Everywhere I turn lately, I see some kind of new patient engagement-centered platform being touted by vendors, providers, and/or payers. Industry people saying things like ‘we’ve got patient engagement’ seems to be the new ‘we’ve got cloud computing,’ a buzz phrase that has taken on a life of its own.
Recently, I had a conversation with Richard Ferrans, M.D., vice president and chief medical officer at Presence Health, a 12-hospital, 29-long-term care and senior residential facility organization, on a variety of topics, related to patient engagement. One of my primary questions was, why now? Why more than ever, do we see organizations trying to improve upon their patient engagement? Dr. Ferrans, who many consider a leading authority in the health IT industry, unsurprisingly had an insightful answer.
“There’s a confluence of factors, but chiefly it is around the recognition that the fee-for-service environment is giving way to fee-for-value. Under fee-for-value, physicians are going to be paid according to patients’ outcomes,” Ferrans says.
“[With patient engagement], physicians are looking at ways to influence patient contribution to their outcomes. Whereas this was always a good idea, now there is a financial incentive for people to do it. In the past, there really wasn’t a financial incentive. You could do the right thing and add costs, but not add benefit, unless you were in a risk arrangement. The risk arrangement has come to fruition at the same time, because of HITECH [the Health Information Technology for Economic and Clinical Health Act], as the rise of EMRs, setting the stage for personal health records (PHRs), makes communicating with patients on a large scale highly probable.”
I would also attribute this to a rise in interest among patients. Some may scratch their heads at this notion, but look at the Department of Veterans Affairs (VA). Recently, the VA announced its Blue Button initiative, which allows VA patients to view and download their personal health information into a single, portable file, reached one million patients. Look at Kaiser Permanente: a lot of praise has been thrown at the integrated health system for its ability to get patients to use its PHR, and rightfully so.
Of course, there are barriers. Ferrans tells me, chief among them, is the trust factor. The concerns about privacy and information security are real, he says. In addition, he says the culture in healthcare and EMRs workflows have prevented providers from getting patient emails and texts as their preferential method of contact, something that would boost engagement, he feels. “People are worried about violating HIPAA [Health Insurance Portability and Accountability Act of 1996],” he notes.
There are also issues with certification and rapid improvement cycles. Additionally, Ferrans says, he thinks the newness of patient engagement, along with the various requirements that have come into the picture thanks to meaningful use, have over-burdened providers.
“It’s just one more thing on top of an overwhelming situation, and that distracts from the fact that this represents an enormous breakthrough, to bring patients more into equation. We know if a patient doesn’t self manage their condition; they’ll probably have a worse outcome. So it’s a good thing, it’s just coming at a stressful time.”
Stressful? Yes. Nevertheless, patient engagement is everywhere right now, because it’s coming at the right time, as Ferrans and others would say, and the VAs and Kaisers of the world would exemplify. I guess I should get used to seeing more patient-engagement platforms pop up.
I would love to hear HCI readers’ thoughts, concerns, questions in the comment section below!