Believe it or not, patient engagement was a concern and focus of many physicians, nurses and other healthcare providers long before these two words became a term of art throughout the healthcare industry.
In today’s world of PAM, MACRA, CAHPS, HEDIS and other U.S. healthcare acronyms that are used to measure and determine insurance reimbursement, patient engagement has become a “holy grail” for a majority of insurance-based healthcare organizations over the past several years.
Defining Patient Engagement
Patient engagement is a broad category with a variety of definitions and interpretations that include patient education, communication, activation, empowerment, compliance, resources and other influences on health outcomes.
In an upcoming article, we will focus on the concept of “Health Consumer Engagement” as really more comprehensive a term because too many people are not even engaged enough with their own health or healthcare providers to be described or think of themselves as a “patient,” but for the purpose and focus of this article and because “patient engagement” is the most commonly accepted descriptor for this topic, we’ll use the definition from a 2013 Health Policy Brief produced by Health Affairs and the Robert Wood Johnson Foundation as published in Health Affairs:
“Patient activation refers to a patient’s knowledge, skills, ability and willingness to manage his or her own health and care. Patient Engagement is a broader concept that combines patient activation with interventions designed to increase activation and promote positive patient behavior, such as obtaining preventive care or exercising regularly.”
The bottom line for all definitions of patient engagement is the same ultimate goal: to improve health outcomes.
The Role of Technology in Patient Engagement
In the rush to leverage technology to improve patient engagement and achieve greater time efficiency for overburdened providers, the human connection is often deprioritized and sometimes even lost entirely. This is nobody’s “fault” and technology does have an important role to play in helping identify, target and communicate with patients who are not currently engaged in their own health care or with their providers and other caregivers.
But technology can’t serve as a substitute for a human connection from actual people who care about, communicate with and encourage a “disengaged” patient. Whether you are a provider, a care manager, a professional caregiver, an insurer, an employer, or even a family member or friend, it’s ultimately that two-way (or multi-way) human connection that inspires true engagement and improved health outcomes.
7 Ways to Use the Human Connection to Increase Patient Engagement
- Start earning the patient’s trust from the first encounter.
- Invite and participate in 2-way conversations.
- Listening is even more important than talking.
- Never stop educating.
- Empower and nurture patients continually.
- Surround patients with support.
- Electronic communication should reinforce human communication – not the other way around.
1) Start earning the patient’s trust from the first encounter.
Patients who are not active and engaged in their own health and care are not likely to change their behaviors or attitudes if they don’t trust that you genuinely have their best interests in your mind and at heart. Simply educating someone on what they “should” know, do and keep in mind isn’t going to change attitudes and behaviors that may have taken years (or a lifetime) to form.
The easiest and most effective time to start building trust is from the beginning of the relationship – at the first encounter, whether that’s in person, on the phone, through a text or other electronic communications or however and wherever that encounter takes place.
It’s certainly more challenging to develop a relationship based on trust later if that has not seemed important before. And it’s really tough to regain trust if you’ve had it and lost it.
Trust has to be earned – over time, not all at once. All of the other ways to use the human connection to increase patient engagement that are listed in this article are part of the process of earning and retaining trust, but at its core, building trust in any relationship is about listening and empathy – even more in terms of someone’s health and well-being than in many other situations.
Really listening and empathizing with a stranger’s (new patient) or acquaintance’s (recurring patient) health concerns seems obvious but it’s often harder than it appears when you have to do it every day, over and over, irrespective of the pressures and distractions you may be dealing with.
It’s a little easier if your job is also your calling, but it’s learnable behavior either way. It requires concentration, focus and an innate curiosity about people
2) Invite and participate in 2-way conversations.
How many people do you know (including you) who like to be “talked at” and told what they should do? Health care is full of one-way conversations between providers and patients, which are really lectures or instructions, not conversations. A conversation is, by definition, a two-way or multi-person, back-and-forth communication.
People who work in healthcare generally know more about health issues than most patients. It’s easy and understandable to feel you are helping patients by telling them what to do and what’s in their best health interests. But if providers are delivering a monologue, the likelihood of engagement by the other party is a lot lower than if it’s a dialogue.
3) Listening is even more important than talking.
Most patient encounters in most clinical settings are relatively brief. If it’s an in-person appointment, maybe the total time that a patient is at their appointment isn’t brief, but their time with their provider may feel even shorter if they’ve endured a significant wait from the time they arrive to the time they meet with their provider.
That makes it even more important that the time spent with the patient starts with listening, not talking. Even when the patient’s chief complaint is already recorded, it’s vital to allow the patient to tell his or her story. Patients don’t trust or engage if they don’t feel heard.
If the encounter takes the form of a phone call, it’s just as important to not only allow but invite the patient to speak and share their concerns, questions and feedback. Even a voicemail or text message should include an invitation for the patient to be heard, not just to “confirm.”
4) Never stop educating.
An informed patient is more likely to be (or become) an engaged patient, assuming that trust, listening and two-way conversations are part of the communications process. This is the most familiar and perhaps easiest to-do on this list because providers are used to educating patients.
Whether the patient education takes the form of verbal or written communication, it’s important to invite questions and feedback. That’s part of the listening and two-way conversations that foster trust and greater patient engagement.
5) Empower and nurture patients continually.
People need more than knowledge to be engaged and take ownership in their own health and care. They need to feel empowered and they need to feel nurtured. (Who among us doesn’t need to feel nurtured?)
Patient empowerment is a process that includes knowledge, tools, confidence and lots of ongoing nurturing to apply the knowledge, tools and confidence to taking ownership and taking action.
These keys to empowerment apply to patient engagement and many other aspects of success. Every key is valuable and the more of these keys that are applied, the greater the potential for success.
- Knowledge/Education
- Setting Goals
- Roadmap/Game Plan
- Reminders
- Repetition
- Celebrating Small Wins
- Forming Good Habits
- Support System
6) Surround patients with support.
Getting and staying engaged on a continual basis requires a support group or system. When it comes to better health, that support should include people and processes.
People support
- Providers/Caregivers
- Clinical and/or administrative staff
- Care managers
- Pharmacists
- Family members/friends
- Social workers (if applicable)
- Community services
- After hours services
- Pastoral care
Support processes
- Information
- Plan of action
- Tools
- Tips and Techniques
- FAQs
- Real-time human access (online chat, phone)
7) Electronic communication should reinforce human communication – not the other way around.
In today’s technology-centric society, there are many forms of non-human, technology-based communications that can support and enhance the process of patient engagement.
From text to chatbots to automated call systems to emails to patient portals to various customer relationship management software systems, these technology tools are powerful and can be effective – IF they are used to supplement and not substitute for human interaction.
Artificial intelligence tools can increasingly learn, “think” and respond to complaints, symptoms and questions. They can even be programmed to mimic empathy, but they can’t be human. And it’s the human-to-human factor, communications and relationships that ultimately create the trust, empathy, communications, nurturing and empowerment that is essential for sustained patient engagement that actually impacts people’s lives and health.
Pro Tip: Identify, Nurture and Get Buy-In from Your KOLs
Most people have heard, and many subscribe to the oft-quoted phrase “Knowledge is Power.” But real power lies in the ability to not only educate but also influence those who themselves have the most influence on your ability to achieve desired behaviors related to the knowledge you share.
As it relates to getting support and approvals for your patient engagement strategies, do you know who your organization’s patient engagement Key Opinion Leaders (KOLs) are? Keep in mind that in most organizations and relationships, there are two types of KOLs: up-front KOLs and behind-the-scenes KOLs.
The up-front KOLs are generally known and easy to identify. They usually have impressive titles, credentials and positions in the organization. But the lower profile (behind-the-scenes) KOLs are often the ones in the best position to help you – or hamper you. In fact, some behind-the-scenes KOLs may have significant influence with your up-front KOLs.
Conclusion: True patient engagement, from activation to compliance and continuity of involvement over time, requires more than a one-directional communications process from providers or insurers to patient. Technology tools are valuable and important as part of the communications strategy and process but must not become a substitute for the human connection. Patient engagement that actually changes behavior and results in improved health and outcomes is built on a relationship of trust and empathy and requires continual two-way communication (listening, not just informing, educating or “talking at”) between healthcare providers and patients.