Patient engagement is more than a catchphrase

Everyone wants to love their job, including physicians. But for today's clinicians, job satisfaction is becoming harder to achieve. One strategy to make your job more satisfying is what is now referred to as “patient engagement.”

Physicians might expect that all patients would be committed to and engaged in their own care. It's their bodies and their health. But many patients take a much more passive approach and expect their clinicians to do all the work: Order tests, prescribe medicine or other therapies, tell them what to do, and make everything better.

Barriers arise with this model. The patient does not understand the physician's instructions, leaves the office and forgets what was discussed, or later discovers that the medication prescribed is too expensive.

If physicians can get their patients and their families fully committed to being on the team, everyone wins. When they function like a well-oiled machine, the physician and patient have a more meaningful relationship, which can only improve physician satisfaction and patient outcomes.

There are other benefits as well. Under Medicare's new Quality Payment Program, there are many incentives for patient and family engagement, particularly in the Improvement Activities performance category.

The first thing a practice needs to do is to identify its greatest challenge to patient engagement. Is it the nonadherent patients? Is it the patients who, no matter what a clinician does or says, seem not to improve? Is it the complex patients on several medications who have trouble understanding their medication routines? Does the practice receive a lot of calls from patients who have forgotten how or when to take a particular medication? While patient engagement may not cure disease, dealing with these challenges can certainly produce positive results.

There are a few simple actions practices can take to move toward more engaged patients. Many practices already have a patient portal. That is an excellent mechanism to engage patients. If the portal is easy to access, and the information is useful, patients are more likely to use it. For instance, patients like to know if they have any tests, such as mammograms or bloodwork, that need to be scheduled, or have recently returned results. It is often hard to reach a clinician or clinical staff person by phone with a question about something that happened in an appointment a few days ago, so allowing patients to email a question is an easy way to help them understand their treatment and therefore be more adherent.

Another common cause of frustration for physicians is patients not understanding what they are told during their appointment. Techniques like motivational interviewing, goal setting, and “teach back” can help clarify what patients don't understand. Providing a printed summary of the care plan can also help and make the patient feel more accountable. For older patients, something as simple as encouraging them to bring a family member to be another set of ears will help keep them engaged in their care.

Patients will sometimes need to go to a subspecialist but not understand who is supposed to schedule the visit, what to take to the appointment, and when and whether to go back to the referring clinician. ACP offers a High Value Care Coordination Toolkit that includes recommendations to help referring practices develop an effective patient-centered referral process. This ensures that the patient and their caregivers are involved in the decision making and that the referring practice accounts for the unique needs and preferences of the patient when referring for subspecialty care.

All of these steps make patients an important part of the health care team, and when they are engaged in treatment decisions, outcomes can improve. ACP's Practice Advisor® has a Patient and Family Engagement module that offers a step-by-step action plan to help practices implement workflows to improve patient engagement. Some are fairly easy to do and others are more challenging, but many of the ideas and processes covered in the module can count toward Improvement Activities and include elements that could be used as quality measures. Continuing medical education and Maintenance of Certification credit is available for completion of the activities in this module.