“The journey of a thousand miles begins with one step.”

The Patient Engagement Journey: Part 1

by Dr. Randall Williams, MD


“The journey of a thousand miles begins with one step.”

Imagine you’re taking a trip. Unless you know your destination, how will you know when you’ve arrived? You’re likely to end up lost, or going in circles, before you find the right way.

The same is true for the healthcare industry. Let’s step back and look at the entire patient engagement journey: where we began, where we are, and where we are heading.

Patient engagement: the starting point

The grand vision of transforming healthcare was put forth in 2001 by the Institute of Medicine’s seminal work, Crossing the Quality Chasm: A New Health System for the 21st Century.  It included six specific aims all organized to:

“…continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States.”

It relied heavily on the concept of “patient-centered care” and it took years to catch on.

Fuel for the journey (health reform)

Transformational journeys need a champion to get off the ground. For our purposes, that champion was Dr. Donald Berwick (at the time, founder and head of the Institute for Health Improvement).  In his 2008 Health Affairs article, he offered a “simpler” version of the grand vision, one focusing on creating a patient-centered health care delivery system.  This version, known as the Triple Aim, had a timing advantage. While still organized around the notion of providers and patients partnering together around their care, it benefitted from the political winds of health reform.

Both the federal HITECH Act and the Patient Protection and Affordable Care Act (commonly known as ACA) began tying economic incentives to:

  • Electronic medical records
  • Patient-centered care delivery
  • Accountable care organization models
  • Patient engagement reporting requirements

With money on the line, transforming healthcare moved from theory to reality.

So, where do we currently stand on this journey toward patient engagement? Are we headed toward a destination? Do we know what that destination is or how we are getting there?

No. And here’s why:

We don’t have a universal definition of patient engagement.

We have a grand vision. We have champions. We have incentives. But as an industry, we have not yet defined what patient engagement is, so we don’t have a way of knowing when we have arrived at it.

Today, if you asked healthcare providers what patient engagement means, you’d hear that every one of them thinks it would be a good thing because patients:

  • Might be better informed
  • Might be more satisfied
  • Might comply more with treatment

Yet you’d also hear them say that patient engagement is just a buzz term referring to whatever the latest EMR, patient portal, or population health vendor is touting to meet meaningful use criteria.

If you asked patients what patient engagement means, you might hear something like:

“I’m more engaged when my doctor actually asks me what I want” or

“I’m more engaged if I can read and learn about my own health conditions or have tools to manage myself better”.

These provider and patient definitions of patient engagement are miles apart.

Rerouting to reach the destination

While the pursuit of patient engagement is frustrating, we should not, and cannot, abandon the journey. In fact, the cost of giving up could ultimately be the cost of an unsustainable healthcare system.

I often say that the patient is the greatest force multiplier there is.  Directly engaging patients in their care is perhaps the ONLY path to a sustainable healthcare system; not only one that is patient-centric, but also one that is both affordable and high quality.

In the coming weeks, I’ll explore this topic in more detail.  I’ll take a look at what other industries can teach us about engaging patients. I’ll share what an engaged patient looks like. I’ll define an engaged patient. And I’ll look at measuring and tracking levels of engagement so we will know with confidence that we’ve arrived at our patient engagement destination.

Take it from a physician: engaging patients is EXACTLY what providers need and want to do.  At Pharos Innovations, we’ve created a technology-enabled model for patient engagement. We have over 10 years of real world knowledge, experience, AND data to support our learning. Keep reading and we’ll teach you what we know so you can succeed too.

Image courtesy of Evgeni Dinev at FreeDigitalPhotos.net

Dr. Randall Williams, MDThe Patient Engagement Journey: Part 1

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