Of course, its focus and prominence are nothing new. I even wrote it about as recently as two weeks ago, and this will serve as sort of a follow-up.

Over the past week or so, I’ve noticed that this idea of getting patients to be more involved with their own health outcomes has really been pushed into the forefront of the healthcare landscape—even more so than usual.

It got a huge boost during National Health IT Week, when Farzad Mostashari, M.D., the national health IT coordinator, publicly challenged vendors to adopt the Department of Veterans Affairs (VA)’s Blue Button initiative. The Blue Button allows veterans to easily view, download, and transmit (VDT) their health information into a single, portable file. Recently, the VA announced the Blue Button initiative had reached one million patients.

More than an actual thing, Dr. Mostashari argued that Blue Button is an evolving concept. It’s the idea that Americans nationwide should be able to download and transmit their data without issue. He said that adapting this capability moves the notion of viewing, downloading, and transmitting personal health information beyond just accessing that information through a personal health record (PHR) that’s tethered to a provider’s data source and makes it a personally controlled health record.

To get vendors to commit to adopt a Blue Button of their own and meet the Meaningful Use standard that requires 5 percent of patients to view, download or transmit their data by the time the 2013 HIMSS Conference rolls around in March of next year, Mostashari established a Twitter feed using the #VDTnow hashtag. Thus far, he has gotten commitments from the following vendors:

  • Alere Wellogic
  • Allscripts
  • athenahealth
  • Cerner
  • eClinicalWorks
  • Greenway Medical Technologies
  • Intellicure
  • NextGen
  • SOAPware

That wasn’t the only patient engagement news I’ve seen over the past week.  A couple of studies were recently released, which both essentially said the same thing: patients are interested in some form of patient engagement. While the systems lag, the demand is high.

This was the same message I heard when I attended a recent event hosted by the Aspen Institute, a nonprofit bipartisan think-tank. The event, “Reinventing Health Care: Frontline Innovations Transforming Local Care Delivery,” had various experts discuss at the challenges to transformative healthcare innovation, while also speaking with leaders at various frontline providers who are tackling these challenges head on and are Centers for Medicare and Medicaid Innovation grant recipients.

It was remarkable how many how many times patient engagement came up as a topic. First, it came up when the panel of experts discussed the Aspen report and the various barriers to innovation. Brent Parton, the founder of SHOUTAmerica, an organization focused on asserting the interests of young Americans in a sustainable, effective healthcare system, talked about how Google and Wikipedia have shown how many patients are clearly thirsty for health information. However, they haven’t gotten far with it, he says, and have received pushback from providers. He had a great line that is validated by many of those above studies.

“The patients are trying, but the tools aren’t quite there to help them navigate this world of information,” Parton said. He said it’s important to develop systems that providers would feel comfortable giving to their patients, since the latter is interested in taking an active role with their care plan.

I thought that was a great point. The onus of patient engagement is on providers just as much as it is on patients. Later in the event, one of the moderators, Andrew Shin, J.D., who is the current acting director for stakeholder engagement at the Centers for Medicare and Medicaid Innovation, mentioned the Leonard Kish blog (where he equates patient engagement to the blockbuster drug) that I talked about last week. He then asked panelists what it would take to get that “blockbuster drug” over the hump. They gave a variety of answers, many of which I thought were interesting.




Great post Gabriel. Clearly, in the absence of effective patient engagement, healthcare reforms and the overall reconstruction of the industry will not be complete.

With all of the talk of providing tools for patients to use that grant access to their medical records so they take a more proactive role in their own care, what is the healthcare industry doing to help lower income individuals who may not have access to electronic devices that would allow them to see their records or engage with providers? Was this addressed?

It's all well and good that we are pushing for more engagement, but does this include all income demographics? It seems that those who may stand to benefit the most from access to medical information are not in a position to actively engage with the absence of the proper tools to do so.

Where does Microsoft's HealthVault fit into the picture? It seems to be a no cost solution to patients of any demographic opposed to Blue Buttons limited demographic of patients. Is there a reason medical solutions vendors are not adopting the MS approach?

Well to be fair, I don't think the government is actually asking them to adopt the same Blue Button the VA uses for veterans. They're asking vendors to adopt a Blue Button capability, that is an easy way for patients to view, download, or transmit their data. The actual software would likely be created by the vendor themselves.

Hi Anonymous,

You bring up a lot of great points, especially about access to the internet. It's the one issue that hasn't been addressed across the board when it comes to patient engagement, and I think it needs to be. I've talked to industry leaders, who are making engagement easier when patients visit the provider by having iPads and other technologies on site, but that doesn't address how to keep it going when they are going home. I'm definitely going to follow up on this, especially with rural providers. Thanks for the comments!


"Importance of having one trusted source for patients to use" is a petrified idea, right along-side "central-planning."

"Anonymous" raised a significant roadblock to universal patient engagement, Gabriel- lack of access to internet, which also suggests poor computer literacy.

Perhaps this problem can be solved by ONC Workforce Training Program certificate holders who, as health facilitators, have an entrepreneurial "streak" in them. Entrepreneurs identify a problem, develop a solution using Steven G. Blank's "Customer Development Process," and build bridges across the "Digital Divide."

Such certainly is not "rocket science;" it will create small businesses and hundreds of jobs they need to "deliver the goods."

Kel Mohror, HIT concierge

Thanks for the information Ken, definitely agree that lack of internet access is definitely a problem that I've seen brought up multiple times when it comes to patient engagement. That solution, and the idea of building bridges across a digital divide, is what you like to see in this industry. It's going to take the extra mile!

The Blue Button puts unprecedented medical files access in the palm of their hands, or yours, via computer or mobile gadget. Overall, the Blue Button software would benefit many of us. But unfortunately, to be able to say that it is successful, the government must ensure that all of us are capable of handling this type of software. Learn more here: Employing the power of the health records Blue Button.