Is Patient Engagement the Root of All Problems?

Lack of Loyalty. No-Shows. Poor Compliance. Readmissions. Meaningful Use. Low Satisfaction Scores. Clinician Inefficiency.

At first these seem like disparate problems within a hospital environment – but I propose that a common underlying problem affects them all: poor patient engagement. When patients are not engaged and empowered in their care, a domino effect can occur. They don’t show up for scheduled appointments or they cancel procedures. On a procedure day (if they do show up), they can delay staff and the entire process with a million last minute questions that could have been taken care of in advance. When they go home, they are unprepared for the transition and have poor follow-through compliance with their discharge instructions. They don’t take their medications, and may end up being readmitted.

Even patient safety problems can be improved by empowering and educating patients before, during and after a hospital stay. Joint Commission’s “Speak Up” program prompts patients to ask about their medication, ask about hand washing, speak up about their pain, and to ask for help to avoid falls.

Lack of patient engagement is a broad, almost universal problem across healthcare settings. Even the ‘Most Wired’ hospitals aren’t there yet. Quoting an article in MedCity News: “Three out of five don’t ask for a patient’s preferred method of communication (email, text, phone). And only two-thirds have piloted or used a patient portal.”

patient engagement

Here’s the oddity. It turns out that patients are highly engaged with their health – just not with their health providers. Consistent statistics over the last three years cite high patient use of the internet for diagnosis and self treatment. Recent Pew findings reported that 81% of U.S. adults are using the internet and 59% are looking online for health information in the past year, and that engaged and empowered e-patients are quickly becoming the majority. Patients are increasingly engaged in determining their health problems and looking for solutions, just likely not with healthcare organizations. Seems to me that there may be a misalignment of expectations. It may also be the case that provider strategies are simply not working.

InformationWeek Healthcare’s July issue centered on patient engagement and finds that patients are ready and willing to engage, but only when providers are willing to engage with them using online tools, content, and interaction strategies that are appropriate for the particular health challenge at hand. Results from leading organizations illustrate the use of a variety of different strategies – appropriately designed for prevention, health maintenance, chronic care and acute care. Patients who are engaged this way have fewer no-shows, increased loyalty, reduced costs and higher satisfaction scores. And hospitals can get way beyond the meaningful use required 5% participation.

It’s also about engaging patients where they are ready. A article in The Wall Street Journal’s “The Informed Patient” finds that doctors are starting to be more accepting of patients coming in with pre-visit internet research in hand. Some are even adding symptom checkers to their website to try and capture these e-patients and bring them into productive conversations.

If your organization is ready to tackle a 90-day service line innovation that can quickly realize the benefits of address underlying patient engagement issues, you should explore the potential of a patient guidance system.


I provide a free documentation tool on my practice website they can download. They can essentially write their history and own follow up notes, track meds serially, update information and bring that along to a vist. etc. Very few people really want to do all this. It is OK for people to do what ever they want with internet! It is up to the physician to use time wisely. Time management is #1 on my “choosing Wisely list”. While I provide useful links to common problems on my website, I do not necessarily direct people to them, because most people with common sense will see that as self-serving. I can push complete patient records in a secure manner to patients who want their records. I see interactive portals as a major time waster in a specialty practice.

Leave a Comment

Comment (required)

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>