When it comes to providing quality accountable care, healthcare organizations need to go beyond the traditional scope of the patient-provider relationship and work to boost patient engagement.
According to Mark Wagar, President of Heritage Medical Systems, those extra efforts are the difference between ordinary healthcare and care that is successful in the long term.
“Certainly we have all the necessary delivery systems to take care of you when you come to us in a physician's office or in an urgent situation… where you have determined that you need something, you’re really sick, you’re injured, we have all that,” Wagar said in an interview with PatientEngagementHIT.com.
“That’s the traditional healthcare system. It’s the engagement with you when you’re not presenting technically as a patient today that is the key.”
In fact, simply being a traditional healthcare system isn’t enough anymore. Asking questions that go beyond the scope of technical medicine – the ones that determine patient risk factors, lifestyle habits, and other concerns – is the best way for a provider to ensure that her patient is going to live a healthy life.
“It’s not enough to be really good when somebody falls in your door,” Wagar asserted. “It’s in fact as important, if not more important, to be able to figure out how to work with them to improve their general health status so that they have fewer events where they fall in the door.”
Getting into the nitty gritty of a patient’s lifestyle that ultimately affects their health has its benefits, mainly that providers are able to prevent adverse medical events that may have otherwise been inevitable.
“If you’re able to outreach to them, if you’re able to help them engage with their lifestyle – things some of which have nothing to do technically with medical benefits – you can change the severity of things that inevitably happen. You can avoid some of them and make them not inevitable, and when they do happen they may be less severe,” Wagar explained.
Asking those questions and getting answers can be easier said than done. Despite concerted actions on the provider side of things, many patients aren’t feeling engagement efforts, which may be an impediment to getting important clinical and non-clinical information from them.
The key to successful buy-in and patient engagement is making sure patients fully understand the benefits. In the case of accountable care, an area in which Wagar is seasoned veteran, patients need understand that accountable care organizations are on their side.
The Next Generation Accountable Care Organization program is a huge opportunity for providers to connect with their patients in this way. The Next Generation program has a higher risk and higher reward model, and a foundation in care coordination and patient-centered care.
“I think that new version, the [Next Generation ACO]… is a big step forward,” Wagar noted. “It’s not yet another company calling and saying, ‘We’ll help you.’ They distrust that. They get hundreds of those calls. This is, ‘We’re calling because we work with Dr. Smith’s office, and we want to tell you about the 24/7 capability you and your daughter, who happens to be 5 states away in Chicago, can access anytime you feel you’re in difficulty.’”
Patient engagement success is also tied to knowing the right kinds of questions to ask. It’s not enough for providers to read off a generic set of questions to every patient, or to check boxes off a list. Instead, providers need to ask questions unique to the patient that will actually result in valuable information that can help them improve their care delivery.
Heritage Medical Systems, a physician organization offering accountable care organization services from California to Arizona to New York, makes sure to review all of the information they have on their patients to make sure it is enough to really advance care.
“We use our database to make sure we know all the patients who are assigned to us,” Wagar said. “So who have we seen lately? What do we know about them? Do we know enough?”
The questions Heritage doctors ask their patients span from where they live to what kinds of family situations they are experiencing.
Collecting these seemingly insignificant insights into patient lives helps doctors cater their care to fit the patient. If a patient is reluctant to go to the doctor because nobody will be around to look after his cat, the provider will find a way to fix that problem so the patient can get care.
This information might come from unlikely sources, not just patient and provider conversations. By creating a network of caregivers, providers can consult patients’ children and grandchildren. These are the people who can help inform providers of new life circumstances, who can take care of the patient’s cat during appointments, or drive patients to wellness visits.
“It’s a matter of adapting your outreach to what will work for [the patient],” Wagar explained. “Maybe if they live in an apartment building in an urban setting, maybe they have a couple of friends who are the best persons to talk with them and help us get information and figure out the best way to access them. If someone’s relatively isolated, get some kind of community care worker, a local person they trust to visit once in awhile.”
And patient engagement isn’t the only thing that enhances overall care. Provider engagement is also an important hurdle to overcome to really advance accountable care.
To boost provider engagement, healthcare organizations need to emphasize to their staff members that these efforts will be beneficial to them, too. By asking patients more questions and getting more information on their lives and conditions, providers have more data with which they can make better care decisions.
“The physicians have to trust that all of this other stuff we’re doing is somehow funneling information into them that is useful and actionable,” Wagar concluded. “The ability to have that kind of information faster, or as real-time as you can get it, that things are happening different with their patients allows them to engage.”
Going forward in this increasingly value-based health system, providers will need to practice these kinds of patient engagement efforts, bringing care beyond the doctor’s office and adding real value.