How can 'patient engagement' really work?

From the mHealthNews archive
By Eric Wicklund

It's not enough to put mHealth technology in the hands of providers and expect them to connect with consumers. In today's healthcare landscape, clinicians need to tailor their message to the patient, making the communication personal and relevant. That's why 'patient engagement' is such a hot topic these days.

"mHealth is really an extension of relationships," says Kyra Bobinet, MD, MPH, an instructor in patient engagement and empowerment at the Stanford University School of Medicine and CEO of the behavior design form engagedIN. "With mHealth, you're getting new tools to extend relationships. The important thing is to know when it works and when it doesn't."

Bobinet, who received her Master's in Public Health at Harvard and studied at Stanford under the noted behavioral health expert B.J. Fogg, is one of the new breed of mHealth strategists working with up-and-coming companies to study the connections between consumers and their healthcare choices. She was recently hired as a consultant for GenerationOne, a Michigan-based company that is marketing its mHealth Connect platform to health plans and providers who want to get a better handle on population health management.

This targeted approach is gaining momentum as both providers and payers seek to create health management plans that reduce waste and achieve positive clinical outcomes. And they're looking to controlled populations, such as those with chronic conditions, to prove that point.

Bill Tella, GenerationOne's CEO and president, said an mHealth program for people with chronic conditions will only work if it can connect patients with care programs that meet their particular needs. That requires knowing a little bit about the patient before connecting them with the care program.

"Individuals come in many different emotional states, so there's no one sure strategy that first everybody," Tella says. "You need to develop metrics that will enable you to identify those challenges. You collect information on the patient, then use that information to create health coaching programs."

Bobinet calls this process the search for "emotional intelligence," or the link between what a patient needs to do and what he or she is willing to do. She says the medical community hasn't, in the past, taken a good look at emotion, so clinicians aren't equipped to analyze and understand the triggers that would move a patient from prescription to compliance.

"mHealth has the opportunity to shine a spotlight in that blind spot," she said.

GenerationOne's mHealth Connect program – one of a vast number of efforts now being introduced to the healthcare market – establishes a line of communication with the patient, most often a messaging link via smartphone or e-mail account. Once that connection is established, the patient answers a series of questions about his or her medical condition, regimen and schedule. Those answers are used to create a program that uses automated reminders, feedback, monitoring, advice and support.

The goal, says Tella, is to create a program that's personal to the patient, on a platform that's big enough for health plans and providers to use for a larger population.

While payers and self-insured businesses are showing the most interest in care management platforms like mHealth Connect, Tella says providers are starting to see the value as well, especially as the healthcare landscape moves toward a pay-for-performance dynamic. Clinicians want to see programs that work for their patients, giving clinical outcomes that are effective and measurable.

"Providers and payers are joining forces to align incentives with preventive medicine," says Bobinet. And new mHealth tools like Apple's proposed HealthKit "might really make the connection in the brain between my cellphone and my healthcare."

Those connections will only work, Bobinet and Tella point out, if consumer and provider are on the same wavelength, and the content being offered by the provider resonates with the consumer. That's why payers and providers need to understand why a consumer might feel compelled to access healthcare on a smartphone.

If it's personal and relevant, says Bobinet, that should work. 

"It's becoming more socially acceptable and … not weird," she added, "to do your healthcare on your phone."

As long as your phone is speaking in your language.