Technology is a must for patient engagement, but it isn't a cure-all

There's no shortage of patient portals, mobile apps and chatbots out there, but too often, health systems haven't deployed them in any meaningful way, expert says.
By Mike Miliard
11:19 AM
patient engagement technology

A panel of experts at the HIMSS18 Patient Engagement & Experience Summit on Monday.

LAS VEGAS -- At the HIMSS18 Patient Engagement & Experience Summit on Monday, a panel of experts from both the vendor and provider sides were asked to rate, on a scale of 1 to 10, healthcare's success so far in engaging patients and creating a good experience for them in care settings.

The low scores may (or may not) surprise you.

"I'd have to say a 1.5 or 2," said Pracha Eamranond, MD, senior vice president of medical Affairs and population health at Harvard-affiliated Lawrence General Hospital. "We don't consistently provide patients and their families the best patient experience."

"We're at a 2 or 3," said Donald Kosiak, MD, chief medical officer at Leidos. "We have a lot of technologies, but we haven't deployed them in any meaningful way."

Shae McBride, managing director and vice president of strategy at Carelike, was a bit more optimistic, but not much. "We're a 5," she said. "We're falling short in terms of vocabulary. People speak different languages. I think our content needs to be better defined."

For all the exciting and innovative tech-enabled use cases showcased throughout the day at the Summit, the consensus of the panel seemed to be that PE tools are still too often used haphazardly – without much of a strategic plan, and without specific thinking about how or why patients would want to engage with them.

"Technology developed without a plan in mind creates more negative impact than positives," said Greg Blew, vice president of product design, and clinical effectiveness at Wolters Kluwer Health.

But that's often what happens in the patient engagement space: Lots of cool and innovative tools and tech that are introduced but underused.

Even basic things like patient portals are often left to collect dust. But that stands to reason. As another of the day's presenters, Stanford Medicine X patient advocate and data liberation guru Hugo Campos put it: "No patient wants to engage with healthcare. They want to engage with life."

So smarter thinking needs to be applied to the ways to get patients engaged with their wellness, and to offer them a better experience when they're in care settings they'd probably rather avoid.

Easier said than done, of course, but one ideal factor would be to invite them to participate in co-design on such approaches, to "get patients involved in the development process," said Eamranond.

On a more basic level, it's worth thinking about what sort of data sharing is done with patients in the first place.

"The challenge is we focus on the what, and not the how and why," said Kosiak.

"Texts and portals are meaningless unless there's some context. We can engineer almost anything, but we often forget what the user experience is going to be. How do you sort through that noise?"

Panel moderator Santosh Mohan, a member of the HIMSS HIT User Experience Committee, agreed: "We're giving them information, but in a horrible format," he said.

It's also worth thinking about some of the potential unintended consequences of too much patient engagement technology, deployed without enough forethought.

The big goal of PE, of course, is to encourage health and wellness, fostering good population health for more efficient and accountable care.

But the irony is that, with the rise of consumer fitness apps and chatbots, all of these things are racing to make it easier for patients to self-diagnose. How to balance this new profusion with technology with the overtreatment it could encourage?

"There's a lot of evidence out there, but we haven't really thought about how to incorporate it," said Eamranond.

"Other industries have solved a lot of these problems," said Kosiak. Consider something as seemingly simple as data exchange. "The challenge of sharing, even across a community, is quite high," he said. "And it doesn't need to be."

One way forward to encourage smarter deployment of patient engagement and experience tools could come from the payer side, Eamranond suggested.

"We should be incentivized structurally, with payments, to do things that are more meaningful and valuable for patients," he said.

But that doesn't remove the responsibility to think critically and proactively about how PE technologies are deployed – and how they're followed up on.

Mobile apps and chatbots won't do much if they're not used as components of larger, human-driven initiatives to encourage medication adherence, phone check-ins for post-discharge follow-up or arranging transportation to get to appointments on time.

"We talk about the apps, but we haven't even done the easy blocking and tackling," said Kosiak. "We're not talking about major interventions. We're just talking about treating people humanely."

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