Making sense of patient engagement, activation and empowerment

How a clear distinction between the three could improve the success rate of digital health pilots.
By Jonah Comstock
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The terms “patient engagement,” “patient empowerment,” and “patient activation” get thrown around a lot in the world of digital health, often interchangeably. But Derek and Tracie Risling, co-founders of RisTech Consulting, believe that firmly differentiating these three phrases could help improve the science of digital health, which could in turn mean more interventions succeeding and fewer failing.

“[We realized that] if we wanted to design health technology that has positive patient outcomes that we can measure and attribute — this technology is better than that technology because it promotes better engagement or creates more control — what we needed were clear and precise definitions so we could actually put metrics to it,” Derek told MobiHealthNews.

RisTech’s model is a marriage — literally and figuratively — of ideas from the world of academics and the world of computer science. Tracie is an associate professor in the college of nursing at the University of Saskatchewan. Derek has a background in software development and project management. And the two are married.

“What started many years ago as a sounding board between us became a more formal collaboration as we went on,” Tracie said. “We would get into these discussions, me from a nursing or a health or a patient perspective and Derek from a software development lifestyle perspective and we would do battle over how we could try and harmonize some of these things so we could end up with something that represented our views. And that’s actually how this model came to be.”

In the Rislings’ model, empowerment, activation, and engagements are three stages in a process of how a user engages with a technology. Empowerment has to do with how the project is designed and set up and how much control is actually put in the hands of the patient. Activation is a measure of how successful patients are getting set up and getting through the early days of an intervention.

“Presumably, if the first two stages have gone well, that will result in user engagement — ongoing, demonstrated, interaction with the technology that presumably will result in improved health outcomes,” Derek said.

But the model isn’t just an exercise in vocabulary. It’s a framework that will help researchers and providers design and troubleshoot health tech interventions.

“We wanted a one-stop shop where we could engage in user-centered design, but more importantly investigate ongoing initiatives once they’ve been implemented,” Tracie said. “And that’s why we created the model this way. We were initially just trying to figure out how these three things worked together. And then we realized it could help us with design and then we realized that adding the arrows and the motion to it, that it actually could help us in categorizing and creating a whole suite of tools for ongoing research and investigation, outcomes evaluation, ROI-type work when it comes to trying to understand all the reasons why people do or do not continue to engage with technology.”

Derek and Tracie Risling will offer more insights at HIMSS19 in a session titled “Empowerment, Activation and Engagement for Digital Health.” It’s scheduled for Tuesday, February 12 from 12:00-1:00 p.m. in room W315B.

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