Patient engagement – Are the benefits real?

April 7th, 2017 / By Steve Delaronde

When people take an active role in their own well-being and participate in their healthcare choices, the Triple Aim of improved outcomes, lower cost, and a positive patient experience becomes much more attainable. Not surprisingly, patient engagement is a major tenet of successful value-based programs. However, there is disagreement among patients and providers regarding the best methods for achieving engagement that results in successful outcomes.

Typically, patient engagement is discussed in terms of healthcare, and not overall well-being.  Patients who indicate that they exercise regularly, maintain an ideal weight, eat nutritious foods, have meaningful social relationships, and have effective ways to deal with stress and maintain their mental health are considered to be engaged in their own well-being. However, engagement is often considered from the perspective of the healthcare system and is more likely to apply to patients with chronic conditions.

Persons with chronic conditions certainly benefit from the same health-promoting activities as the general population. However, managing their condition with regular visits to healthcare professionals, monitoring such vital signs as blood sugar, blood pressure, and cholesterol, as well as adherence to prescribed medication is more often considered the yardstick for measuring the effectiveness of patient engagement activities.

The problem is that physicians and patients don’t always see it the same way.  A recent survey of 200 physicians and 200 patients found that 58 percent of physicians indicated they had become more engaged with their patients in the past year, but only 35 percent of patients agreed that their physicians had become more engaged. Patients and physicians don’t necessarily prioritize the same methods of engagement either. Providers saw more value in mobile applications than patients, while patients placed value on greater access to their providers through online chats.

Becoming more engaged with one’s patients is not the same as patients becoming more engaged with their own care. Among the 340 clinicians, clinician leaders and healthcare executives that responded to an online survey, only 29 percent felt that the majority of their patients were “highly engaged.” Despite this, 59 percent acknowledged that the most effective patient engagement practice was to spend more time with their patients, which theoretically is within the control of the healthcare provider.

The majority of respondents had a dim view of 1) wireless monitoring devices and 2) incentives offered by health plans to improve their health. These results are interesting, since the proliferation of wearable devices to track vital signs and physical activity may be a way for healthy individuals to become more engaged, rather than an effective method of engagement for the chronically ill. Additionally, the use of value-based insurance design (VBID) by insurers has been shown to increase adherence to chronic medications, but the results are small and do not necessarily lead to cost savings.

Ultimately, patient engagement seems to make sense. Active involvement with healthcare decisions and the adoption of self-care practices should lead to better health outcomes and lower costs.  However, not all engagement strategies are equally effective across all populations at 1) engaging the patient, or 2) achieving outcomes consistent with the Triple Aim, or 3) both. Targeted and evidence-based approaches are the key to achieving desired outcomes.

Steve Delaronde is director of consulting for populations and payment solutions at 3M Health Information Systems.