Why patient engagement is an essential part of population health

By Jonah Comstock
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At the HIMSS Pop Health Forum in Boston today, a panel of healthcare executives spoke about the relationship between population health and patient engagement, and the ways in which technology can enable both.

“This is the Gutenberg moment,” Dr. Gregory Weidner, medical director for primary care innovation and proactive health at Carolinas Healthcare System, said. “The democratization of healthcare where patients have more access to information, data, and tools to manage, track, and interact with their health. That gives us a huge opportunity to deliver value, designed with our patients, ways to deliver care that provides value to them and engages them in ways that promotes overall health of groups and populations.”

Population health — especially in value-based care — is about managing all the potential patients a hospital can have, including those who have not yet interacted with the healthcare system. 

“It’s not a single effort that’s going to be able to drive population health,” Dr. Adrian Zai, clinical director of population informatics at Massachusetts General Hospital, said. “It starts with leadership. … Care coordination is a big deal. Right now care is centered around disease groups and it tends to be not coordinated … and finally we talk about patient engagement. But what’s important is the linkage between all these different areas, from the analytics identifying gaps in care to addressing those needs. And we’re not talking about finding the 20 percent of sickest patients, we’re talking about patients who will become sick in the future.”

Reaching out to those patients through engagement efforts, offering wellness coaching or similar offerings, is part of managing a population’s health, Dr. Thomas Lundquist, SVP and Chief Medical Officer at Optima Health in Virginia, said.

In order to reach out to a population broadly, panelists agreed, the healthcare system has to think about designing systems the way consumer products are designed. Dr. Shafiq Rab, VP and CIO at Hackensack University Medical Center, made the point with some questions to the audience.

“How many people in this room have actually used their portal in the last three days?” he asked, prompting a small smattering of hands. “One week? One year? Now how many of you have used the app to watch Netflix? We are dumb enough not to understand how human behavior works. We are all learning towards it. We want human engagement but we don’t know how to get into the rooms and into the lives of our patients.”

Lundquist also pointed out that getting patients involved in their care will help hospitals to fulfill quality measures to meet requirements for MACRA.

“If we can, we need to get the patients to do some of the work,” he said. “Why shouldn’t we have an app where the patient gets asked every day, ‘How’s your blood pressure been?’ 120/70. Boom, done, now we’ve got success measures built-in, the patient has solved one of the MACRA issues for us.”

The possibilities for digital engagement tools are extensive, but population health goals will always be served best by remembering the patient at the heart of them, Weidner pointed out.

“Writ large, population health is about people, not patients,” he said. “At the end of the day we have to remember that whatever we do, whether we’re talking about patient engagement or data analytics or care coordination, at the end of every data point is a person trying to live their life. And at the end of every enterprise patient engagement strategy, is a group of individuals trying to find out how to find additional bandwidth in their lives to figure out how to be heathy, stay healthy, and interact with the healthcare system as it’s currently configured.”