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Taming the Wild West

November 27, 2012
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One organization's effort to create a patient engagement road map

There is a famous saying: the journey of a thousand miles begins with a single step. In healthcare, there are many places where that saying applies. For instance, the journey of an engaged population begins with a single informed patient. But how do you get from the beginning to the end – or at least some semblance of engagement?

This question has been asked several times by countless people in all sorts of positions within provider or payer organizations. While some have done well in this area, it’s fair to say most have struggled. In addition, the impending patient engagement regulatory requirement in Stage 2 of meaningful use has upped the proverbial ante for many providers.

Enter: the National eHealth Collaborative (NeHC), the public-private partnership created through a grant from the Office of the National Coordinator for Health IT (ONC). NeHC, which has been well known for its work in championing a nationwide health information exchange (HIE), recently created a five-step patient engagement framework for providers, payers, and other healthcare entities.

I’ve seen patient engagement compared to the Holy Grail, and I like that metaphor. However, I like what Jeff Donnell, president of NoMoreClipboard, a personal health record (PHR) vendor, said even better. In a webinar discussing the framework, Donnell said the framework was an attempt to bring a road map to an area has become like “the wild west.”

In the past, I’ve commented on how the patient engagement market has become the trend du jour for vendors, both established and upstart. While this is exciting in many ways, I think it has just muddied the waters somewhat.  There seems to be a lack of consensus what patient engagement is –and with that, it’s hard to get that clear picture and figure out where you should focus your resources.

That will be the case no longer, NeHC is saying. No, the framework is not exactly a structured, meticulous plan, in the form of one of those travel agent second-by-second itineraries of a trip to Disney World. However, as Donnell said, “it represents a journey.” The five steps are “inform me,” “engage me,” “empower me,” “partner with me,” and “support my e-community.” These steps represent a natural progression, NeHC says.

You can read about the steps and what each one represents here, or on the NeHC website. One thing to note, it goes well beyond the simple goal of getting patients to view and download their health record electronically (that’s step two, technically) or using mobile health (mHealth) for engagement (also step two).

It’s about integrating patient-generated data with an EHR, integrating it with an HIE, secure messaging, virtual coaching, patient ratings, and much more. The ultimate goal is a patient-defined community across different levels of care supported by multiple e-Visits, interoperable patient and clinically-generated records, and numerous online resources. What it shows me is there are many ultimate outcomes when it comes the destination of engaged population.

NeHC has even gone a step further and released a patient engagement tool, which assesses specific organizations on how far along they are and where they can improve. Credit goes to the people involved with this effort at NeHC. At the end of the day, I think it shows healthcare organizations that engagement is more than just a single product or application. It’s a concerted effort, which if done correctly, can take several years.

Of course, every worthwhile journey starts with that first step.

Please feel free to leave comments in the section below or tweet me at @HCI_GPerna