Patient Engagement: Not Waiting "Patiently" to Be Told What to Do

February 28, 2018 Donald Kosiak, MD, MBA, FACEP, CPE

Thirty years ago, when my grandmother would get sick, she would go to the doctor, listen to his advice — and then do as she was told. These days, though, when my daughter gets sick and the doctor tells her to take a medicine or complete a test, her first response is to ask questions about the medicine that she's being prescribed: What is it? Why should I take it? What are the potential side effects? How much does it cost? Is there a generic alternative?

One way to look at this is to lament how high maintenance today's patients are compared to how they used to be. Another way to look at it, though, is to say this is good news. Patients are getting more engaged and are taking an ownership stake in their own healthcare. Patients want to know not just their diagnosis, but what the plan of treatment is, what the options are and what to expect if they choose one option over another — not just today but also six weeks, six months, or even six years down the road.

Patients typically spend five to 10 hours per year visiting healthcare providers — and spend the remaining 8,750+ hours of the year managing their condition on their own. The goal for healthcare providers is to use those five to 10 hours to engage the patient and his or her family, help them to understand the disease and what they need to do to manage it when they're outside the doctor's office.

When patients know these things — and when they're encouraged to ask questions and give feedback on how they feel about their plan of care — there are several beneficial effects. For the patients, it's less stressful when they can participate in planning a treatment and when they know what to expect from that plan of treatment. The less stress a patient feels about their illness, the more likely a positive outcome is.

Physicians see good things happen when a patient is engaged in a course of treatment. Their patients are more likely to follow directions, for example, if they've had a hand in putting those directions together, choosing among options and planning the course of treatment. They're also more likely to follow directions correctly if they're actively involved in a give-and-take, and understand not only exactly what they're expected to do, but why — and what the consequences of not following instructions might be.

There are a lot of ways to facilitate patient engagement, and technology plays an important role. Improving patients' access to their electronic health records is important, but even more important is improving patient understanding of those records. Physicians need to help patients identify the important data points in a much larger pile of data that indicate a negative (or positive) trend. We need to ensure that patients know what to look out for — for example, how to distinguish a "good" blood pressure reading from a "bad" one. And we can use texts, emails and other common forms of telemedicine to make sure patients are aware of upcoming tests and appointments — and why it's important that they show up.

This, in a nutshell, is what we're trying to accomplish at Leidos: getting patients engaged in their healthcare to improve outcomes for patients and providers alike.

I will be speaking more on this subject as a panel member at the Patient Engagement & Experience Summit at this year's HIMSS18 Annual Conference, beginning at 9:05 am in the Petrus room at the Wynn Las Vegas on March 5, 2018.

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