One of the major problems with patient engagement is that it’s a buzzword. Like most buzzwords, it is often used without much thought going in to what it really means. I admit to being part of the problem. I’ve written about patient engagement without providing a real definition for it. I think I know what I mean by patient engagement, but my definition tends to be use case driven, meaning I have something very specific applications of engagement in mind when I write about it.
This KevinMD article tries to clarify patient engagement and commit to a definition. The author concludes that, “supporting patient engagement means fostering an effective collaboration in which patients and clinicians work together to help the patient progress towards mutually agreed-upon health goals.” That definition is growing on me, but it’s optimistic in terms of what it expects from patients. I don’t think all patients will participate in shared decision making and goal setting.
While providers are essential to engaging patients, physicians will be as much of the process of patient engagement as the article above defines it. Physicians will help to promote patient engagement and be a part of scalable solutions to engage patients, but they will be the only way patients are engaged.
The more I thought about defining patient engagement, the more I settled on seeing it as simply promoting healthy behavior with an ultimate goal of getting patients to take a more active role in their health on a day-to-day basis. Patient engagement is just a new form of healthcare marketing that I call “patient engagement marketing, “ but, instead of traditional marketing that attempts to get people to click on a link to buy something or to show up at the a certain urgent care, engagement marketers are trying to get people to read and respond, make minor behavior changes, and ideally reduce healthcare services utilization while maintaining or improving overall health.
That’s a broader definition for patient engagement, which is important because patient engagement marketing will be more than just provider and patient. It will also be employer and employee, payer and member, ACO and patient, PCMH and patient, pharmacy and customer, drug maker and patient, to name a few. Not all of those will involve shared decision making or even clinician involvement. The best example I can come up with is cost transparency to help people choose services.
I like changing the definition of, and approach to, patient engagement to be more about engagement marketing because we can look to lessons learned and best practices from the marketing world. I’ve also been thinking about this recently because I’ve talked to several marketing firms that are now looking to build apps and campaigns for patient engagement. Most of the marketing firms I’ve talked to are working with payers, not providers. I also want to clarify that I don’t think marketing firms and marketing departments should own all of patient engagement for organizations. Marketing firms and departments should be seen as resources and partners for IT and clinical IT when it comes to patient engagement marketing.
As with marketing, engagement is very personal, so some people will respond to certain types of campaigns and channels while others will not. Engagement marketing has to be flexible enough to accommodate this. Also as with marketing, mobile is a massive opportunity and SMS has much higher open rates than email. We can start to look at marketing funnels and split testing websites to drive engagement. These are just a few examples.
More importantly, and this relates back more directly to the definition, is that we should be thinking about marketing metrics for patient engagement, not just clinical metrics. Marketing metrics involve downloads, clicks, time spent on a site or app, opens, etc. These are the metrics that marketers use to assess how effective campaigns are going, and these are things that health organizations should be using to assess the effectiveness of patient engagement marketing campaigns and strategies.
The problem with this definition of patient engagement is that it is broad. It has to be. It’s not hedging to say that patient engagement will take on many forms. It is not hedging to say that many different organizations will try to engage patients, members, customers, and consumers in different ways. The part that makes this type of marketing separate and distinct from traditional healthcare marketing is that patient engagement marketing is geared towards value-based care, not volume-based care. The goal of patient engagement marketing should align with the goals for changing our health system – reducing costs, improving access, and making patients happier.