Patient Engagement’s (Not So) Secret Ingredient

April 30, 2012
When it comes to patient engagement, one developer has realized many of the current platforms lack an essential element: physician involvement. Steven D. Freedman, M.D. and and Camilla Martin, M.D., from Beth Israel Deaconess Medical Center, who are working on their own patient engagement platform, says input from the actual physicians can be a critical missing element in the care-coordination process.

Recently, I had a fascinating conversation with Steven D. Freedman, M.D., chief of the Division of Translational Research at Beth Israel Deaconess Medical Center in Boston and a professor of Medicine at Harvard Medical School, and Camilla Martin, M.D., director for cross-disciplinary research partnerships in the Division of Translational Research at Deaconess, as well as a professor at Harvard Medical School.   Freedman and Martin are heading up the Passport to Trust program at Deaconess, in an attempt to improve patient-physician encounters.

Their latest foray in this movement is the Digital Passport to Trust, an online medical dashboard, currently in development, aimed at creating a constant two-way communication platform for physicians and patients. Excerpts from my interview with Freedman and Martin can be found here. The dashboard will showcase care plan that is easily accessed by patients and providers, with an easy-to-understand, mapped out step-by-step, week-to-week guidance plan.

One of the interesting things that Freedman and Martin talked about with me was the past attempts by various companies, providers, and others to get patients involved in their own healthcare. Freedman and Martin said the developers of many personal health record (PHR) platforms have failed to obtain input from the actual physicians themselves, and some PHRs lack true physician connectivity. This was a critical missing element in the care-coordination process, they said. In a very telling quote, Martin explained to me what they meant when they implicated patient engagement platforms for their lack of provider involvement.

“We were at a conference where we were able to see a lot of different applications, health applications, things that you use to monitor and track your health,” Martin said. “I applaud those efforts, it’s amazing technology…but what we both realized at the conference is that the physician was completely missing. If I want to use that application on my device, who is looking at it? Who is acting on that information? The physician isn’t because they aren’t equally armed with those systems to react to it.”

Not only are physicians not armed to act on it, I’m guessing they are less likely to make the effort if they weren’t involved in the process. As Freedman said to me, in the metaphorical Venn-diagram of patients and providers, very few platforms are looking to enter into that intersection of both.          

It’s not really rocket science, and the results can be encouraging. In one recent report, 29 Philadelphia area hospitals reported they cut 400 patients from unnecessary hospitalizations thanks to the work of a digital passport, similar to the one the Passport to Trust team is developing, in the Preventing Avoidable Episodes (PAVE) Project. The care-coordination strategies from both PAVE and Passport to Trust both include heavy physician involvement. Kaiser Permanente’s patient portal has been a success, with nine million engaged patients according to recent reports from the company, and you can be physician involvement is a big reason why.

Patient engagement is not just another buzz term, in my opinion. It can lead to improved outcomes and reduced readmissions. Physicians can’t afford to roll their eyes when they hear it. Obviously, we know if patients want to be more engaged with their own health, they must take the onus themselves. However, physicians, and the role they will play in getting these platforms off the ground, cannot be ignored.  So allow me to close by paraphrasing a very popular political phrase: It’s the physicians, stupid!

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