The top 5 roadblocks of patient engagement

By Geoff Fiedler
09:55 AM

As paper-based health records continue migrating to electronic platforms, more opportunities arise for a new level of patient education and engagement using interactive patient-information systems and other forms of collaborative care. According to a recent report from KLAS, educating patients and their families about their current condition and ongoing treatment is one of the most effective means for reducing hospital readmissions, be that among active-duty military personnel, veterans, or civilians.

Lowering readmission rates is not the only value associated with patient education. As patients and their families are better informed they will be better able to manage those conditions over the long term.

[Related: Blues back ONC patient engagement HIT efforts.]

Health providers also benefit from patient education and engagement. When patients fully participate in diagnosis and treatment by being better informed, providers are able to treat patients in a more-timely manner. Far less bedside instruction is required and follow-up compliance is more likely because patients better understand the requirements for healing. For example, at-home medical devices are likely to be used more effectively, leading to fewer recurring visits and follow-up phone calls.

Another added benefit? Lower malpractice events due to managed expectations is also likely.

The “improved engagement” concept may sound great on paper, and when it works it is very beneficial. Unfortunately it’s not always smooth sailing. Like any great undertaking, providers are going to run into a few roadblocks. Here’s a look at five types of roadblocks providers may be up against as they implement new electronic patient engagement systems.

1. Cost: Finances play a substantial role in patient engagement. As hospitals and health providers transition to electronic records in order to satisfy Meaningful Use requirements, they have to make significant investments in human and technical resources. Even though the incentives for implementation defray up-front costs, CIOs and CFOs need to factor in the pros and cons of long-term management.

2. Integration: The days of purchasing best of breed, standalone technology without a well planned strategy for systems integration are long gone. Patient engagement systems have traditionally created silos of data making it very difficult for legacy systems to communicate with electronic health record systems. In order for Patient engagement systems to deliver their prescribed ROI, they must be capable of integrating with existing electronic systems. Equally important, they must integrate with current work flow or they risk being another drain on care providers’ time.

3. Technology: Patient engagement technologies have been cumbersome on many levels. Traditional systems require a computer in every patient room, for example. This presents many challenges associated with supporting and maintaining equipment, not to mention the added strain on the facility’s network. On the backend, most patient engagement systems have a distributed architecture making integration with other data sources virtually impossible, and again, creating a maintenance nightmare for health system IT leadership.

4. Organizational Culture: Unfortunately, some health providers don’t focus as much as they should on customer service, which is the heart of patient engagement. If an organization isn’t going to make patient engagement a strategic priority from the top down, these systems will fail. Instituting a new patient engagement system needs to be an all-in project with strategic focus on the end game… a healthy patient outcome. As with any new technology, people naturally avoid the uncertainty of change. Patient engagement needs to be a cultural commitment to improving operational processes. Technology should complement the operational change.

[Feature: The 5 roadblocks HIEs face. Also, see Q&A: On the trials and tribulations of unlocking patient data.]

5. Relevance: Some patient engagement systems simply don’t live up to that word, engagement. In order for the tools to be successful, the information provided to the patient must be relevant to all aspects of their care. In the past, patient education and engagement systems have provided a “one size fits all” user experience. The same generic information provided to all. Naturally people are going to be less inclined to use this type of system if the information is not relevant to them as a consumer. Utilization is critical to any system and this has been a significant barrier in the past. Fortunately some current systems do allow for personalization on a patient-by-patient level.

Patient engagement systems are going to continue playing an increasingly important role in healthcare. As methods of care transition from reactive to proactive and preventative, engaging patients will increase in importance. When patients and their families have opportunities to learn about specific, relevant conditions, they’ll be able to better manage their own health.


Geoff Fiedler is co-founder and president of Aceso. His career is highlighted by a range of experiences including HIT consulting, sales and business development. Geoff co-founded Innovative Medical Solutions, the predecessor to Aceso, in 2007. Prior, Geoff spent seven years in sales, consulting, marketing and business development with Cerner, where he pioneered several strategic initiatives focused on interoperability and managing data across disparate health systems. Geoff is a graduate of the University of New Hampshire with a B.S. degree in kinesiology.