The patient-centric movement: What’s driving it, what’s ahead?

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Jonathan Karl, Director,
CDW Healthcare

The focus on expanding patient engagement has grown in the U.S. healthcare market. Several factors have converged to spur this interest, including new policies and reimbursement models, technology innovation, and mounting evidence¹ that engaged patients often experience better outcomes and can be treated more cost effectively.

This new dynamic creates both opportunities and challenges for providers and will require innovative approaches and technologies to realize the full benefits of expanded patient engagement.

Policy influences

The development and continued rollout of game-changing public policies are driving much of the focus around patient engagement. Meaningful Use and the financial incentives associated with it top the list. Stage 3 raises the bar significantly, establishing three measures of patient engagement. First, it elevates the target for getting patients to view, download, and transmit personal data from 5% to 25%. In addition, it requires that more than 35% of all patients seen by a provider receive a secure message using an EHR messaging function or in response to a secure message sent by the patient. Finally, it calls for more than 15% of patients to contribute patient-generated health data to their EHR. While providers have to report on all three of these measures, they are only required to successfully meet the requirements of two.

As important, under the Affordable Care Act (ACA) and continued Medicare reform, we are seeing the U.S. healthcare model increasingly evolve from a fee-for-service to a pay-for-performance model, further amplifying the need for expanded patient engagement.

Additional drivers are on the horizon. One of the most interesting is the 21st Century Cures Act, which was signed into law by President Obama Dec. 13, 2016. It extends the concept of patient engagement to the clinical research and development realm, seeking to create the elusive closed loop from bench to bedside and back again, which is required for truly personalized medicine.

The 21st Century Cures Act looks to place patients at the center of the drug development process and advance their engagement to determine the impact of various treatments on their daily lives. The legislation includes a process to collect patient experience data for submission to the Food and Drug Administration (FDA) and requires the FDA to use this information in conducting regulatory review and risk assessments.

Technology advances

Rapid advances in health IT applications (such as EHRs and patient portals) and broader proliferation of mobile and cloud technologies (paired with a more consumer-oriented approach to healthcare delivery) are spurring the ability of patients to play a more active role in managing their care.

For example, more than 28% of consumers in a recent PricewaterhouseCoopers survey² reported having a healthcare, wellness, or medical application on their mobile device—a 16% increase from the previous year—and 65% of respondents with one or more health apps on their devices use these apps at least once a week. Research from Alego Health³ underscores the potential impact of mobile technologies on patient engagement, with consumers saying they expect the adoption of mHealth technology to significantly change their healthcare experience when it comes to information on health issues (59%), health management (49%), and communicating with healthcare providers (48%). Additionally, we are now even seeing the expansion of health systems posting patient reviews of their physicians on their own websites,⁴ highlighting new trends for the healthcare experience and patient engagement.

Clinicians and providers appear to be on the same page when it comes to the value of digital devices: 47% of patients and 79% of physicians say mobile devices help with the more effective coordination of healthcare, which supports greater involvement, according to PwC’s 2014 study, “Healthcare delivery of the future: How digital technologies can bridge the gap of time and distance between clinicians and consumers.”⁵

Patient portals, which facilitate scheduling and information sharing as well as video consultations also have vital roles to play in expanding patient engagement.

Challenges ahead

While there is general consensus around the need for expanded patient engagement, the road to success has its fair share of twists and turns.

For instance, the absence of an adequate budget and definitive leadership often hampers many healthcare organizations’ efforts to develop an effective, comprehensive patient engagement strategy, according to HIMSS Analytics research.⁶ Many organizations lack an effective structure when it comes to their patient engagement strategies, with spending and responsibilities spread across a variety of departments, from IT to ambulatory and marketing. As a result, this approach results in siloed information and best practices, which in turn stifles progress.

It is important to centralize the function—understanding that the team must include representation from across the organization. This approach provides the foundation for building a cohesive patient engagement strategy versus undertaking singular, one-off tactics. Involvement of IT leadership from the start is imperative due to the formidable role that technology plays in efforts to expand patient engagement. Tackling patient engagement from an enterprise level also enables organizations to optimize existing investments (including technology), avoid duplicate spending, and better identify and address information integration requirements that are essential to a successful initiative.

Security concerns remain paramount for both providers and patients, as we are reminded frequently with reports of the latest health data security breach. As providers and patients increasingly use personal mobile devices to access personal health information, these devices represent a new endpoint that organizations must secure on their network. Becker’s Hospital Review⁷ identified the use of personal mobile devices in healthcare settings as providers’ second greatest data security concern, highlighting the need for secure infrastructure and connections to support patient engagement. To optimize the use of technology in advancing patient engagement, providers and patients must both have confidence in data and device security.

Focusing on the three pillars of secure mobility—the device, the network, and the data—can help ensure end-to-end protection. That being said, focusing solely on securing the technology is not enough; organizations must also consider the people and processes involved. A trusted partner that specializes in the health IT industry can help provide guidance to mitigate and manage these concerns, ensuring that a multilayer security strategy is in place.

Lastly, as we see with many emerging technologies, health IT innovation is outpacing the development of public policy paradigms, specifically when it comes to interoperability and integration. This leaves the industry at a disadvantage for unlocking the full potential of the health information exchange to expand patient engagement and improve outcomes. We are seeing progress on this front, with recognition from the Office of the National Coordinator for Health Information Technology (ONC). Its Federal Health IT Strategic Plan 2015-2020 and Nationwide Interoperability Roadmap⁸ have potential to be significant stepping stones in overcoming lingering interoperability hurdles.

Framework for the future

The foundation for the patient engagement movement has been set, and the outlook is promising for organizations that embrace it and plan carefully by adopting a holistic approach, leveraging technology innovation, and ensuring security at every step. Expanded patient engagement represents a true win-win situation for patients and providers alike, with the promise of better outcomes and more efficient care delivery ahead.

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