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Patient Engagement Keystone Summit 2018 White Paper
Author
Adam Cherrington
On October 2, 2018, healthcare IT leaders (19 leaders from healthcare organizations and 29 leaders from vendor organizations) gathered outside Salt Lake City for one day to discuss patient engagement initiatives, outcomes, strategies, and best practices. The goal of this summit is to create a patient engagement framework that organizations can use as a compass to guide their goals and strategies and as a scorecard to assess progress along the way
Patient Engagement
On October 2, 2018, healthcare IT leaders (19 leaders from healthcare organizations and 29 leaders from vendor organizations) gathered outside Salt Lake City for one day to discuss patient engagement initiatives, outcomes, strategies, and best practices. Goals of the summit included:
- Define patient engagement and its key pillars
- Establish a common, patient-centric language
- Align HIT capabilities
- Explore patient engagement outcome measurements
- Gather best practices
Objective
Patient engagement is as old as medicine, but the use of information technology to engage patients is just taking shape. Broad visions and experimentation abound, but pathways are still being cleared, and there is a lack of consensus regarding end goals. The resources needed to move forward are scarce, with investments largely being dedicated to more obvious business cases that are tactical and departmental. The goal of this summit is to create a patient engagement framework that organizations can use as a compass to guide their goals and strategies and as a scorecard to assess progress along the way.
Patient Engagement Barriers
Nebulous Definition
Patient engagement can mean many different things to many different people. Administrators, clinicians, IT staff, payers, and patients all have unique points of view.
Siloed Efforts
One cause of these differing points of view is that the various players often operate in silos. Goals and investments are established at a departmental level based on short-term needs that are often financially based.
Skewed Incentives
External pressures to improve patient engagement, such as government regulation, often result in a checklist mentality that drives patients to feel manipulated rather than engaged.
Patient Disinterest
Too much focus on organizational needs and too little focus on patient needs results in patient disinterest, hindering the ultimate goal of active patient participation.
Principles of Patient Engagement - What We Learned
Over the years, KLAS has worked with leaders from provider and vendor organizations to develop HIT-focused frameworks in areas such as population health, interoperability, and enterprise imaging. The primary goals of these collaborations have been to create consensus definitions and choose metrics for HIT performance measurement. 2018’s Cornerstone Summit on patient engagement began with similar objectives, but feedback from attendees was clear: the patient-engagement framework must be patient-centric.
What Does Patient-Centric Mean?
Like other KLAS frameworks, the initial version of the patient engagement model was technology–centric, organized around HIT market segments and tool sets. Based on early feedback, the model evolved to a more provider–centric framework that concentrated on activities that provider organizations participate in to activate patients (and consumers) in their care.
In table discussions at the summit, opinions about various elements of the framework were wide ranging and sometimes even contradictory. There was no disagreement, however, on the need to shift from a provider–centric to a patient–centric point of view. Instead of placing providers in the central role, the framework needed to treat patients as the primary actors. This patientcentric approach needed to account for the following:
- Care should be driven by patients’ own goals for their health rather than by provider needs
- Providers need to be able to get to know their patients and meet them where they are
- Patients and providers should work together, actively and effectively, toward their goals
- Technology should support patient-provider relationships, not just patient and provider activities
All in all, summit attendees described seven key principles that provide a foundation for patient participation, provider strategies, and vendor development.
The Seven Principles of Patient Engagement
- Patient-centric: Actively helped by their providers, patients achieve their own goals for their health and care.
- Personalized: Providers get to know their patients and provide a personalized experience, meeting patients where they are (for example, by taking into account social determinants and patient preferences).
- Connected: Providers maintain constant and meaningful communication with patients, patient families, and other caregivers. Care is wellcoordinated between all parties.
- Simple: Engagement tools and processes are as easy and convenient as possible for patients and their families.
- Timely: Care delivery and interactions happen on time. Information, including health data, is made available to patients in real-time.
- Continuous: Patient-provider relationships extend beyond individual episodes of care. Care plans and other patient requirements (including financial) are documented and communicated and represent a pathway into the future.
- Measured: Providers continuously measure their performance in achieving their patients’ goals and in achieving their own organizations’ patient engagement goals, adjusting strategies as needed over time.
The Patient Engagement Framework
The concept and practice of patient engagement is as old as medicine. However, the use of information technology to enable and scale patient engagement is relatively new, especially when done in a strategic and coordinated enterprise-level way. As a result, the term “patient engagement” means different things to different people—whether provider, vendor, or patient. Creating a framework for patient engagement helps by establishing a common scope and language among all stakeholders and can provide guidance around key concepts.
HIT Capabilities
The capabilities—and thus value—of different vendor solutions is highly variable, even within the same market segment. Including HIT capabilities in the patient engagement framework provides a map that provider organizations can use to differentiate vendors and assess their own HIT portfolios. The patient engagement framework includes three broad pillars (Access, Partnership, and Navigation), each of which contains multiple capability groups.
Principles Foundation
Too often, technology becomes a means rather than an end, and organizations depend on HIT to define strategy instead of merely automating it. By virtue of its name, patient engagement is about relationships in a broad context that goes far beyond tool sets. Framework principles connect HIT to patient-provider relationships and the overall goal of wellness.
How to Use This Framework
Aside from providing a common scope and language, the patient engagement framework is meant to serve as an assessment and planning tool. Its potential value is not only in what it says but in what questions it raises for patient engagement stakeholders.
Providers can use the framework to assess their current patient engagement capabilities, leverage investments across the enterprise, and select vendors. When planning a new initiative, providers might ask themselves and their vendors, How well will this effort or solution advance the principles of patient engagement?
Vendors can use the framework to evaluate their current product portfolios and guide development and market strategies. When considering product development, a vendor might ask, In what ways will this product help providers more closely align with the seven principles?
KLAS plans to use parts of the framework to measure vendor performance in two ways—first, as a method to validate with live customers the capabilities of vendor solutions, and second, to measure customer satisfaction in terms of how well vendor solutions meet the needs outlined in the framework.
HIT Capabilities
Access
Finding a Provider
Triage/symptom checker
Web-based provider search/matching
Provider profile/quality data
Care-setting guidance
Arranging Care
Self-scheduling/rescheduling
Pre-registration forms/intake
Insurance verification
Self-registration/check-in
Prescription refill requests
Patient Account Management
Price transparency (including longitudinal TCO and financial steps)
Online bill-pay
Bill details/explanations
Marketing and Communication
Contact management
Market intelligence/analytics
Marketing campaigns
Broadcast messaging
Presence/Awareness
Community/social media tools
Social media optimization
Reputation management
Advertising
White-labeling
Key HIT Solutions
Consolidated patient portal
Telemedicine/virtual visits
CRM/PM platform
Language translation tools/services
Kiosk support
Partnership
Knowing the Patient
EMR integration
Interoperability tools
Risk assessment/analytics
Care-gap identification/reminders
Access to social determinants of health
Readiness/behavioral assessments
Capture of patient health goals
Capture of patient communication preferences
Capture of other patient-generated data
Tracking of patient-reported outcomes
Remote patient monitoring
Patient Empowerment
Patient access to own data
Ability to share own data
Provider messaging
Shared decision-making tools
Family/caregiver enrollment
Family/caregiver collaboration tools
Provider/care team visibility
Care plan/schedule visibility
Multi-language support
Patient Experience
Patient satisfaction surveys/analytics
Provider satisfaction surveys/analytics
Patient and staff rounding tools
Patient access to requests/orders (e.g., meals)
Environmental controls
Service recovery tracking
Entertainment/programming
Key HIT Solutions
Secure communications
Secure email
Interactive patient systems (IPS)
Bedside communication
Navigation
Education
On-site education
Pre-visit education/instructions
Discharge education/instructions
Wellness education
Longitudinal care planning
Coordination
Care management/care planning tools
Referral management
Transitions-of-care planning
Care-gap reminders
Appointment reminders
Care-adherence reminders/tracking (e.g., medications)
Post-visit follow-up
Visit-planning tools
Wayfinding
Online patient guides/directions
Mapping/geolocation (inside and outside facilities)
Virtual tours
Transportation arrangement
Patient Self-Management
PHR capabilities
Patient self-assessments
Online coaching
Fitness/activity tracking
Key HIT Solutions
Comprehensive mobile apps
Multi-modal patient outreach
High-Level Learnings from Outcome-Measures Discussion
Having discussed patient engagement strategies and ways to enable HIT, attendees turned their focus to the use of outcome measures to track the effectiveness of patient engagement efforts. In table discussions, a number of key ideas developed:
- Every patient engagement initiative must be clearly defined. Given any particular context, participants imagined numerous options for measurement.
- HIT capabilities can be easy to measure in terms of changes in patient behavior. For example, does an appointment-reminder solution reduce no-show rates? Are patients using a mobile app?
- While the measurement of HIT capabilities can track the effectiveness of initiatives (e.g., patient access, utilization, etc.), it doesn’t necessarily reflect patient success.
- Patients can help define measures that are meaningful to them. Patients want to be heard and understood, and providers must ask themselves how well they know their patients. Provider organizations must assess how good they are at gathering feedback and insights that reflect the voice of the patient.
- Another type of measurement is to gather feedback regarding what things patients do after a care episode. Do they recommend their provider to friends and family? Such net-promoter and loyalty measures reflect individual patient success.
Recommended Best Practices
During the summit, participants took part in table discussions about best practices they have seen or used. The following is an overview of often-mentioned successful practices.
- Create easy-to-use apps
- Create cloud-based software solutions
- Adopt telehealth capabilities
- Gather and analyze social determinants of health
- Gather and analyze behavioral habits (e.g., travel patterns, transportation)
- Enable 24/7 access to care team
- Enable communication with care team (e.g., text, email, phone, video)
- Enable communication with patient (e.g., text, email, phone, video)
- Enable families to communicate with care team (e.g., text, email, phone, video)
- Allow patients to choose how they want to communicate
- Direct patients to the appropriate care setting (e.g., nurse practitioner, urgent care, or primary care physician)
- Let patients go to the care setting at which they will be best served
- Bring the right care to the patient (e.g., 24-hour nurse line, telehealth)
- Provide patient education and personalized discharge instructions
- Assign health buddy or care manager to patients as they leave
- Include patients in the process of setting goals and choosing interventions
- Enable physicians and nurses to engage with patient during the encounter
- Incentivize patients to participate in wellness activities and make healthy lifestyle choices
- Develop a patient engagement vision and road map
- Adopt effective change management when implementing patient engagement strategies
Summit Attendees
President & CEO
Rhode Island Quality Institute
Damon AuerVP, Healthcare
DXC Technology
Nikia BerganChief Revenue Officer
GetWellNetwork
Sean BinaVP, Access & Patient Experience
Epic
Liz BoehmResearch Director
Vocera Communications
Russ BranzellCEO
CHIME
David CerinoGroup VP of Digital Innovation
Providence St. Joseph Health
Albert ChanVP, Chief of Digital Health
Sutter Health
Suzanne Clough, MDChief Innovation Officer
ArmadaHealth
Michael DavidofVP, Marketing & Business Development
Phreesia
Caroline DeLongchamps, B.S.Manager, Patient and Family Centered Care
The Medical University of South Carolina
Amy DeutschendorfAdjunct Appointment
Johns Hopkins School of Nursing
William Feaster, MD, MBACHIO
CHOC Children’s Hospital
Louis Filhour, PhDCEO
Better Health for Northeast New York
Jamie GunsiorPartner
PwC
Senior Director, Client Development
Docent Health
Morgan HorwoodProject Coordinator
Sutter Health
Chaim IndigCEO
Phreesia
Janice JacobsGlobal Patient Engagement Lead
NTT DATA Services
Benjamin Kanter, MDCMIO
Vocera Communications
Terri Keeling, DSc, CPHIMS, PMPVP, Information Technology
University Hospitals
Atul KichambareGlobal Leader, Patient Engagement
NTT DATA
Adam KochChief Performance Officer
TVR Communications
Roy KosugeChief Commercial Officer
SONIFI Health
Shawn LemeriseExecutive VP and Managing Partner
CipherHealth
Emily Lord, MBAProduct Marketing Lead, Patient Services
athenahealth
Toran MacArthur, MDPhysician
Premier Family Medical
Jerry MansfieldECNO/CPXO
MUSC Health
Susan MarinoVP, Chief Nursing Informatics Officer
Hartford Healthcare
Sonika MathurSVP, Digital Content
Elsevier
Ben MooreCEO
Telmediq
Lonny NorthrupCare Transformation
Intermountain Healthcare
Ru OkamotoResearch & Development
Epic
Matthew O’NeilCEO
Ichi Go
Founder & CEO
GetWellNetwork
Ahmad OuriCEO
SONIFI Health
Nikki ParhamPartner
PwC
Shannon PhillipsChief Patient Experience Officer
Intermountain Healthcare
Tammy RichardsAssistant VP, Clinical and Patient Engagement
Intermountain Healthcare
Steve SchaeferCEO & President
ArmadaHealth
Mohamed Shoura, Ph.DCEO
CarePassport Corp
Zach SilverzweigCo-Founder
CipherHealth
Ming Tai-SealeProfessor
UC San Diego
Tim TarnowskiSVP and CIO
UMassMemorial Healthcare
Raj ToletiCEO
HealthGrid
Glenn Updike, MDPhysician
UPMC
Jukka ValimakiVP, Commercial, Patient, Nursing & AHP
Elsevier
Gerbrand van de BeekGlobal Solutions Lead
Philips
Keith WashingtonCEO
TVR Communications
Les WoldMedical Consultant
Philips
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.