It seems that while everyone in healthcare is talking about patient engagement, many are struggling to come up with strategies to achieve it.  

Stage 2 of the Meaningful Use electronic health records (EHR) incentive program requires 5 percent of patients to log into and upload data via a portal or personal health record for providers to earn incentive payments from the program. And last year, the National eHealth Collaborative and the Office of the National Coordinator for Health Information Technology (ONC) created the Patient Engagement Framework, which was vetted by over 150 healthcare stakeholders, and is meant to help providers understand how to start and continuously improve a patient engagement initiative.  According to the lead authors of the framework, a properly implemented patient engagement strategy should transform the way a health system delivers care. 

To further push the patient engagement movement and give recognition to those medical centers that make a true commitment to getting patients invested in their own health, Axial Exchange, a Raleigh, N.C.-based health IT software provider, ranked U.S. hospitals state-by-state based on an analysis of publically available data in three categories: personal health management, patient satisfaction and social media engagement. Personal health resources was given the highest weight and took into account tools that hospitals make available to patients like websites, mobile apps, or interactive tools to help them manage their health.

Axial has constructed a Patient Engagement Index (PEI) in three states thus far—Florida, Texas, and California—with rankings for the other states coming in the next several months. The company says that while the US News and World Report has produced its popular hospital rankings for 23 years running, those rankings don’t include patient satisfaction. Consumerization in healthcare is driven not only by the transparency brought about by the internet, but also by rising deductibles and a boom in patient engagement. The term ‘patient engagement’ has been so widely used that its true meaning has been diffused; people talk broadly about improving patient engagement, but have not done the analysis and research to determine exactly what types of patient engagement programs improve outcomes, Axial officials say.

Axial said it decided to focus on Florida first because the state's demographics are a "bellwether" for the rest of the U.S. As such, in Titusville, Fla., Parrish Medical Center (PMC), a 210-bed acute care hospital, landed atop the Florida PEI, which included 74 major hospitals in the state. PMC scored 89 out of 100 on the index, one of just three Florida hospitals to score above 80.

For Axial’s index, maximum points in the personal health management category are awarded to health systems that not only offer electronic access to patient health records, but also provide resources needed for the day-to-day management of disease. The best health systems offered these tools via the device of the patient's choice: desktop, tablet, and mobile. The information was gathered from publicly available websites and mobile applications.

Natalie Sellers, chief communications officer at PMC, says the medical center’s HealthBridge program— an online patient portal designed to be the community’s ‘bridge’ to manage all of their health needs—“provides a health management platform that helps to coordinate care in a way that enhances the overall healthcare experience and provides easy access to personalized health resources including education, breaking news, personal messages from your physicians, and health tracking tools all delivered via your smartphone, tablet, computer, or by mail.”

HealthBridge includes: a personalized page based on health interests; communication whichever way the patient wants it; one- click access to an exclusive health education video library; the ability to RSVP online for events and classes; and for patients of Parrish Medical Group physicians, the ability to e-mail physician offices, request prescription refills, schedule  office appointments, and  view lab results.

 “We use patient relationship management technology (also known as customer relationship management, or CRM) to engage the right patient, at the right time, with the right information based on an individual’s specific health profile.  We use that technology to deliver personalized health management education and tools from anywhere, at any time,” says Sellers.

In other attempts to improve patients’ personal health management, PMC has launched a series of online presentations, called Emmi, that make complex medical information easy to understand, says Sellers. “We empower patients to take action around their particular healthcare event or condition in language they understand, at a time when they are ready to learn, and through the devices they already own. Using a soothing voice, animated graphics, and easy-to-read text, Emmi programs take you through your upcoming procedure or help you manage your chronic condition.”

A further example of personal health management at PMC is its Ask 3 Initiative, which urges patients to ask the following three questions every time they talk to a doctor, nurse, or pharmacist: What is my main problem? What do I need to do? Why is it important for me to do this?

The patient satisfaction category is based on industry response from public patient satisfaction data collected by Centers for Medicare & Medicaid (CMS). The survey is called the Hospital Consumer Assessment of Health Plans Survey (HCAHPS), with the intent to provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care.  The points awarded in this category are directly driven by HCAHPS performance. According to some studies, higher patient satisfaction via the HCAHPS survey is associated with improved guideline adherence and lower inpatient mortality rates.

Based on assessments of 2,985 hospitals by the CMS, PMC is Central Florida’s No. 1 hospital in areas of clinical care, patient’s hospital experience, and low cost, says Sellers. “Each month, every hospital department reviews a matrix of quality, service and safety measurements related to our strategic plan.  We call it our Game Plan, and it has enabled PMC’s care partners to earn numerous quality distinctions.”

The last criteria, social engagement, is the extent to which health systems engage with their communities via social networking channels. Maximum points are awarded to health systems that not only have a social media presence, but also have engaged a relatively large audience that expresses positive sentiment towards the health system.

According to Sellers, “Since experiences on the internet and in social media are held to the same standards of excellence as any other experience with the medical group, PMC made a deliberate decision to not rush into social media without first understanding what our community really needed to manage their health with social media platforms. PMC chose to listen first and thanks to social media’s broad reach, we can hear our community’s voices more today than ever before.”

Certainly, patient engagement, like many other aspects of healthcare, is still an emerging concept, but according to Sellers, it’s not the notion of engaging patients and their families to achieve their best health that is new to healthcare.  “[Instead], what is ‘new’ are the ever-advancing technologies that breakthrough access barriers to reliable information and tools that serve to engage and empower people to manage their health from anywhere and at any time. However, the challenge is not to keep pace, but to lead the race.”