High-touch, tech-enabled patient engagement + patient activation resolve barriers to accessing care

Healthcare decision-makers increasingly recognize that patients who are more actively involved in their personal health care will experience better health outcomes and incur lower costs. While there is broader understanding of the term “patient engagement” — strategies ranging from educating people about their conditions to involving them more fully in making decisions about their care – the term “patient activation” may be less understood.

A component of engagement, patient activation is defined as empowering a person with skill, knowledge and confidence to manage his or her health and healthcare in illness and wellness. It describes the behavioral change, knowledge, skills and confidence a person develops to take a proactive role in personal health management. Patients who have fewer resources and lower motivation are less likely to proactively act to better their health status.

The good news is a survey showing 83 percent of healthcare consumers said they are ready to make health and wellness improvements. Thirty-seven percent want to be more proactive in their healthcare, suggesting that healthcare providers will need to counter with stronger patient engagement and activation. Activation emphasizes a patient’s willingness and ability to be proactive in managing their practical, non-clinical issues associated with their continuum of care.

This is the challenge: exactly how can health systems effectively activate patients to become proactive in resolving non-clinical barriers to care?

Thankfully, there are answers and solutions.

High-touch, tech-enabled partnerships: A proven approach for activating patients

Vendor-partner relationships with hospitals, health systems, payers and provider organizations can positively impact patient and member lives, activating patient behaviors to enhance health outcomes and concurrently drive financial and operational improvements in Value-Based Care. Utilizing trained non-clinical resources to work with patients and caregivers to understand and resolve their barriers to care will result in a uniform care experience and optimal outcomes.

Care guides

Today’s care is being bridged by an innovative patient-centric approach that is creating measurable impact on patient outcomes, reported satisfaction and quality scores, as well as lowering care management expenses and total cost of care.

Trained and focused non-clinical care guides establish a connected relationship with patients and their families. Serving as the main patient point of contact, this peer-to-patient connection lowers patient resistance to sharing personal information and provides individuals with the guidance they need to take action and engage in the process of their care.

A good care guidance program includes several components, including specially trained and managed care guides, evidence-based disease and condition-specific protocols, as well as a comprehensive care guidance technology platform. To ensure smooth operations, the process begins with an Action Gap Assessment, which evaluates the preparedness of a health system to implement personalized patient engagement and make sure the organization is prepared to deliver the proper care protocols for the best experiences.

AI and machine learning anticipates patient needs based upon condition-specific protocols that enable care guides to deliver an unprecedented level of vital, just-in-time human communications. Led by this intelligence, specially trained Care Guides provide individuals with the information they need to engage in the process of their care – to activate behavioral changes. As a result, patients have a better understanding of their care transitions.

Essentially, care guides extend health system’s clinical care team, reaching patients beyond facility walls to improve patient experiences and health outcomes. Effective care guidance requires collaboration with like-minded partners that are dedicated to improving health and welfare for entire communities. This requires the development of joint programs with clear metrics for improved patient outcomes. The efficient and effective Service-as-a-Solution model delivers on the promise of health equity.

The Centers for Disease Control and Prevention (CDC) defines health equity as being achieved “when all people have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance.”

This is particularly relevant as Covid-19 continues to stress health system capacity for treating patients and amidst a critical nursing shortage nationwide. In fact, nurses report that up to 70% of their workload is dedicated to non-clinical, practical tasks that only address the bare minimum of Social Determinants of Health (SDoH): non-clinical factors including personal conditions like an individual’s language skills, literacy and education, their job opportunities and income, the safety of housing and neighborhoods, and access to transportation. SDoH factors exist with the individual patient and their community—outside of the hospital’s visibility and control. Care guides effectively address SDoH and effectively relieve the burdens on nurses and clinicians.

Tech-enabled approach

A key component in the collaborative process is ensuring that the vendor-partner has the resources to hire and appropriately train the best non-clinical care guides. Hospitals and health systems should confirm the vendor’s successful track record with other hospitals or health systems.

Another crucial element is the operating platform used by the non-clinical care guides. A well-designed platform should guide and inform the care guides to resolve non-clinical patient barriers and automate the escalation of clinical patient barriers to the clinical teams in place. That approach allows the organization to capture data for required reporting and conduct quality improvement activities.

The high-tech capabilities are the “secret sauce” for driving the human touch, which results in highly structured and protocolized peer-to-patient interaction. While analytics can identify probable risk and technology can facilitate communication, neither can establish the needed personalized, peer-to-patient relationship, as provided by care guides, that leads to real, meaningful patient activation and barrier resolution.

Impact on health equity

Having a vendor-partner act as an extension of existing clinical teams makes health equity actionable and benefits the patient, member and healthcare organization. It allows nurses and physicians to operate at the highest level of their license, lowers operating expense, decreases acute care utilization, alleviates clinical staffing shortages, and drives consistency in results.

Validating results

Importantly, value-based care metrics are applied to validate the role of non-clinical interventions to reduce unnecessary utilization, improve patient care adherence, advance health equity and enhance the patient experience. This approach to improving quality and patient outcomes is viable and cost-effective, directly targeting important issues and providing the industry with a proven pathway to health equity.

The benefits are felt throughout health care organizations. Freed from practical, non-clinical tasks, high-value nursing staff can focus on clinical work. Health systems also regard care guides as an important part of their organization’s efforts to improve their HCAHPS scores — the first national, standardized, publicly reported survey of patients’ perspectives of hospital care. Furthermore, health systems enjoy reduced and even eliminated readmission penalties as well as a strengthened reputation in their community.

Guiding the future of health care

Achieving successful health outcomes, reducing readmissions and achieving quality improvement and satisfaction scores is dependent in large part on patient activation.

But cultural changes such as this do not happen overnight. The years ahead will require the ongoing enactment of meaningful policy, ongoing research and investment, and foresighted dedication to innovative solutions and technical advancements that support patient engagement and activation. Fortunately, the validated results of care guidance are paving this exciting journey to better health outcomes as well as improved hospital and health system financial performance in the transition to value-based care.

Photo: kieferpix, Getty Images