In 2008, the National Quality Forum (NQF) declared patient and family engagement to be one of the six national priorities to eradicate disparities, reduce harm and remove waste from the health care system in the United States.
This year, at their annual conference and membership meeting, in May 2012, they once again focused on patient engagement, insisting that we must give have more than lip service to the idea that patients must be truly involved in their care. At this meeting patient engagement was defined as an environment where providers must listen to patients, understand patient preferences, incorporate these preferences into the decision-making process and provide health care that is patient-centered.
The NQF is not the only group to focus on patient engagement.It seems that patient engagement is a current hot topic. One of the provisions in the Health Care Reform Bill would eliminate co-pays for all preventive care for patients of all ages.The bill also mandates that along with CMS, where at the CMS web site, patients can find comparisons of individual physicians based on quality and patient experience metrics, that the States develop patient web sites that provide comparisons of private insurance plans. This puts information that patients need to make critical health decisions directly into their hands.
Wrapping our thoughts around the concept of patient engagement is not easy. There are many definitions: some that put the onus of engagement on physicians, while others contend that it is the patient who needs to become proactive and take steps to make personal health and lifestyle decisions that directly affect their outcome, including:
- Patients engaging in a model of clinical partnership sharing the power and responsibility for treatment decisions with health care providers
- Patients having a voice in selecting their particular health care payment plan: (Consumer Directed Health Plans) including health savings accounts, health reimbursements accounts and flexible spending accounts
- Patients participating in governance as working members of hospital boards of overseers, government advisory groups and patient advocacy organizations.
In e-Patients Live Longer, I provide a very specific portrayal of what a patient must do to engage and become the master of their health care. I talk about patients taking charge by thinking through how to most effectively communicate with their providers, showing up for their annual exam with a well thought out list of questions; initiating email communication with their doctors. registering and using a patient portal (if one is available) to do their referrals, make appointments, renew medications, get their labs and send messages to their . doctors. I discuss in-depth the importance of how individuals who have chronic conditions can monitor those conditions and send daily or weekly reports to their providers; how they can use their smartphones to download healthcare apps that are useful, perhaps critical in an emergency; how they must become diligent about their own safety in all medical settings; how they are responsible for medication adherence; how they must become more tuned into their health care payment plans and make good decisions based on what they can afford to pay for all of their health care needs.
What patient engagement really boils down, to is not a patient in isolation who reads about health issues on the Internet, downloads health apps on their smartphone, or uses the hospital’s patient portal; nor is it a physician who implements one of the many patient engagement systems that help achieve better metrics for chronic care patients. It is a patient-centered collaborative process that involves both the patient and the physician who put their heads together to share decision-making and find the best information and treatment solution that will lead to better long-term outcomes.