Barriers to Patient Engagement and Ideas to Deal with Them
Written by: Cheryl Reifsnyder, PhD
Barriers to Patient Engagement and Ideas to Deal with Them
Patient engagement describes the scenario where patients become active members of their care teams, helping to better manage their own healthcare. The best approach to improving patient engagement in healthcare involves extensive patient-provider collaboration throughout the patient’s care. For the majority of patients, higher engagement levels lead to increased participation in making healthcare decisions and improved clinical outcomes, reduced hospital admissions, improved effectiveness of healthcare, greater efficiency, higher quality of care, and more cost-effective utilization of healthcare services.
Unfortunately, there is growing evidence that those patients who are least engaged in their care are more likely to have unmet medical needs and to delay care.
Despite the evidence, though, many organizations still struggle to get patients and their caregivers more engaged in their healthcare journey. This is partly because patients intrinsically have different levels of interest in their care. Engaging patients can also be difficult because patients have different levels of health literacy surrounding their health and healthcare. Research even suggests that patient attitudes toward engagement are moving in the wrong direction: In 2012, Deloitte published a report stating that one-third of healthcare consumers self-identified as “disengaged.” These consumers see little need for preventive care and have little interest in health education—all of which makes it much more challenging to treat them as active members of their care teams. In this article, we will look at some of the most common barriers to encouraging patient engagement—as well as some ways to overcome them.
In this article, we will look at some of the most common barriers to encouraging patient engagement—as well as some ways to overcome them.
Obstacles involving providers
One frequent obstacle to patient engagement is a lack of patient trust: Patient engagement can only be established when patients trust their providers. Providers can face numerous obstacles that make it difficult to gain a patients’ trust, though, such as time constraints, insufficient training, or information system shortcomings.
Communication challenges can make it difficult to establish trust as well. Patients often have diverse cultural backgrounds and socio-economic statuses. Along with these traits, they have differing comfort levels with speaking in different languages. For providers to effectively engage with these patients, they may require specific competencies, such as language skills or an awareness and understanding of certain religious beliefs. These skills improve communication which, in turn, helps to foster patient-provider trust.
Obstacles involving patients
One of the most common barriers to patient engagement is health literacy. Often patients’ lack the minimal health literacy required to engage effectively in shared decision-making about their conditions. Given the complexity of modern healthcare, many patients must struggle to obtain, communicate, or understand even basic health information and services. Numerous patients lack any amount of health literacy; that is, they lack a true understanding of their medical conditions, an understanding that is required if they are to effectively share in decision-making. Patients with low levels of health literacy also have difficulty following directions on how to care for themselves and how to stick to treatment regimens, such as taking prescribed medications.
In some cases, this falls on the providers. Many providers fail to provide patients with the information they need to make informed decisions about their care and treatment. Even when patients do receive this information, though, they are often overwhelmed by it or lack confidence in their choices. In particular, patients often have difficulty evaluating choices related to costs in healthcare decisions.
Principles for sustained patient engagement
Johnson & Johnson Health Care Systems addressed the question of how to get patients invested in their own health. In answer, they came up with principles for sustained engagement, organized on a framework based on motivational psychology. The 3 most basic needs, which form the hub of this framework, are:
- Connection: People who feel connected to others feel like part of a community or social group. They also feel recognized and understood. Strong interpersonal dynamics between provider and patient are crucial to fostering a sense of connection in your patients. When the provider uses strong, empathic, and active listening skills, they can help the patient to feel more engaged.
- Confidence: People who experience success will feel a sense of confidence; but even if they are not successful, they can feel confident if they receive clear, encouraging feedback explaining how they can improve their performance. A confident, competent patient is supplied with a set of skills that can be used to overcome a challenge.
- Ownership: When people take ownership of their health, they take action because they want to, not because they feel compelled to do so. Many health behaviors—such as following a medication regimen or adjusting a diet—lack intrinsic appeal, but patients can still develop a sense of ownership when they see these behaviors as instrumental for achieving personal goals. Our engagement guidelines related to ownership emphasize helping patients to fit care behaviors into existing structures whenever possible.
Fulfilling these 3 psychological needs can help to give patients a sense of control over their health experiences and help them to believe in their ability to feel understood and accepted and, as a result, to take action.
FollowMyHealth®: a mobile-first patient engagement tool
Veradigm offers a cloud-based, EHR-agnostic, customizable patient engagement platform called FollowMyHealth that redefines how healthcare professionals interact with their patients. Because FollowMyHealth integrates agnostically across EHRs, it can provide a unified view of the patient’s record. FollowMyHealth is also mobile-first, giving patients more efficient access to their health information and streamlining the patient experience.
Before-visit engagement features
Before-visit patient outreach communication integrates directly with existing practice management solutions to reduce gaps-in-care with appointment confirmations, waitlists, and reminder notices. These include functionality for direct cancellations, overdue appointment notices, patient education, and notices of office closures. Other before-visit features include:
- Appointment self-scheduling
- Electronic check-in and clinical assessments
During-visit engagement features
During visit engagement features simplify the patient intake process and enhance patient safety by providing the ability to deploy mobile check-in when needed to decrease face-to-face interactions. FollowMyHealth also provides telehealth virtual modalities of care:
- Email: Asynchronous email private consultation related to patient’s chief complaint. Patients are notified when to expect a response.
- Video visits: Real-time clinical consultation with selected provider by video, using a smartphone, tablet, or computer.
After-visit engagement features
FollowMyHealth enables providers to send after visit summaries, instructions, and patient education. It also provides automated care plan follow-up with patients. Remote patient monitoring enables providers and patients to create patient goals and capture patient data via wireless and wearable devices.
See for yourself how the FollowMyHealth mobile patient experience can help you empower your patients to become active members of their healthcare teams—and, in the process, give a boost to their healthcare outcomes.