Patient engagement encourages patient participation, and patient participation encourages patient activation. These are stages in the patient’s partnership in healthcare, with each stage contributing to improving clinical outcomes. It’s about shared decision making.
To empower patients for shared decision making, he/she needs to be actively involved. To make a partner out of patients, he/she needs to be able to take independent actions pertaining to health and care. That willingness, that ability to engage, to participate and get involved, is patient activation.
According to research, activation appears in four stages:
believing the patient role is important
having the confidence and knowledge necessary to take action
actually taking action to maintain and improve one's health
staying the course even under stress
In each of these steps, patient engagement is key. Here are some use cases where patient activation is enabled through a patient engagement platform.
SMS Activated Interaction: A VA Experience
A VA facility wanted to address the low response rate of using traditional mail and phone calls to get patients in for screenings. Its pharmacy group was dealing with a population group of 95 veterans who were not responding to mail or phone calls to schedule a HEP-C screening.
Amongst the variety of modalities available, LifeWIRE’s standard SMS messaging was selected to contact each vet using the facilities’ predefined workflow. LifeWIRE was to engage the hard to reach vet, capture their responses, generate resulting reports to schedule screenings.
LifeWIRE worked with the healthcare provider to develop plain language interactions with the patient that guided them through the defined workflow. The workflow was then initiated for each vet. When a vet chose a date for their screening, the system would set up a reminder in the system for that vet on the day before. This workflow is designed to be reusable by VA or other clients for scheduling future vets or patients
This resulted in an overall response rate of 73%, with 17% of patients contacted using LifeWIRE completing scheduled appointments.
Mobile “Check-Ins” to Support PTSD Care: Case Study
A VA facility wanted to address readmission and relapse rates due to Post-Traumatic Stress Disorder in a population.
A LifeWIRE process was designed with the client to send interactive messages to maintain connection with the patient during off-hours. SMS messaging was chosen by each of the vets for this and also used to conduct ‘check-ins’ in order to support the participant’s recovery and provide a periodic assessment of the participant’s level of distress. Numerical responses had pre-defined thresholds that would trigger a call to action message back to the participant, as well as notification to clinical staff.
The clinicians found the use of the technology as a valuable adjunct to treatment. Results were most successful when the technology caused minimal disruption to daily routines, and response rates improved when data collection was made a part of the daily routine.
As noted in the resulting paper based on the study, “...this text-messaging intervention enabled effective triage, improved clinical outreach, provided accurate charting, and reduced workload. Notifications about an individual either not responding or responding poorly to check-in questions, enabled the Suicide Prevention Coordinator to rapidly respond to stressful events before they escalated into a crisis.”
It further concluded that “...after monitoring and managing text messaging as an intervention, it is clear that this tool for providing added support, managing and monitoring individuals at risk for suicide is capable of providing the same benefits to any individual with any issue requiring additional support. It is clear that this is a valuable supplemental resource to providing a supportive link to individuals outside of a clinical setting.”
Interactive Communication for Pre-Op Care: An Anesthesiologist Take
Anesthesiologists Gregory Davis M.D. and Perrin Jones M.D. of the East Carolina Anesthesia Associates required a system that could seamlessly do preoperative work, ranging from simple information gathering to active patient monitoring and engagement. LifeWIRE was used to reach out to patients scheduled for surgery and start a dialogue with them about their health and demographic history, educate them about the procedure, and coordinate pre-op tests and results with the surgical team.
With the LifeWIRE patient engagement platform, they were able to onboard patient data and automate the process that had previously been carried out manually. In a bundled healthcare system, pre-optimizing a patient is essential, and they estimated the cost savings LifeWIRE enabled decreased the need for additional operative testing by 60-65%.
Jones noted that from a cost standpoint, on a government-pay-patient that saves about $200 to $250 per patient having surgery, and for a commercial-pay-patient, that is about $1,000 per patient. With the use of LifeWIRE to pre-optimize the patient, they estimated a day of surgery cancellation dropped from roughly 18-20 per month to less than one in a month.
In a video interview, Davis underscored how engagement through LifeWIRE’s communication platform can activate patients to engage in their own health and improve outcomes. LifeWIRE has allowed him to continue to communicate with patients up until the day of surgery, as well as postoperatively to limit complications, make sure patients are okay and identify potential issues earlier to enable early intervention.
“All of these will dramatically reduce the cost of care and more importantly will improve patient experience with the surgical process,” Davis said.
In a study on “What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs”, researchers note that “...the focus on activation and engagement rather than compliance recognizes that patients manage their health on their own the vast majority of the time, making decisions daily that affect their health and costs.”
Researchers suggested that innovative delivery systems can measure activation “...to improve and individualize patient care and to strengthen the patient’s role in improving outcomes.”
Such is the innovative technology of LifeWIRE’s patient engagement platform, where the active engagement, participation, and activation of informed healthcare consumers and patients are achieving better health outcomes. It’s not just about having the technology, but knowing how to use the technology for the benefit of our clients and patients.
About the Author
Howard is the innovator behind LifeWIRE technology. He is widely recognized as a healthcare IT entrepreneur and thought leader. Connect with him through @LifeWIREConnect on Twitter and @HowardRosen129 on LinkedIn.