Patient Engagement

Are you read for the newest term to hit healthcare reform?  It is called “patient engagement”.    Somehow this will defined in a muddy kind of way and used to grade a physician or practice to see if they are truly “engaging” patients.  In the American Medical News, they discussed the layers of patient engagement that are being batted around.  “The National eHealth Collaborative asked health care organization leaders (god knows who they are?)to pick their top two ways to describe patient engagement out of a list of 10. These were the five most often cited definitions and percentage of those who chose them.”

  • 64.0%: Patient uses educational material and online resources to learn about better health or their own health conditions.
  • 58.7%: Patient uses tools and resources to manage his or her medical record and other health data.
  • 41.3%: Patient feels comfortable challenging doctor when something doesn’t seem right or when explanations are not clear.
  • 38.4%: Patient feels comfortable discussing health issues and questions with doctor or nurse face to face.
  • 38.4%: Patient communicates with doctor about changes in health status in a timely way.

When I put my business hat on I understand where this comes from.  If I was able to own and run my own practice and had control over my career then I could see how this can be used for good.  A direct care model with patients paying less but paying me would push me to allow for incredible engagement.   Go to as a great example.  Using the present insurance/Medicare/Medicaid model is a whole different animal and this will only lead to confusion and penalties for not following their “rules”.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “Patient Engagement

  1. mamadoc
    April 4, 2012 at 10:13 pm

    What about, “patient thinks computers are from the devil and will never, ever use one for any reason?” Describes a lot of mine perfectly

  2. April 2, 2012 at 6:58 am

    With Stage 2 Meaningful Use having patient engagement as its core, you can be guaranteed that you’ll be hearing a LOT more about it, for better or worse. Without a doubt, the AtlasMD’s of the world are able to think that way from the get-go as the practice answers to who pays the bills (patients in their case, not insurance).

    Feel free to repurpose a couple of pieces I have written recently (links below) that touch on this topic. Most people buy the notion that reimbursement is shifting from a “do more, bill more” to a value/outcome based model. The HUGE question is how one transitions from one to the other without losing your shorts. It seems clear to me that it is going to be virtually impossible to succeed in the value/outcome based model without heavy patient engagement.

    In the pieces below, probably the most impressive reinvention of a healthcare delivery model I have heard about took place with a beleaguered gov’t funded system serving the Alaska Native population (vast majority of funding is a blend of Indian Health Service, Medicaid & Medicare). The videos go into more detail. The bottom-line was they addressed the core issue — with 75% of healthcare spend being on chronic conditions, that is where patients are fundamentally in control of decisions driving outcome. Thus, if you want to effect outcome, it entails a lot of “messy human” stuff as they say describing their “Nuka system of care.” It’s worth carving out some time to view what they have done.

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