Patient Engagement Is More of an Issue In Ambulatory Practice than In Hospitals

After having spent several days in a hospital recently caring for a loved one, I can unequivocally say that there is no comparison for patient engagement – in relation to meaningful use and in regard to health IT such as EHRs – between the hospital setting and the ambulatory practice.

Simply put, there is no comparison between the amount of attention given to the topic of patient engagement in ambulatory practice and in hospital care, at least as far as the patient experience is concerned.

I say this with certainty, having been in and out of multiple doctors’ offices and two hospitals during the last six weeks. In at least three separate doctors’ offices, the staff and physicians at each made some attempt – even if only very small – to make sure I was engaged and that the technology used during the visit was not too much of a distraction.

One nurse, as previously reported on this site, even went so far as to say that there was too much technology in the exam room getting in the way of patient care.

On the contrary, in the hospital, especially during our two-day stay, the technology we encountered felt more like the kind you might find at your local retailer – scanner, computer cart, etc. – than you might find in a hospital.

What does this seem to mean? From my limited perspective it means that hospital care is often more urgent than that of the ambulatory setting, as it likely should be. Clearly, though, not all care encounters in the hospital are urgent, but from my experience, patients engaging with care providers who use EHRs in the hospitals at the point of contact, is overly hyped.

As such, should we really be spending so much time on the patient engagement argument when it’s only an issue for ambulatory?

Seriously, the only time the use of technology came up during our two-day visit was when I asked our nurse which system the hospital used. She happened to be a traveling nurse who had taught herself to use more than 10 EHRs. Cerner was her response to the system the hospital used; also the most difficult system she has encountered (in part because it is clunky and often leads to death by clicking, she said.) The best system she’s used: Epic.

But I digress. My point here is simple. Those of us bent on engaging patients, and ensuring patients are engaged, might learn a lot from the experience I’ve just had.

Patients are no less important in the hospital than they are in private practice; however, in my experience, the only place where the interaction between patient and the employed technology in the care setting is in the ambulatory setting.

Despite the reason for it (I’d appreciate some comments below), perhaps it’s time to get real and stop pretending that the topic is top of mind for our hospital and health system friends in healthcare.

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