According to the Pew Internet and American Life Project, 88 percent of American adults who have Internet access research information about their health online. Sixty percent say Internet information influenced a decision about how to manage a health condition. Social networking using web 2.0 has changed Internet and mobile phones which are evolving from a one-way stream of information to real-time interactive exchanges [1]. Patients go online to interact with other patients; and increasingly with their health care providers. This trend provides a unique opportunity to improve the patient experience and quite possibly their health outcomes.
I see three posts of engagement interacting to become pillars of a new era in health care: comfort, support, and behavioral change, which I will discuss in more detail below.
Armed with an MBA in Finance and Marketing, I spent the first 25 years of my professional life producing feature films, television, live events, and commercials. Having been trained to engage customers as an MBA, and then audiences as a producer, I came to health care with a unique perspective. How can we engage patients in order to achieve successful outcomes? Can these techniques span multiple disciplines such as behavioral health or case management? No matter how great the health care or health management solution is, if the patient won’t use it or follow its regimen, its promise is for naught.
Comfort
How do we engage patients? To start they must feel a comfort with the provider and solution; where they feel that solution is addressing their particular needs. All of which relates the first key post to engaging patients – comfort. A solution must capture patients’ interest, motivate them to use it, and keep patients’ interest enough to follow the solution over and over again. To do so patients must feel that the interactions and/or solution are addressing their particular needs and providing valuable interactions. Ideally, patients should be directly involved in customizing their treatment so that they take ownership of the process, without compromising issues critical for their particular situation or condition. To improve and maintain patient engagement, it is crucial that the implementation integrate seamlessly to each patient’s unique lifestyle. The patient must be involved as a key member of the treatment team – the driving influence in the evolution of their treatment. Finally, unless the intervention is designed to modify long-term behaviors, evolving with the patient, outcomes will continue to be driven by habitual actions. Unless these comfort issues can be adequately addressed, it stands to reason that the health care/health management industry and the patient will experience a large outlay of resources with limited result.
Treatment should create a responsive environment. With today’s informed consumers, it is no longer adequate to simply tell them what they need to know. Responsive environments help inform patients so they become active participants in their recovery. Collecting biomedical information from patients, whether objective data or subjective observations over the life of their treatment, forces patients to be conscious of their circumstance or condition at multiple points in time. Reporting on chronic symptoms or wellness or behavior issues over time and on a regular basis develops a better understanding of their condition. Real-time feedback allows patients to become an active participant in recovery.
Support
Engagement goes beyond the individual patient, addressing our second post of engagement – support. Peer, family, and social support can be accomplished using social media delivered in a wide array of platforms, such as the Internet, mobile phones or just plain meeting at a local coffee shop. Psychosocial connectedness increases patients comfort, and social media has proven to be effective at engaging the patients’ psychosocial support groups in their recovery.
Engaging with others experiencing similar issues is an effective way of providing patients with perspective and of alleviating any fears they may experience. Patients derive great comfort in interacting with others who “know” – who have experienced similar trials. Social media creates a vehicle to connect patients with peer groups who empathize, and who can provide nonjudgmental interaction and support. Peer support contributes to an environment wherein patients may interact and respond in a manner that more closely reflects the reality of their situation and condition. Throughout the process, treatment and results data are collecting that informs both the patient and care provider.
Behavioral Change
Health care providers need a vehicle to focus on patients’ treatment at those times most critical to their recovery. Routine treatment can and should be automated to free overstressed health care workers from routine daily tasks while focusing on those patients most in need. However, to engage their patients, they must provide individualized focused treatment through customized interactions. Effective health care solutions must engage care managers as well. They have to be able to address the capacities and capabilities of the provider and the patient, to tie together their work and lifestyle without creating barriers. This is the third post to the pillars of engagement – behavioral change.
Recovery should be distributed across the entire community of care which includes: case managers, family, psychosocial networks, and peer groups who can provide a sense of comfort and support to patients and their family. A community of care creates supportive independence for patients while maintaining a tether to providers, loved ones, and buddies if, and when, needed. Through effective and personalized automation, where the ‘community’ can be included through information or notification about patients, these efficiencies are accomplished by providing real-time feedback to the treatment team. When following an engagement roadmap being the approach followed by the providers that builds on these pillars of engagement, all these elements can come together. The results are more involved and knowledgeable patients who are more acutely aware of themselves, their psychosocial network, their needs, and their providers’ resources.
At present, one means that has proven effective in creating community of care lifestyle-oriented interactions is the use of mobile devices as a point of interaction. Mobile phones have quickly become a constant in most peoples’ lives. Cellphones accompany people wherever they go or whatever they do. However, just having a mobile application does not mean the app is used properly or at all. According to the PEW Internet Report (1), 35 percent of adults have downloaded an app to their phone. Of those who have downloaded an App, only 65 percent have used it. Only 24 percent of all adults effectively use cell phone Apps. This is why the mobile phone is not necessarily the means to an end, but more likely a very effective conduit of interaction where the solution itself is cloud based, with data accessible to all who need it, when they need it.
In the rush to satisfy a perceived need to have these technical solutions, the concept of usability has often been forgotten. Just having an app isn’t the answer; but, having a meaningful interaction which engages patients in their application may be.
Health care success is not defined by the gadget. Success is accomplished by a patient with improved long-term outcomes. This cannot happen in isolation where the health care system is providing solutions to patients. It must be accomplished with patients – in a form that truly involves patients and their providers. Long-term success will be found following the three pillars of engagement: where patients are engaged, are partners in their solution, and where the solution is personal to them.
References
1. Purcell, K., Entner, R., & Henderson, N. (September, 2010). The rise of app culture. Retrieved from http://www.pewinternet.org/Reports/2010/The-Rise-of-Apps-Culture/Overview.aspx.
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