How To Achieve Better Patient Engagement

Sooner or later, everyone gets upsetting health news either about themselves or a loved one. When a clinician delivers that news, a stunned patient often goes into a fog and doesn't hear what's said next. Having another person accompanying the patient is great, but not always possible. The proposed new Stage 2 MU rules can help.

Compared to Meaningful Use Stage 1 criteria, under the proposed rules for Stage 2, eligible providers and hospitals must provide access to more information to a greater percentage of patients in a shorter amount of time. Some Stage 2 proposals for patient engagement are changes to what Stage 1 required, while other Stage 2 rules are brand new.

For instance, Stage 2 requires that clinical summaries be provided to patients within 24 hours for more than 50% of office visits. That shortens the time from three days in Stage 1. Another proposal for Stage 2 requires that 50% of patients discharged from emergency rooms or hospitalizations have their information available online within 36 hours, up from 10% in Stage 1.

Among the new requirements, Stage 2 proposes that 10% of patients discharged from hospitals or ERs electronically view, download, or transmit to a third-party their health information during the hospital's reporting period for MU. Also new is a requirement that eligible clinicians use secure electronic messaging to communicate relevant information to 10% of patients during the MU reporting period.

While some of these new proposals might appear like minor variations of Stage 1 rules, they indicate a growing acknowledgement of how important it is for healthcare providers to communicate with patients and give them access to their information.

Granted, as more patients are granted access to their information, they also need to be made aware that this information is available. Having just 10% of patients downloading, viewing, or electronically transmitting discharge instructions regarding recent hospitalizations won't happen if not enough patients know to look for that capability.

Meanwhile, I suspect that many consumers who haven't recently been hospitalized or suffering from a major illness--or aren't caring for someone with a significant health issue--would also find it handy to access to their health information periodically, whether it's seeing results for routine blood tests performed during annual physical exams, or printing out copies of their kids' immunization history for summer camp applications. Consumers need to know the information is available, and healthcare providers should be proactive in getting the word out.

Some healthcare providers say patients generally don't ask for access to their information unless they're collecting records to take to a new doctor, specialist, or for a second opinion. But perhaps some consumers don't realize what they're missing by not having access, even if they think it's pretty routine content. Wouldn't it be great for more elderly patients to know they can view a clinical summary of an office visit, and then share that information with a family member who can double-check if Mom or Dad is complying with the doc's instructions?

A study released this week by the National eHealth Collaborative (NeHC)--a public-private healthcare stakeholder organization focused on advancing interoperable health information exchange--found that nearly all healthcare players think engaging patients is critical to transforming healthcare.

In fact, of the 185 stakeholders who participated in the NeHC online survey conducted in mid-February, 77% of respondents said patient and consumer engagement is "very important" to transforming healthcare and 18% said it is "important." Only 5% think that engagement is "somewhat important," and no one thought it was unimportant.

Still, "while consumers want access to basic health information, the challenge is engaging people who don't have chronic illnesses, or see their doctors more than once a year," said Kate Berry, CEO of NeHC in an interview with InformationWeek Healthcare during the recent HIMSS12 conference in Las Vegas.

Of course, it's also possible to engage patients through health information exchanges (HIEs), which are organizations that facilitate the regional or statewide sharing of patient data among member healthcare providers. As Berry points out, "some are looking to involve consumers … but need to look at patient consent issues."

Some HIEs are looking to incorporate patient portals into their service offerings, or to populate health information into records that patients can access, she said. Meanwhile, "some HIEs say it isn't their role to give patient access, it's up to the providers to do that," she said.

When asked to define patient engagement, 64% of NeHC survey respondents said it's "best reflected" as online resources and education material to inform patients about health and health conditions; 59% said it was patients using tools and online resources for managing their health records and other data; 41% said it was patients feeling comfortable to challenge a doctor when something doesn't seem right or clear.

Sooner or later the ability for patients to check lab test results or see other health information electronically should be as common and easy as going online to confirm their checking account balances. Similarly patients should be able to send secure messages to their doctors when they don't understand in those test results, and have docs respond with links to educational information that explain them.

The proposals in Meaningful Use Stage 2 can help encourage all sorts of enhanced patient engagement. But healthcare providers might need to enlighten some patients so they actually starting looking for those capabilities and participate.

Marianne Kolbasuk McGee is a senior writer for InformationWeek.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)