By Stephen Wilkins, MPH

First Posted at Mind the Gap on 2/6/2014

Steve Wilkins, MPH, host of "Mind the Gap"

Steve Wilkins, MPH, host of “Mind the Gap”

I recently came across an interview with Stephen Beck, MD, Chief Medical Information Officer (CMIO) at Catholic Health Partners. Dr. Beck was being interviewed on the subject of patient portals and patient engagement.

Here’s a quote from that interview.

“While we have many enrolled patients in our patient portal, it’s not simply the enrollment but the actual use in Stage 2 that meets the criteria. Although the threshold is fairly low, there is still ongoing concern about how we can encourage patients to use the portal regularly…. We want patients to use electronic communication rather than pick up the phone. For many patients this transition will take quite some time to achieve. I have confidence the patients will see the light — the question is: How quickly?”

Get To Know Me

No wonder Catholic Health Partners is having trouble getting 5% of their patients to “use” their portal for secure messaging, etc. They are doing patient engagement for the wrong reasons.  And as we as have seen with Mayo Clinic and others…Catholic Health Partners is not alone.

There Are Two Reasons For Doing Patient Engagement

There are two reasons why an organization should get involved with patient engagement. The right reasons and the wrong reason. The use of the terms right and wrong is not intended to imply any moral connotations.  Rather it refers to the likelihood that one’ engagement efforts will succeed or not.

The Right Reason

If your engagement efforts are done principally for the patient’s benefit (patient-centered) then you are doing it for the right reason. Examples of the right reasons include:

  • Ensuring that each patient is as involved as they want in their own care,
  • Reducing patient risks of infection or injury due to medical errors or safety issues
  • Helping patients make health decisions that are right for them
  • Providing patients with important self-care skill, and so on.

You get the idea.

The Wrong Reason

If you are trying to engagement patients principally for the benefit of someone else (health care executives, physicians or regulators) then you are doing it for the wrong reasons…and patients will quickly sense this. Examples of the wrong reason abound and include:

  • Doing it to achieve Stage 2 MUEngagement Quote 1
  • Off-loading work heretofore done by clinicians to patients via a patient portal
  • Engaging is shared decision-making to coach the patient away from costly service requests
  • Putting a patient or two on an advisory committee as window dressing
  • Requiring that patients view their physician notes on the patient portal or health app before allowing them to find what they really want

 

Sure you can rationalize that everything ultimately is for the patient’s benefit but come on. Patients aren’t stupid. They know when something benefits them and when it really is for someone else’s benefit. Forcing patients to go online to use secure messaging to communicate with their health care provider instead of calling is a pretty transparent way of trying to eliminate staffing costs and achieve Stage 2 Meaningful Use. But from a customer service perspective it’s not very smart. Person-to-person interactions are much more meaningful from an engagement perspective than “going online.” Heck even the airlines let you call and speak with a reservation agent if you don’t want to book your flight online.

The Take Away?

Remember, many patients (people) are already engagement in their health albeit in ways that differ from the way providers tend to define engagement, e.g., patients doing what we provider consider to be the right thing.  Following the admonition to “do no harm” the health care providers job is to be engaging and avoid pissing off the patient and disengaging them.

Also remember that for every action there is an equal and opposite reaction – call it unintended consequences. In this case Catholic Health Partners might not only fail to achieve Stage 2 MU but also increase patient dissatisfaction in turn disengaging more patients than they actually engage.  I doubt that their patients will ever see the light as Dr. Beck hopes.   But then patients are not the one’s who need to “see the light” are they….

My advice is you do something nice for your customers – something that they find to be a benefit – you can never go wrong.

That’s what I think. What about you?