Everybody's talking about accountable care nowadays. But providers aren't the only ones who need to be held accountable as we push off into the uncharted waters of care coordination and payment reform. The folks on the other side of that storied and sacred doctor/patient relationship have important responsibilities too.
It’s a refrain one hears over and over again, from the National Coordinator on down to smallest software start-up company: Only once a critical mass of people start thinking more about and taking more responsibility for their own wellness, can the health system transformation toward which we're all striving really come about.
The hard part? Making sure that actually happens.
No surprise, patient engagement was a big topic of conversation at HIMSS12 in Las Vegas, earlier this year.
The proposed meaningful use Stage 2 rules, delivered like Moses' stone tablets to the conference's eagerly waiting throngs, focus intensely on open access, calling for patients to have the capability to electronically view and download their health information, rather than needing to request their records, and requiring that providers have secure electronic messaging to communicate with them.
National Coordinator Farzad Mostashari, MD, in his keynote address, spoke passionately about this emerging paradigm – lauding what he called, "fundamentally a return to the ethos of medicine, where the relationship between patient and provider is more than the relationship between shoe seller and shoe purchaser. Where we don't just wait for the patient to walk through the door and say, 'How can I help you?' Where we have a responsibility to the population of our patients."
The age of "engaged and empowered patients" is upon us, especially with smartphones and ubiquitous access to information "changing everything," he said. "Patients now have the tools at their fingertips."
Meanwhile, on the show floor, hundreds of companies in booths gargantuan and small were doing their best to drive that point home, showcasing their EHRs, patient portals, personal health records, and a near-limitless array of smartphone and tablet-ready health and wellness apps. But how many people are ready to use them?
Starting to get IT
Truly getting patients to take charge of their own health "means undoing the hundred years of patient passivity that we have trained people to live," says Eric Dishman, director of health innovation and policy for Intel's Digital Health Group. "It's a big challenge." Not to mention, "it's not enough to engage patients with their health," he adds. "To do that first they have to engage with the technology – and they have to want to do that."