Care that is unique to the individual and maximizes their outcomes and improves their experience is what patient engagement is all about. Research shows that along with improving patient access to health care, patient engagement strategies like patient-centric communication, patient education, and patient activation lead to greater self-management, better outcomes, and lower costs.
There are three levels of participation in patient engagement: consultation or curiosity, involvement, and collaboration or shared decision making. It’s important to understand these levels in order to deliver quality behavioral health care and achieve better outcomes.
The concept of patient engagement can often seem nebulous. However, with this guide, you’ll learn specific qualities about each level, plus any tools or skills your patient will need for engagement.
From Paternalism to Autonomy
Before jumping into the three levels, it’s helpful to know some history. For many years, medical paternalism was the height of a patient’s engagement. Paternalism in medicine is the idea that a clinician should make decisions about a patient’s care regardless of the patient’s wishes or choices.The patient and clinician paradigm at this time was “doctor knows best.” Patients were passive participants in their health care.
Paternalism still exists in behavioral health. It is often necessary when a patient is unable to participate in care due to mental or psychological decline or in cases of self-harm. In general, though, providers try to strike a balance between respecting the patient's right to self-determination and restoring the patient’s health.
What is Patient Activation?
You can’t discuss patient engagement without mentioning patient activation. The two concepts are closely linked, but activation explicitly means that your patient is armed with the knowledge, skills, and tools needed to take charge of their care.
In summary, patient engagement is the patient’s desire to meaningfully participate in their care, health, and well-being, while patient activation means they have the skills and tools to do so.
Patient experience is also closely related to patient engagement. It includes a patient’s interactions with the health care system, including care they receive from health plans, hospitals, physician practices, and other health care facilities. Along with better health outcomes, patient satisfaction is a goal that usually results from targeted patient engagement initiatives and other patient-centered activities. With each level or stage of engagement discussed, this guide will also cover how you would activate patients accordingly.
Patient Engagement Level 1: Curiosity
The curiosity or consultation stage of patient engagement can take many forms. It can occasionally be part of a paternalistic care system where a patient is a passive participant. More often, though, it’s active participation that occurs without feedback. Either way, engaging patients at this stage is not interactive.
Today, the consultation or curiosity level of patient engagement may start before your patient even contacts you. About 89% of patients turn to Google before making an appointment. Whether they are checking their symptoms or looking for a new provider, today’s patients are savvy health care consumers who regularly engage in online learning.
You have reason to be concerned about the quality of the health information your patients are consuming and their ability to understand it. Health literacy — the degree to which patients can learn, internalize, and grasp their personal health information — directly correlates to their ability to make educated health choices. According to research, 90% of adults struggle with health literacy.
Activating Patients at This Level
Your patients or prospective patients are likely taking initiative with their own online research regarding their health. You need to be there, too. Having a website is a great start, but it may not be enough. ContinuumCloud’s patient engagement platform provides patients with the tools they need — in this case, information from resources you trust.
The content library features patient and alumni education sources tailored to align with your organization’s culture and approach. You can also use the platform to deliver surveys for self-evaluation. When they are ready, it’s easy to access the patient portal to schedule an appointment, send a message, or deliver feedback.
Patient Engagement Level 2: Involvement
This stage of patient engagement is categorized by two-way communication. The patient may participate in an open dialogue with a provider during a session or with a group of peers. In terms of decision making at this level, the provider actively seeks the patient’s opinion but ultimately takes responsibility for the final decision.
It’s important to mention that not every encounter requires or warrants full engagement. For instance, if you were sharing diagnostic results with a patient, the optimal amount of engagement you would expect is “involvement.” You would encourage the patient to ask questions and have an open dialogue. However, their input wouldn’t influence your interpretation or diagnosis.
Activating Patients at This Level
To encourage patient involvement, you can start by emphasizing the importance of participation in the decision making process by validating input toward a patient’s needs. Next, give your patient the tools they need to be a full partner in their care. Provide access to multifaceted information, systems, and tools they need to communicate.
For example, ContinuumCloud’s patient engagement services allow you to reach out to users more frequently using a HIPAA-compliant private messaging app. The platform also includes patient engagement tools, such as appointment reminders, that are important in helping patients succeed with measures like accountability and reliability.
Patient Engagement Level 3: Autonomy and Shared Decision Making
When a patient is fully engaged, it signals that they are ready to be a full partner in their care — not just a participant. Based on your clinical judgment, you can allow the patient to take the lead in the decision making of their own health. Studies have shown that supporting a patient’s autonomy in shared decision making positively influences health outcomes.
Activating Patients at This Level
At this level, the tool patients will need the most is support. Family and caregivers are often a wonderful source of support. When possible, they can be included in decision making. Depending on the family dynamic, some members may serve as allies for the patient to help with accountability.
Apps like ContinuumCloud’s patient engagement platform CaredFor offer several features designed to support this stage of engagement. CaredFor’s peer support community enables users to reach out to somebody at any time. They can share personal milestones and achievements and offer support to others. It’s a safer alternative to social media as all interactions on the platform are moderated. The community encourages positive feedback and interactions for patients, alumni, families, and caregivers.
Engage Patients at Every Level
For this high-level overview of patient engagement, we divided the stages into three levels. But, like so many things in life, patient engagement is a spectrum. Your patient may be experiencing lower levels of engagement in one area but higher levels in others. The common factor in all levels of engagement is the patient’s desire to meaningfully participate in their care. The question, then, is how to activate them at each level.
Meeting patients where they’re at is where we come in. ContinuumCloud offers a multifaceted patient engagement solution designed for behavioral health and human services patients and clients.
Our patient engagement platform is a mobile app that complements our electronic health record (EHR) system and patient portal. We also offer multiple communication tools and targeted resources for patients, family members, and alumni, no matter which stage of engagement they’re experiencing. To learn more about improving patient engagement for better outcomes, schedule a call with us today.