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Pathways to Patient Engagement:
MD Insights
#PatientEngagement
Kelley Connors, MPH, Founder KC Health
The Brand Engagement
Champion for Health
Innovators
Host/Producer
“Pathways to Patient Engagement”
Twitter @kelleyconnors
LinkedIn @linkedin.com/in/kelleyconnors
Patient Engagement:
The actions that people take to
better control their health and
benefit from care

#PatientEngagement
Why Patient
Engagement?
60%
Of all healthcare costs are
influenced by the behavior and
decisions of individual patients

#PatientEngagement
From e-patient, Jamia Marisha Crockett:

“I don’t want to be engaged… I
want a partnership with my
healthcare team.”

#PatientEngagement
As Laura Kersting-Barre said:

“We also need to give equal weight
to provider engagement. I have seen
a few providers that were much less
engaged in my treatment than me.”

#PatientEngagement
Patient Engagement Goals Vary By Sector
Pharma:
Improve
Compliance

Health
Insurers:
Wellness &
Prevention

Patient
Engagement

Workplace
Wellness:
Higher
Productivity

Hospitals:
Reduce
Readmission
#PatientEngagement
Kathleen Poulos, CMO and Co-Founder of InCrowd, Inc.

@katseyemedia
linkedin.com/in/kathleenpoulos
google.com/+KathleenPoulos
InCrowdNow.com
Kathleen.poulos@incrowdnow.com

#PatientEngagement
#PatientEngagement

Pathways to Patient Engagement:
State of the Union

Tuesday November 19, 2013
Background
Understand the current ‘state of the union’ in
terms of patient engagement
Highlight gaps and opportunities

Using the InCrowd platform, surveyed 300 US
based primary care physicians
#PatientEngagement
Current State of Patient Engagement
61% of surveyed physicians participate in patient
engagement activities

Practice website containing educational information is
leading patient engagement activity
Increased patient involvement in their care and health,
cited as the major benefit
Time required to implement and execute was most
common barrier

#PatientEngagement

“A meaningful
collaboration
between patients and
clinicians, working
together to help the
patient progress
towards mutually
agreed upon health
goals”
Do you currently participate in
patient engagement activities?

#PatientEngagement
Almost 40% of PCPs stated they currently participate
in NO patient engagement activities

No

39%
116 PCPs
61%
184 PCPs

Do you currently participate in patient
engagement activities? n = 300 PCPs

Yes
44% of those 116 non-active PCPs state they are not
familiar with the term patient engagement

No
116 PCPs
Yes
184 PCPs

Do you currently participate in patient
engagement activities? n = 300 PCPs

51 PCPs
indicated
they had
no idea
what
‘patient
engagement’
meant
I don’t know what
I have no idea what this means.
this would be.
Sounds like a silly buzzword.
No idea what that is.
I’m out of the loop here. I’m not sure what you are
referring to. Support groups? Diet groups?
I can’t say I know what is meant by that moniker.
Don’t know what you mean.
Satisfaction surveys? Educational sessions?

Unsure what that is.
#PatientEngagement
Which statement best defines the
concept of patient engagement?

#PatientEngagement
Patient Engagement Statements
Technology, mobile
applications
and online
communities that
provide patients
access to medical
information

Enhanced physicianpatient
communications,
both in person and
via technology

Secure
communication
tools that give the
patient easy access
to
their medical
information

A meaningful
collaboration
between patients
and clinicians,
working together to
help patient
progress towards
mutually agreed
upon health goals

Nothing more than
a buzz word for
things we have
been doing for
years

Other
(please define)

18 / 300 PCPs

53 / 300 PCPs

13 / 300 PCPs

161 / 300 PCPs

48 / 300 PCPs

7/ 300 PCPs

6%

18%

4%

54%

16%

2%

8 / 116 PCPs

18 / 116 PCPs

3 / 116 PCPs

50 / 116 PCPs

31 / 116 PCPs

6 / 116 PCPs

7%

16%

3%

43%

27%

5%

Which statement best defines the concept
of patient engagement? n = 300 PCPs
Which of the following patient
engagement activities and tools
do you currently offer?

#PatientEngagement
Websites and patient portals top the list of current
patient engagement tools being offered
Other (describe in comments)

7%, 22/300

Mobile health apps

Non
Active
PCPs

5

11%, 32/300

6

20%, 61/300

None of the above

46

Schedule appointments via website

26%, 78/300

Secure communication via email / text

17

36%, 108/300

Patient portal

42%, 125/300

Website with educational information

49%, 147/300
0%

Which of the following patient engagement activities and tools
do you currently offer? Select all that apply. n = 300 PCPs

20%

40%

60%

24
31
46

80%
What do you see as the most
significant benefits resulting from
patient engagement?
Please rank the options below from greatest
potential benefit to lowest potential benefit.

#PatientEngagement
Benefits of Patient Engagement
Active PCPs Selected
as #1 Benefit

Non Active PCPs
Selected as #1
Benefit

80

49

31

3.8

65

43

22

Improved communications with office and healthcare
staff

3.6

44

22

22

Allows physicians to be proactive, planning around
patient needs prior to appointment

3.4

31

25

6

Patients given easier access to their personal medical
records

3.2

50

29

21

Minimized underuse or overuse of medical services
resulting in reduced health care costs

3.0

30

16

14

Overall Ranking

PCPs Selected as
#1 Benefit

Increased patient involvement in their care and
health

4.0

Better patient adherence to their treatment plans

Benefits of Patient Engagement

What do you see as the most significant benefits resulting from
patient engagement? Please rank the options below from greatest
potential benefit to lowest potential benefit. n = 300 PCPs
What do you consider to be the
greatest potential barriers to
implementing a patient engagement
program at your practice?
Please rank the options below from greatest
potential barrier to lowest potential barrier.
#PatientEngagement
Barriers to Patient Engagement
Barriers to Implementing Patient
Engagement Programs

Overall
Ranking

PCPs Selected as #1
Barrier

Active PCPs
Selected as
#1 Barrier

Non Active PCPs
Selected as
#1 Barrier

Time required to implement and execute

4.2

90

55

35

Cost required to implement and execute

4.2

74

46

28

Lack of patient interest in engagement

3.4

40

28

12

Positive results of engagement not
worth the effort

3.1

39

23

16

Don’t have the technology/software
needed for patient engagement

3.1

31

17

14

Unsure what to offer

2.9

26

15

11

What do you consider to be the greatest potential barriers to implementing a
patient engagement program at your practice? Please rank the options below from
greatest potential barrier to lowest potential barrier. n = 300 PCPs
Gaps & Opportunities
No clear understanding of patient engagement
Broader list of patient engagement offerings
Uncertainty around patient engagement
– Technology, appropriate content, risks, benefits

#PatientEngagement
Fard
Johnmar, President, Enspektos

Twitter @Enspektos
Web Site Enspektos.com

#PatientEngagement
Featured Blogger:
Katie McCurdy: E-Patient

Katie McCurdy's thoughts on the intersection of
user experience, healthcare and data visualization

#PatientEngagement
KC-Health.com
InCrowdNow.com
Enspektos.com
Upcoming with KC Health
Patient Engagement Webinars:
December 10th
January 14th
#PatientEngagement
Thank you for attending!

#PatientEngagement

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MD Insights for Patient Engagement

  • 1. Pathways to Patient Engagement: MD Insights #PatientEngagement
  • 2. Kelley Connors, MPH, Founder KC Health The Brand Engagement Champion for Health Innovators Host/Producer “Pathways to Patient Engagement” Twitter @kelleyconnors LinkedIn @linkedin.com/in/kelleyconnors
  • 3.
  • 4. Patient Engagement: The actions that people take to better control their health and benefit from care #PatientEngagement
  • 6. 60% Of all healthcare costs are influenced by the behavior and decisions of individual patients #PatientEngagement
  • 7.
  • 8. From e-patient, Jamia Marisha Crockett: “I don’t want to be engaged… I want a partnership with my healthcare team.” #PatientEngagement
  • 9. As Laura Kersting-Barre said: “We also need to give equal weight to provider engagement. I have seen a few providers that were much less engaged in my treatment than me.” #PatientEngagement
  • 10. Patient Engagement Goals Vary By Sector Pharma: Improve Compliance Health Insurers: Wellness & Prevention Patient Engagement Workplace Wellness: Higher Productivity Hospitals: Reduce Readmission #PatientEngagement
  • 11. Kathleen Poulos, CMO and Co-Founder of InCrowd, Inc. @katseyemedia linkedin.com/in/kathleenpoulos google.com/+KathleenPoulos InCrowdNow.com Kathleen.poulos@incrowdnow.com #PatientEngagement
  • 12. #PatientEngagement Pathways to Patient Engagement: State of the Union Tuesday November 19, 2013
  • 13. Background Understand the current ‘state of the union’ in terms of patient engagement Highlight gaps and opportunities Using the InCrowd platform, surveyed 300 US based primary care physicians #PatientEngagement
  • 14. Current State of Patient Engagement 61% of surveyed physicians participate in patient engagement activities Practice website containing educational information is leading patient engagement activity Increased patient involvement in their care and health, cited as the major benefit Time required to implement and execute was most common barrier #PatientEngagement “A meaningful collaboration between patients and clinicians, working together to help the patient progress towards mutually agreed upon health goals”
  • 15. Do you currently participate in patient engagement activities? #PatientEngagement
  • 16. Almost 40% of PCPs stated they currently participate in NO patient engagement activities No 39% 116 PCPs 61% 184 PCPs Do you currently participate in patient engagement activities? n = 300 PCPs Yes
  • 17. 44% of those 116 non-active PCPs state they are not familiar with the term patient engagement No 116 PCPs Yes 184 PCPs Do you currently participate in patient engagement activities? n = 300 PCPs 51 PCPs indicated they had no idea what ‘patient engagement’ meant
  • 18. I don’t know what I have no idea what this means. this would be. Sounds like a silly buzzword. No idea what that is. I’m out of the loop here. I’m not sure what you are referring to. Support groups? Diet groups? I can’t say I know what is meant by that moniker. Don’t know what you mean. Satisfaction surveys? Educational sessions? Unsure what that is. #PatientEngagement
  • 19. Which statement best defines the concept of patient engagement? #PatientEngagement
  • 20. Patient Engagement Statements Technology, mobile applications and online communities that provide patients access to medical information Enhanced physicianpatient communications, both in person and via technology Secure communication tools that give the patient easy access to their medical information A meaningful collaboration between patients and clinicians, working together to help patient progress towards mutually agreed upon health goals Nothing more than a buzz word for things we have been doing for years Other (please define) 18 / 300 PCPs 53 / 300 PCPs 13 / 300 PCPs 161 / 300 PCPs 48 / 300 PCPs 7/ 300 PCPs 6% 18% 4% 54% 16% 2% 8 / 116 PCPs 18 / 116 PCPs 3 / 116 PCPs 50 / 116 PCPs 31 / 116 PCPs 6 / 116 PCPs 7% 16% 3% 43% 27% 5% Which statement best defines the concept of patient engagement? n = 300 PCPs
  • 21. Which of the following patient engagement activities and tools do you currently offer? #PatientEngagement
  • 22. Websites and patient portals top the list of current patient engagement tools being offered Other (describe in comments) 7%, 22/300 Mobile health apps Non Active PCPs 5 11%, 32/300 6 20%, 61/300 None of the above 46 Schedule appointments via website 26%, 78/300 Secure communication via email / text 17 36%, 108/300 Patient portal 42%, 125/300 Website with educational information 49%, 147/300 0% Which of the following patient engagement activities and tools do you currently offer? Select all that apply. n = 300 PCPs 20% 40% 60% 24 31 46 80%
  • 23. What do you see as the most significant benefits resulting from patient engagement? Please rank the options below from greatest potential benefit to lowest potential benefit. #PatientEngagement
  • 24. Benefits of Patient Engagement Active PCPs Selected as #1 Benefit Non Active PCPs Selected as #1 Benefit 80 49 31 3.8 65 43 22 Improved communications with office and healthcare staff 3.6 44 22 22 Allows physicians to be proactive, planning around patient needs prior to appointment 3.4 31 25 6 Patients given easier access to their personal medical records 3.2 50 29 21 Minimized underuse or overuse of medical services resulting in reduced health care costs 3.0 30 16 14 Overall Ranking PCPs Selected as #1 Benefit Increased patient involvement in their care and health 4.0 Better patient adherence to their treatment plans Benefits of Patient Engagement What do you see as the most significant benefits resulting from patient engagement? Please rank the options below from greatest potential benefit to lowest potential benefit. n = 300 PCPs
  • 25. What do you consider to be the greatest potential barriers to implementing a patient engagement program at your practice? Please rank the options below from greatest potential barrier to lowest potential barrier. #PatientEngagement
  • 26. Barriers to Patient Engagement Barriers to Implementing Patient Engagement Programs Overall Ranking PCPs Selected as #1 Barrier Active PCPs Selected as #1 Barrier Non Active PCPs Selected as #1 Barrier Time required to implement and execute 4.2 90 55 35 Cost required to implement and execute 4.2 74 46 28 Lack of patient interest in engagement 3.4 40 28 12 Positive results of engagement not worth the effort 3.1 39 23 16 Don’t have the technology/software needed for patient engagement 3.1 31 17 14 Unsure what to offer 2.9 26 15 11 What do you consider to be the greatest potential barriers to implementing a patient engagement program at your practice? Please rank the options below from greatest potential barrier to lowest potential barrier. n = 300 PCPs
  • 27. Gaps & Opportunities No clear understanding of patient engagement Broader list of patient engagement offerings Uncertainty around patient engagement – Technology, appropriate content, risks, benefits #PatientEngagement
  • 28. Fard Johnmar, President, Enspektos Twitter @Enspektos Web Site Enspektos.com #PatientEngagement
  • 29.
  • 30. Featured Blogger: Katie McCurdy: E-Patient Katie McCurdy's thoughts on the intersection of user experience, healthcare and data visualization #PatientEngagement
  • 32. Upcoming with KC Health Patient Engagement Webinars: December 10th January 14th #PatientEngagement
  • 33. Thank you for attending! #PatientEngagement

Editor's Notes

  1. The lens through which I see patient engagement is influenced by my role as caregiver and patient advocate for my dad who has CML. I was so inspired by the patient and organizational partnership that is the Leukemia and Lymphoma Society, that I joined TNT and rode 100 miles around Lake Tahoe..having never biked more than 20 miles on a single trip before!
  2. A limited but useful construct…
  3. Why are we talking about patient engagement today? It’s about theeconomic and health consequences of a misaligned health care system that is now undergoing reform in a big way.Healthcare reform, while it is already law, will on October 1st, become more affordable to most of the 48 million people who remain largely uninsured. 50 million are currently covered under Medicaid, but that number will expand by millions when half the country expands Medicaid under the Affordable Care Act.So far, 25 states plus the District of Columbia have opted to expand coverage that will allow those with making up to 138% of the federal poverty level to sign up for Medicaid. As many as 21 states have rejected plans to expand coverage to their low-income residents, while three states—New Hampshire, Tennessee and Ohio—are still debating whether to move forward.As a result of health care reform, millions of uninsured will be entering that is already overburdened with aging baby boomers, an obesity epidemic and misaligned financial incentives that reward sick care.15 million women – women make up 45% of the uninsured, many women are caregivers.One in four are hispanicsNon-citizens had the highest rates of uninsured of any demographic at 43%, a figure unlikely to change much under the Affordable Care Act, which explicitly excludes anyone living in the U.S. illegally. The next most likely people to be uninsured in the U.S. are Hispanics (29%). Young people, ages 19-34, are close behind at 27%. HHS and its partners are aggressively targeting those groups in their outreach efforts. The Census Bureau also found the highest concentration of uninsured residing in Southern and Western states. Many of them will become newly eligible for Medicaid in Western states such as California, Nevada and Arizona. 
  4. 60 percent of all health care costs are influenced by the behavior and decisions of individual patients. This is just a fact that has been ignored by our paternalistic health system that has made patients largely ignorant of their role in improving their health through lifestyle, fitness and in general, behavior change.
  5. What do e-patients think? They are agents of change in healthcare today.
  6. Patient Engagement has been called the holy grail of the 21st century. The main idea is that if you engage patients you have the opportunity to lower costs and improve health…it’s a necessary part of delivering innovation in this country during an era of incentive reform. Patient engagement is the next frontier for plans, and really all of health care,” he says. “Returns have been diminishing for narrowing provider networks, redesigning benefits, and other top-down strategies. strategies such as consumer-directed health plans with cost sharing provisions, cost and quality transparency efforts, wellness programs, and disease management programs have had limited success.
  7. To give you a little background on what we have to share regarding patient engagement…We really wanted to understand the current ‘state of the union’ in terms of patient engagement – get a snap shot of today’s reality.We felt this would be a good way to begin to highlight ‘gaps’ and opportunities within the current patient engagement environment Using the InCrowd micro survey platform, we surveyed 300 United States based primary care physician, we selected primary care physicians or PCPs because they tend to see a high volume of patients on a monthly basis and are kind of a gateway into the healthcare system (Friday November 1st at 5 PM started fielding, finished mid day on Sunday November 3rd)The average demographic for our PCP Crowd was… 10 -19 years in practiceOffice basedSeeing 150 – 600 patients in a monthSo what is the current’ snapshot’ on the state of patient engagement?
  8. So what is the current’ snapshot’ on the state of patient engagement? We found that…61% of the PCPs we surveyed are actively participating in some type of patient engagement activitiesThe physician’s practice website is the leading patient engagement activity currently being offered ‘Increased patient involvement in their care and health’ was noted as the biggest benefit while time was seen as the biggest barrierThe most commonly selected definition for patient engagement was… A meaningful collaboration between patients and clinicians, working together to help the patient progress towards mutually agreed upon health goals Now this is the high level “snapshot’ – what did we learn from the details….
  9. So this is the high level “snapshot’ – what did we learn from the details….We started simple – very open and broad – wanting to understand what they would tell us before we put our scope and context around the the topicWe asked… Do you currently participate in patient engagement activities?
  10. We found that almost 40% of the PCPs said NO, they don’t participate in ANY patient engagement activities.I’ll admit, this was a bit of a surprise. I expected there to be some that said No, but not 40%I call this ’No Group’ the non active PCPs and the ‘Yes group’ the active PCPsBut what was even more surprising that this…
  11. But what was even more surprising than this…That 44% of that ‘non-active group’ or 51 of those PCPs - indicated they had no idea what patient engagement meant, they stated…
  12. They stated…Unsure what that isDon’t know what this would beSounds like a silly buzzwordI’m out of the loop here – do you mean support groups, diet groups? Satisfaction surveys? Educational session? To have a group of physicians - a group of primary care physicians that are the gateway to the healthcare process – say they have NO idea what patient engagement means – despite all that has been done in terms of implementing meaningful use – is concerning. I assume the Affordable Care Act and the rise of the educated health consumer will drive change in terms of patient engagement ANDI think this represents opportunity for stakeholders in the healthcare process to develop tools and programs that support both providers and the patients. At this point we did offered some guidance or context around the concept of patient engagement…
  13. At this point we did offered some guidance or context around the concept of patient engagement… We provide some definitions and had the PCPs select the statement they felt best defined the concept of patient engagement
  14. We provided 5 statements or definitions that were pulled from a literature search on the topic of patient engagementThe one selected by the majority of PCPs’ highlights collaboration and mutually agreed upon health goals, it was good to see the more well rounded statement selected. We also pulled out the data for the non-active group (those 116 PCPs that are not currently participating in patient enjoyment activities) to see what their information reflected. I’m happy to report that despite not participating in patient engagement and many of them being unfamiliar with the term – when provided with options the majority of this group also selected the more well rounded statement. As for Other – the PCPs offered things like…-Providing EASY ways to securely communicate with their doctors-Haven't ever heard that term-I have never hard this term before so have no idea-Advertising-person to person contact...we do this and have many great comments from our patients.even those who are very tech friendly.appreciate the warmth and friendliness of our office-Engagement does sound a good word to use. Not a buzz word. Make sure patients understand.-Other than in office discussions, I prefer the use of telephone rather than e-mail or text--more personal--
  15. To get a bite more granular we provided the PCPS with a list of patient engagement activities and asked them which they currently offered.
  16. To get a bite more granular we provided the PCPS with a list of patient engagement activities and asked them which they currently offered. This was a select all that apply question. Here you see that the practice website is the most common patient engagement tool being offered, with the patient portal running a close 2nd. I was honestly surprised at the numbers for secure communications via email to text and scheduling appointments via the website - I expected those numbers to be lower. While disappointed, I wasn’t surprised at the numbers for health apps. We also broke the data for the non active PCPs and didn’t really see any surprises here.For those that selected OTHER, they stated things like:-Fax, telephone contact-Future E-mail messages to self (physician) or staff to call patient and remind them of the agreement and ask about progress.-The old fashioned call me and get a live person to answer your questions then and there. It beats all the other nonsense people want to promote as progress. It actually takes patients and staff longer to go through all this other junk of portals, log ins, passwords, and other quasi time saving lies we have been fed-some of this is risky-We call patients and actually speak to them regarding results.-We are close to getting all of this implemented.-Portal under development-I won't spend a nickel I don't have to-All of the above could be part of it but I would also include on site teaching by ancillary personnel.-Some chart access through EMR-my office answers phone calls directly-Goal setting forms for patients-Patients are rarely willing to spend time or money without Tremendous incentive-Refill requests-Community forums-How about can walk in or call and get a live voice and come in the day u call guaranteed-Telephone follow-up on lab results-facebook page-Being available 24/7 by phone or in office-electronic scheduling-Our EHR includes a patient portal-I don't plan on starting any of these.-Family-centered inpatient rounding-Patient given results of testing and or other findings and options for correcting health conditions/problems.-events held at the clinic-Working on portal-Telephone-Make myself more approachable to my patients.
  17. From here we asked about benefits, again providing a series of statements - but this time asking them to rank the statements from greatest to lowest benefit.
  18. From here we asked about benefits, again providing a series of statements - but this time asking them to rank the statements from greatest to lowest benefit. Based on an average, overall ranking ‘increased patient involvement in their care and health’ ranked the highestSometimes when you use an average score or ranking you loose some of the detail so we looked a little deeper and pulled out the number of PCPs that selected each of the statements as the greatest benefit – we did this for the overall sample of 300 PCPs and then further broke it down for the active and non-active PCPsAcross the board ‘increased patient involvement in their care and health’ ranked #1 What I found interesting was the difference between the active and non active PCPs related to that statement Allows physicians to be proactive, planning around patient needs prior to appointment –this was the lowest ranked benefitfor the non active PCPs and I think reflects a fundamental difference between the 2 groups and their approach to providing care and truly engaging with the patient.
  19. From here we asked about the barriers, again providing a series of statements - but this time asking them to rank the statements from greatest to lowest barrier.
  20. From here we asked about the barriers, again providing a series of statements - but this time asking them to rank the statements from greatest to lowest barrier. Based on an average, overall ranking time and cost are seen as the biggest barriers – I’m sure this is not a surprise to anyone. Again using an average score or ranking you can loose some of the detail so we looked a little deeper and pulled out the number of PCPs that selected each of the statements as the greatest barrier – we did this for the overall sample of 300 PCPs and then further broke it down for the active and non-active PCPsAcross the board time and cost are the biggest barriers What I found interesting here is the high number of active PCPs that selected ‘lack of patient interest in engagement’ and ‘positive results not worth the effort’ as the #1 barrier – I see this as concerning as it could prevent PCP’s from taking patient engagement to the next level and offering tools and activities that go beyond websites, portals and secure email – if physicians truly don’t believe in the patient's desire to be involved in their own care as well as the results being worth the effort – I can see a real limit to what physicians will offer or implement and I was surprised to see this from the active PCPs
  21. So what have we learned about patient engagement…-I think #1, there doesn’t seem to be a clear understanding of patient engagement and this makes it difficult to meet the expectations for both patients and healthcare providers -There needs to be a broader list of patient engagement offerings – the current static tools are a start but they fall short of what’s needed to truly engage patients and pull them into the healthcare process. There also seems to be uncertainty around what is involved in patient engagement - there are more questions than there are answers and whose responsibility is it to answer these questions and further define the concept of patient engagement – is it the federal government, healthcare providers, health consumers and patients, treatment providers – who? Again - I think this represents opportunity for different stakeholders in the healthcare process to develop tools and programs that support both providers and the patients along the patient engagement pathway.