I like to ask people from health systems, most of them from the IT side, about their patient engagement or digital engagement strategy. It’s interesting to hear how systems think about digital engagement considering the buzz and hype it is getting from vendors and pundits.
My unscientific opinion is that very few systems have anything resembling a patient engagement strategy. Despite getting so much attention, most healthcare delivery organizations aren’t preparing for patient engagement.
A typical conversation I have with somebody in an IT group goes a bit like this:
Me: “How are you thinking about patient engagement tools and strategies, either in place today or planned for the future?”
Response: “MyChart is our patient engagement tool.” (or some variation of that statement)
Me: “Are you using other mobile apps or technologies to connect with patients for communication, education, or self management?”
Response: “Well, there have been a couple of small initiatives. For the most part, we use MyChart.”
Me: “How do patients use MyChart?”
We now live in such an Epic-centric world that Epic is synonymous with EHR and MyChart is synonymous with PHR. More surprisingly to me is that MyChart is also now synonymous with patient engagement.
The systems I’m talking to are larger systems, so it’s not surprising to see Epic. I’ve had similar conversations with non-Epic systems and those usually just conclude with, “We’ve tried a couple of things for patients, but nothing at scale.”
My sense is that the root of the problem with patient engagement has two parts. The first problem is the lack of definition around patient engagement. There have been efforts to define and standardize patient engagement, but I don’t know many systems that have adopted a framework around it. Lack of definition makes it hard to create and implement a strategy.
The second problem is that most systems, especially IT groups within those systems, are drowning in other projects such as EHR implementations. For health systems, patient engagement still has an unclear ROI. With limited resources (“our group is fully booked for the next 12 to 18 months”), it’s hard to justify assigning labor and capital to projects that won’t deliver immediate value.
I was telling a friend (and former Epic employee) about what I’ve been seeing with patient engagement, specifically MyChart. His response was, “Give them two years. When they see the timelines for some of the desired features, they’ll be out of the honeymoon phase and be looking for new ways to do things”.
That might be the case, but there are systems outside the honeymoon phase implementing Epic or other EHR. I’m curious what, if anything, those systems are doing with patient engagement.
Lacking definition and clear ROI, using the PHR solution of Epic or other EHR vendor for patient engagement makes sense. Looking at patient engagement broadly and defining it as people being more actively involved in their health and wellness, an EHR vendor won’t succeed in building a “one size fits all” solution.
This is not a knock against the EHR vendors or a reference to the intuitiveness (or lack thereof) of their products. I just don’t think one solution, built by any organization or developer, will ever have the flexibility and features needed to meet the hype of patient engagement. MyChart and other provider-based PHRs are a stopgap solution that have a lot of adoption because they are bundled with EHRs.
Where does that leave all of the developers and startups that are building technology to engage patients? One of the major challenges for them is overcoming the stopgap PHR objections from enterprises. They can certainly go directly to consumers, and many of them are. The data silos opening up are helping those engagement startups populate their apps without having to rely on manual entry.
It’s easier to get patients to adopt something when the provider and health system buy in. That’s why MyChart is the most popular PHR. But is MyChart what people want, or rather is it what people get?