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 www.atlas.md 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”.
What about, “patient thinks computers are from the devil and will never, ever use one for any reason?” Describes a lot of mine perfectly
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.
http://techcrunch.com/2012/03/29/patients-are-more-than-a-vessel-for-billing-codes/
http://www.forbes.com/sites/davechase/2012/03/29/diy-health-reform-from-massachusetts-to-alaska/