Activating Patients: The Keystone to Healthcare’s Transition of Value

By Abhinav Shashank, CEO, Innovaccer.

Abhinav Shashank

What do the best care teams in healthcare have in common? They don’t just take care of the sick — they help them get better. They engage and empower their patients to play a central role in their care and become healthy. The RWJ Foundation suggests that compared to highly engaged patients, patients without the skills and confidence to manage their own health end up incurring up to a 21 percent higher cost of care. It’s time we brought patients on to the center stage for the healthcare transformation.

While consumer engagement always plays an important role when delivering any kind of service, patient engagement is an important cog in the wheel of value-based healthcare; this much has always been clear. Whether or not we are capable of meeting these needs — or if meeting them is easy — is up for debate.

Patient engagement: The ‘quarterback’ of healthcare’s transition to value

As Dr. Geeta Nayyar, chief healthcare and innovation officer at Femwell Group, expressed in an interview this HIMSS19, “Patient engagement is the quarterback to get us from fee-for-service to fee-for-value,” and one cannot agree more.

Leading health systems recognize that patient engagement is a high priority. At face value, the term may seem pretty straightforward, but there is a lot more nuance to defining a truly engaged patient. It may start with giving them the tools they need to understand what makes them sick, enabling access to a portal where they can look at their information, and motivating them to take care of themselves with help from friends and family.

The well-being of a patient — broadly, the entire population — is an important measure of the quality of care and its effectiveness in a particular network. And that’s what providers need to realize. The healthier and happier their patients are, the better their network would be.

Measuring patient engagement in value-based care

As more and more providers turn to value-based care, there needs to be some way to tie those initiatives to outcomes. Some regulatory requirements, such as MACRA, measure patient engagement by rewarding reimbursement to providers who are successful in their outcomes, but they are not as effective. Additionally, even the most well-intentioned of initiatives could end up differently. A 2016 Health Affairs study estimated that an average-sized practice spent 785.2 hours reporting on quality measures that did little to improve patient care. In monetary terms, that is $15.4 billion per year in aggregate.

One of the top measures is the Consumer Assessment of Healthcare Processes and Services or CAHPS. CAHPS are somewhat an industry standard when it comes to patient satisfaction and experience, assessing patient-provider communication, patient education, hospital environment, and the discharge process. However, since they are retrospective, an organization can’t go back to fix its issues to enhance patient engagement in real time.

Since patient engagement has started to gain importance, it has also become a measure of financial success for a provider. As patients have begun to assume a significant amount of financial responsibility for their own healthcare, they can easily choose to shift their healthcare dollars someplace else if they have a negative experience. To make sure nothing like this happens, providers need to focus immensely on real-time engagement and a good experience of care at all times.

Engaging patients with activated data

Simply defined, patient engagement is drawn from all interactions influencing patient perceptions across the care continuum. It’s much more than talking to patients after they have been discharged; it is about making them healthy, which can only be achieved when providers are able to understand their patients.

Empowering care teams and providers with the activated data is really essential for them to learn about their patients and connect with them at critical touch points of the care delivery. First of all, providers need to know what works best for the population within a particular region to come up with the best possible treatment procedure. Second, they need to know how that treatment affected their patients to be able to analyze what did or did not work for them.

Most important of all, the right data would help providers to plan the next step of action, similar to your calendar sending you a notification as you’re about to be late for a meeting, or navigation telling you the best route to reach your destination. Activated data needs to be the keystone of the patient engagement strategy for any provider. That’s how they’ll get to know patients’ history and ongoing treatments (if any) to deduce a strategy that works best on a per-patient basis. Unless they have those insights, they cannot effectively engage their patients or create a dedicated action-plan for them.

Another important aspect is establishing a relationship with patients. It was found that 89 percent of PCPs spend less than 25 minutes with their patients during a single encounter, and often this also includes the time they spend on feeding and retrieving data. While the priority should always remain to reduce the administrative workload that physicians face, patients should also be given access to virtual care assistants, telehealth, health apps, 24×7 health concierge services, and direct chats with care teams.

The road ahead

If you’re thinking that creating an effective patient strategy to help you sail smoothly into value-based care is going to be a resource-intensive affair, think again. As value-based care models push providers to drive wellness and positively impact behavior change, it’s essential providers can reach patients- and vice versa- no matter where they are. Providers must understand the level at which patients are engaged. All that is needed is the delivery of timely, relevant, and helpful interventions to patients. The key is to maintain transparency across the network, and that would be the biggest segue into driving more patient-centric care, and ultimately, achieving value-based success.

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