For this project, I am discussing patient engagement, which is an important technological issue because it has been shown that patient involvement is important in high quality healthcare. Engaging patients requires the use of online applications and smartphones for patients to track their health records and data; however, limitations in the availability of these technologies could deter patients from participating. These applications are able to track nutrition, medication reminders, symptoms, physical activity, and more. Currently it has been shown that applications do help boost patient engagement; yet, it seems to primarily be in the millennial generation and younger. The overall objective of this study is to determine what is currently in place for engaging patients and what deters people from utilizing it as well as discover what would increase the usage for patients and how it could be made better or more accessible. Access is the driving factor to utilizing these resources and there are multiple factors that play into what makes a patient have more accessibility than others. Many hospitals utilize online applications for patient’s use, especially within mobile devices. The factors that contribute to the success or failure of the applications include accessibility, user friendliness, and cost.
So what is patient engagement? “Patient engagement is a key strategy that refers to the tools and actions taken by patients, caregivers, and healthcare providers to promote informed decision-making and behaviors to facilitate improved health outcomes” (Foisey, 2015). The importance of patient engagement has been researched and discussed with evidence supporting its significance in lowering costs and improving patient outcomes. Most people in the healthcare industry agree that the future of healthcare is being shaped largely by patient engagement evolution. So, while the concept of patient engagement is not new, the role of technology within it is. A recent survey performed by Deloitte suggest that patient engagement is seeing a growth within the use of technology due to the increased connectivity and engagement within our society through the use of technology platforms. In fact, 47 billion google searches are made daily with 1 out of 20 being related to healthcare, 77 percent of patients used a search prior to booking an appointment, and 70 percent of internet users look online for information about a disease or medical problem (Foisey, 2015). Some of the latest technologies focused on patient engagement involve “managing patient health data, managing communication with physicians, self-care at home, education, and financial management…from wearable tech and medical devices to patient portals and electronic health records” (Foisey, 2015). In the past, the largest driving factor for technological influence in patient engagement, was the introduction of electronic health records and the phasing out of paper charting. Along with this, the Office of National Coordinator’s established the Meaningful Use program (Dolan, 2014). This began the initiative that hospitals must provide patients with relevant health information accessible through online formats that they can view, download, and transmit after visiting with a provider. Mobile phones made this information even more accessible and applications specific to healthcare and text updates became prominent (Dolan, 2014).
In a perfect world where technology that improves patient engagement is consistently utilized, there can be many benefits. The first benefit is the increase in better health outcomes for patients. When they become invested in their health, they are more aware of signs and symptoms and are more likely to contact their providers when they have concerns. When communication is improved between patients and providers, negative outcomes are reduced. The second benefit is the increase in patient satisfaction. When patients have access to their providers and healthcare records, it improves trust and decreases anxiety about entrusting a stranger with their care. It also improves their satisfaction with life, since they are inspired to live healthier lifestyles and adhere to treatments that improve the outcomes of their diagnosis. Thirdly, it reduces emergency room visits by making sure patients proactively address red flag symptoms. Lastly, it lowers the cost of health care and increases revenue. Patients that are engaged spend less time on repetitive visits and they follow through with treatment plans. These preventative measures lower the overall cost that falls on the patient. At the same time, it increases the profit of a practice through increasing the likeness of patients following up for routine visits and care. The more patients that a practice has that are investing their time into their personal care, the more likely they are to increase their revenue as more procedures are going to be completed (Rossow, 2018).
However, all these tools are useless if the patient does not have an interest in taking an active role in their health or they do not have access to the resources they need. Patient engagement requires action that must be initiated and sustained by the patient and it must be encouraged by the healthcare providers through teaching. All parties must be willing to embrace the shift of technology in order to achieve the desired outcomes; yet there are still barriers. Some of these barriers include cost, integration, technology access, and culture. Finance plays a substantial role as hospitals and providers transition to electronic health records to satisfy the meaningful use act, they have to make investments into the human and technical resources. “Even though the incentives for implementation defray up-front costs, CIOs and CFOs need to factor in the pros and cons of the long-term management. Integration is also a drawback because while many technologies exist to promote patient engagement, they do not all necessarily work together. This makes it difficult for communication to occur between systems and can be very draining of time on the providers end as well as the patients. Similarly, access to technology may not be readily accessible for the patient or the caregiver as they require the use of expensive electronic equipment. This is where most of the cost is derived from in the clinical setting, and patients who are not as well off as others, may suffer from lack of access to these technologies. Finally, as mentioned previously, one of the largest issues with technology in patient engagement is the unwillingness of the patient to utilize the resources and the unwillingness of the provider to promote the tools. The culture of the clinical organization must be focused on promoting these tools and prioritize the end goal of utilizing them, which is a healthy patient (Fiedler, 2011).
In an interview with Kathryn Duevel, MD, Medical Director of Quality and Innovation at ACMC Health, she states that better patient engagement is a goal for nearly all health care providers; yet, she states, “the problem is that incentives for patient engagement are not aligned. The time and effort to educate, motivate, and troubleshoot issues are not recompensed very well at present” (Gittlen, 2017). Since it requires extra work from providers many believe that they should not be responsible for it, but Duevel went on to say that, “physicians need to realize that patient engagement is our job and we all have to be involved in the design of healthcare delivery to ensure it works in terms of quality, productivity, and the overall mission” (Gittlen, 2017). Therefore, creating seamlessly integrated technology would resolve the issue of the time requirement that physicians must utilize and it would make patient teaching more effective. If the system being utilized is easy to maneuver, less time is needed to teach someone how to use it.
With this in mind, it is easy to identify that the benefits of these technologies greatly outweigh the cost of equipment or upkeep and time commitment. As technology becomes more readily available, patient teaching on the importance of utilizing these features is important to the success of their involvement. This can be completed easily if a system is installed with an IT team managing system technicalities to prevent the physician from being overworked and allowing him to spend time giving the patient information on how to best use these tools. As our society shifts into a technology based culture, the promotion of patient engagement is even more important to the success within clinical settings. If hospitals and providers, along with patients, are willing to dedicate the time and finances into implementing and utilizing these tools, both will reap the benefits of quality care and reduced costs. It can be one of the most useful tools within the clinical setting and can address the needs illustrated below in a simple, cost effective way (Rossow, 2018).