The Importance of Patient Engagement in Healthcare Delivery
Effective patient engagement is essential for improving health outcomes, enhancing the patient experience, reducing costs, and even benefiting the clinician experience. Patient engagement can be defined as “patients, families, their representatives, and health professionals working in active partnership at various levels across the healthcare system – from direct care to organizational design and governance, and policy making – to improve health and healthcare.”
This article will explore the relationships between health literacy and patient engagement, focusing on three key scenarios: (1) decision-making, (2) health behavior change, and (3) chronic disease management. We’ll delve into the theoretical underpinnings of engagement, the systems required to support patient engagement, how social determinants of health influence engagement, and practical examples to demonstrate approaches for better engaging patients in their health and wellbeing. Finally, we’ll discuss the future of patient engagement, which extends beyond traditional domains to influence healthcare delivery, policy, and research.
Engaging Patients to Better Understand Decisions
Medical decisions often involve trade-offs between the benefits and harms, and sometimes the balance is delicate. By including the patient’s values and preferences, clinicians can make better decisions that align with what matters most to the individual. Krist et al. (2017) found that chronically ill patients who are engaged in their care tend to live longer than their unengaged peers who receive similar treatment.
Patient engagement has an ethical basis, supporting patient autonomy and self-determination. It also has an interpersonal basis, promoting confidence and trust in the clinician-patient relationship. Engagement further has an educational basis, improving knowledge, setting reasonable expectations, and reducing decisional conflict.
A study of patients with complex needs across 11 industrialized countries found that countries with higher levels of engagement had better quality of care, lower medical error rates, and greater satisfaction with the care experience. Osborn et al. (2015) These findings demonstrate how patient engagement shifts the clinical paradigm from “what is the matter?” to “what matters to you?”
Engaging Patients to Improve Health Behaviors
Chronic disease management and health behavior change must be driven by the patient. Without complete buy-in and understanding, the patient will be unable to effectively manage their health. The patient is ultimately responsible for suffering or enjoying the outcomes associated with any medical decision, test, treatment, or lifestyle change.
Torres et al. (2015) found that clinician communication styles are critically important to effective patient engagement. “Good” communication creates a sense of not being rushed, a feeling that the clinician understands the patient, and a partnership built on trust. Torres et al. (2015)
Arora et al. (2010) demonstrated that better engagement increases the patient’s perception of personal control, increases trust, and decreases uncertainty. Arora et al. (2010) Engaged and activated patients are more likely to participate in preventive services, adhere to treatment plans, and experience better health outcomes.
Engaging Patients to Improve Chronic Disease Management
Many studies have shown the benefits of actively engaging patients in the management of their chronic conditions. Kish (2012) described the potential impact of widespread patient engagement as analogous to the introduction of a “once-in-a-century blockbuster drug.” Kish (2012)
The U.S. Institute of Medicine’s report “Crossing the Quality Chasm” emphasized that healthcare providers should be “respectful of and responsive to individual patient preferences, needs, and values,” and ensure “patient values guide all clinical decisions.” Institute of Medicine (2001) This has been further advanced by research funded by the Patient-Centered Outcomes Research Institute (PCORI) and national healthcare initiatives like Meaningful Use and the Medicare shared-savings program for Accountable Care Organizations.
Engaging patients in the management of their chronic conditions can lead to better health outcomes, reduced costs, and improved satisfaction for both patients and clinicians. By partnering with patients, clinicians can better understand the individual’s needs, barriers, and preferences, allowing for more tailored and effective care plans.
The Influence of Health’s Social Determinants on Engagement
Social determinants of health, such as socioeconomic status, education, and access to healthcare, can significantly impact patient engagement. Minority patients often receive lower rates of preventive services, experience delays in disease diagnosis and treatment, and may have higher levels of medical mistrust, which can be overcome through effective patient engagement.
Sheppard et al. (2004) found that medical mistrust may contribute to these disparities, underscoring the importance of building trust and fostering meaningful partnerships between patients and clinicians. Sheppard et al. (2004)
Addressing social determinants and tailoring engagement strategies to the unique needs of diverse populations is crucial for promoting equitable and inclusive healthcare. Clinicians must be cognizant of these factors and work to create an environment that encourages open communication, shared decision-making, and collaborative care planning.
Health Information Seeking Behaviors and Engagement
Patients’ health information seeking behaviors can also influence their engagement in healthcare. Krist et al. (2016) found that patients who actively seek health information are more likely to be engaged in their care, participate in shared decision-making, and experience better health outcomes. Krist et al. (2016)
Clinicians should encourage patients to be proactive in their health information seeking, provide reliable and easy-to-understand resources, and integrate these insights into the care planning process. By fostering a collaborative environment where patients feel empowered to explore and discuss health information, clinicians can further enhance engagement and improve the overall quality of care.
The Future of Patient Engagement
The future of patient engagement extends beyond the traditional domains of decision-making and self-care. Engaged patients can influence the design of the healthcare delivery system, shape local, state, and national health policies, and contribute to research that addresses their needs and experiences.
As patient engagement becomes more widespread, healthcare organizations should prioritize the development of systems, tools, and training to support clinicians in effectively partnering with patients. This includes the use of decision aids, patient portals, and other technologies that facilitate shared decision-making and empower patients to manage their health.
Furthermore, policymakers should consider the patient’s voice in the development of healthcare regulations, payment models, and quality measures. Engaging patients in these processes can help ensure that policies and initiatives align with the priorities and preferences of the communities they serve.
In the research realm, patient engagement can inform the selection of study topics, study design, data collection, and the dissemination of findings. By incorporating the patient perspective, researchers can ensure that their work is relevant and impactful, addressing the most pressing concerns of those they aim to serve.
Conclusion
Effective patient engagement is essential for improving health outcomes, enhancing the patient experience, reducing costs, and even benefiting the clinician experience. By partnering with patients in decision-making, health behavior change, and chronic disease management, clinicians can better understand individual needs, preferences, and barriers, leading to more tailored and effective care plans.
Addressing the influence of social determinants of health and fostering patient health information-seeking behaviors are crucial for promoting equitable and inclusive patient engagement. As the future of patient engagement continues to evolve, healthcare organizations, policymakers, and researchers must prioritize the development of systems, tools, and initiatives that empower patients to be active partners in their care and the broader healthcare ecosystem.
By embracing patient engagement as a core principle, the healthcare industry can transform the delivery of care, improve population health, and ultimately, enhance the overall well-being of the communities it serves.
