When Dr. Ken Ong, now chief medical information officer (CMIO) for New York Hospital Queens, began his medical career, he was treating infectious diseases. It was the outbreak of the AIDS epidemic and, he states flatly, "We knew nothing." Only by working closely with patients could Ong and his colleagues begin to determine which drugs made AIDS a largely treatable condition.
Years later, patient engagement has emerged as a key strategy for not just treating chronic conditions but also providing better, more collaborative and more efficient healthcare. This is especially true of healthcare systems aiming to pursue models of coordinated care such as the accountable care organization (ACO) in an effort to eschew what many consider an outdated, expensive fee-for-service model.
A range of innovations, from wearable tech and medical devices to patient portals and personal health records, appear poised to improve the patient experience by streamlining administrative tasks and providing physicians with data to enhance the care process.
For such technology to have an impact, though, patients must use it, physicians must be accept it and healthcare organizations must integrate it - as well as the basic principles of patient engagement - into their strategic plans.
Patient Engagement a Necessary, but Difficult, Sell
If you think of patients as customers, the healthcare industry is essentially backwards. Banks, retailers, utilities and other firms constantly reach out to their customers with deals, tips and other forms of communication. Healthcare providers,however, wait for patients to reach out to them. Many patients don't reach out until they need urgent care - which is the most costly and, in many cases, the least effective form of care.
Regulatory efforts requiring providers to demonstrate that 5 percent of patients are viewing, downloading or transmitting electronic versions of their records, then, should be an easy sell, says Norm Chapin, CMIO and medical director for Columbia Memorial Hospital. It negates the need to take time off work, get in the car, drive to the doctor's office and make a co-pay for what often amounts to a one-minute conversation with a physician.
Unfortunately, providers often struggle to justify the expenditure, says Chapin, speaking with Ong and other at the Institute for Health Technology Transformation's New York Health IT Summit. The return on investment for health IT projects is rarely as advertised; as Chapin says his CEO points out, staffing levels at Columbia Memorial remain the same, and people still print paper records. "It's a challenging paradigm shift," he says.
As a result, says Joanne Rohde, CEO of Axial Exchange, which makes engagement applications for patients as well as providers, it's easy for organizations to give in to the temptation to expose a "vanilla" patient portal, one that does little more than let patients book appointments and refill prescriptions and that's implemented with little to no clinical or patient input. In such situations, it's no surprise that patient portal adoption remains as low as 2 percent.
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