Patient engagement key to doing more with less

Today's physician practices are more burdened with administrative, technological and regulatory challenges than ever--all in the midst of dramatic reimbursement changes and a physician shortage. But adding human resources--which already comprise 56 percent of healthcare providers' costs--isn't the best way to accomplish more with less, according to a recent article for Medical Economics.

Instead, authors Alexandra B. Kimball, M.D., Kristen C. Corey, M.D., and Joseph C. Kvedar, M.D., recommend empowering the consumer (patient) to share more of the load, as the banking industry and others have done with ATMs and other self-service innovations.

In medical practices, administrative areas ripe for better patient engagement include scheduling appointments, managing correspondence, handling refills and prior authorizations, and facilitating communication with the medical team. "These tasks require more health literacy and familiarity with technology than we have asked of patients previously," they wrote. "Not all patients will be able or eager to handle this, but many will."

The argument is also strong, of course, to engage patients medically, the authors noted, citing initiatives that have led to reduced hospital visits, decreased morbidity and mortality, and improvements in treatment adherence and quality of life associated with chronic diseases.

A separate article in the same issue of the magazine focuses on motivational interviewing as a communication strategy to help patients take on more responsibility for their own health. Keys to implementing the technique, according to physicians who were interviewed, include the following:

  • Solicit patients' ideas for habits they are willing and able to incorporate into their daily life, such as walking to the mailbox daily.
  • Listen to and respect patients' health priorities. Craig M. Wax, D.O., a family physician in New Jersey, cited an example of a recent visit with a patient who had hypertension, high cholesterol and smoked two packs a day, but arrived at the office because he had an ingrown toenail. "Of course I wanted to address his hypertension, hyperlipidemia, smoking habits and lack of preventive care over the last five years; but he just wanted to deal with his toenail," Wax said. "And if I didn't deal with his toenail first, none of the other stuff would be on the table."
  • Invest more time for discussion at the beginning of the process to reap better outcomes in the long run. Once patients begin to make progress and see their efforts snowball into dramatic improvements in their health, they will become more motivated to keep up the work on her own, according to Barbara Clure, M.D., a family physician at Interfaith Community Health Center in Bellingham, Washington.

To learn more:
- read the column and article from Medical Economics