Patient Engagement: One Secret To True Healthcare Reform

All one has to do is listen to the Democratic and Republican rhetoric about the role of government in healthcare to get a sense of how contentious this issue has become. And anyone who has ever spent time dealing with his local DMV or Social Security office can certainly understand why critics question the wisdom of further involving government bureaucracy in healthcare.

But there's at least one area in which government bureaucrats have gotten it right: Stage 2 Meaningful Use. The Centers for Medicare and Medicaid Services requires providers to meet several patient engagement benchmarks that will have a positive impact of the quality of care the public receives.

Specifically, MU Stage 2 requires that more than 50% of all patients seen by clinicians get timely online access to their health information, including diagnostic test results and medication lists. It also requires that more than half of a provider's patients must receive a clinical summary of their office visit within one business day. These and similar CMS rules are a step forward in getting patients more engaged and enthusiastic about participating in their own care, rather than just passively accepting whatever their provider deems necessary.

But such mandates only scratch the surface. In fact, in many respects, Meaningful Use is almost meaningless to many patients. What the public really needs is a full- throttled campaign to get them on the road to self-care, and full transparency from hospitals and medical practices. Health IT can play a role in both endeavors.

Patient portals are probably the best vehicle to provide patients with the data that CMS requires, but smart clinicians will offer much more than these basics, including a well-stocked patient education library; an "internal Facebook" that gives patients the opportunity to share coping skills with others suffering from the same disorder; help with health insurance procedures; telemed capabilities; recommendations for health-related smartphone apps; and secure email access to clinicians.

Similarly patients want to know that if they travel far from home, data that's stored in their primary care physician's records are available elsewhere. All the more reason for providers to sign onto a health information exchange.

There's certainly no lack of creative e-tools on the market to help providers meet this patient engagement challenge. InformationWeek Healthcare recently posted a slide show featuring a handful of promising tools. To widen physicians' choices, Allscripts just announced its Open App Challenge at Health 2.0 in San Francisco. It's a competition that should bring even more innovation into this market niche. The contest, which offers substantial cash awards, is looking for developers in several categories, including what it describes as "enhanced patient engagement (i.e. remote monitoring, self-management, healthy lifestyles.)"

Obviously, patient engagement tools can get expensive and each practice and hospital has to find the right mix. But offering patient the bare minimum required to meet MU rules and grab that coveted financial incentive check is short-sighted.

What's also short-sighted is the less than transparent relationship that so many healthcare organizations have with their patients. I've spoken with countless friends and acquaintances who are deeply skeptical about the quality of care they receive from their physician. Frankly some of this skepticism borders on paranoia and the unfounded belief that organized medicine is only interested in its bottom line.

But some of the concern is based on well-documented medical mismanagement, misdiagnosis, and sloppiness on the part of the healthcare industry. A disturbing analysis in the Wall Street Journal, penned by Marty Makary, MD, a Johns Hopkins Hospital surgeon, points out that: "Medical mistakes kill enough people each week to fill four jumbo jets."

Given this very real threat, patients have the right to see a hospital's statistics on infections, readmissions, and surgical complications. If your facility hopes to gain full patient engagement--which depends in part on patients' trust--it needs to offer an online dashboard to list this kind of data, along with the annual volume of each type of procedure it does, mortality rates for various surgeries, patient satisfaction scores, nurse-to-patient ratio, and much more.

The federal government and independent analysts have already done some of the leg work on these issues. You can, for example, view a US map that rates hospitals on readmissions and mortality rates.

This kind of transparency is long overdue. And it will foster the kind of patient engagement that can truly transform healthcare.