Top Patient Engagement Technologies for Population Health Management

July 19, 2023 - Any good population health strategy needs good patient engagement, and as a part of that, good patient engagement technologies.

Defined by the Centers for Disease Control & Prevention, population health is an “interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally,” the agency says on its website. “This approach utilizes non-traditional partnerships among different sectors of the community — public health, industry, academia, health care, local government entities, etc. — to achieve positive health outcomes.”

As part of their population health management strategies, many stakeholders home in on patient engagement. Population health programs that emphasize patient access to care, social determinants of health interventions, and healthy behavior change will be more successful.

But it’s not just the patient support that’s important. Population health management relies heavily on data, and some of that data will be patient-generated health data (PGHD) that comes from self-reported health histories and the self-management tools patients use outside the clinic or hospital.

In short, good population health needs good patient engagement technology.

Below, PatientEngagementHIT will outline the different patient engagement technologies that can support a population health management strategy. This list won’t dig into the data analytics tools necessary for population health but rather the patient-facing tools that help providers achieve better outcomes.

Telehealth & Video Visits

Telehealth, and particularly video visits, helps healthcare providers to remain connected with the high-risk populations often included in population health management programs. By allowing patients to interact with their providers remotely, telehealth also expands patient access to care.

And that can have tangible benefits to patient outcomes and experience, one study looking at telehealth use for rural cancer patients found. The researchers found that telehealth cut travel times and costs for patients and still helped maintain good clinical outcomes.

“Patients experienced substantial financial and time savings manifested by reduced mileage, hotel stays, and lost wages,” the Utah-based researchers found. “This project highlights that telehealth can be a cornerstone of a population health model to deliver value-based care to provide high-quality, low-cost care to patients residing in rural communities.”

There are limitations to using video visits for population health. For one thing, numerous studies have found unequal access to telehealth. Low-income populations of color, many of whom often qualify for population health interventions, are less likely to use telehealth compared to their White counterparts.

With health equity being a cornerstone of population health, it will be critical for healthcare providers to consider the barriers keeping these patients from using video visits. Creating easier access to the technologies necessary for video visits, offering language interpreters via telehealth, and giving navigation support to those with limited digital health literacy will be integral first steps.

Remote Patient Monitoring

Remote patient monitoring (RPM) is a subset of telehealth in which providers use wearable devices to track a patient’s health status outside of the clinic or hospital. Holter monitors or continuous glucose monitors are two examples of RPM.

These technologies are useful for helping providers manage the complex health needs of individuals typically included in population health management programs. Patients and providers who notice an irregularity can flag the issue quickly and get the patient in for higher acuity care.

Moreover, RPM can improve patient engagement and empowerment in care. A 2021 study in JAMA Network Open showed that patients with access to an at-home blood pressure monitoring tool, plus some health coaching, were able to lower blood pressure from between 53 and 85 percent.

The crux of the program was the health coaching, the researchers said, but there may have been other byproducts of patient engagement, like better medication adherence and overall investment in healthy behavior change.

Using RPM, particularly in population health programs, does have its challenges. For one thing, patients need access to the devices, and data indicates there are financial barriers to that. And even when patients can get their hands on the devices, there’s a learning curve, and digital health literacy can stand in the way of utilization.

Providers themselves face some reimbursement issues. RMP use skyrocketed in 2020 as the pandemic prompted lawmakers to loosen restrictions on remote patient monitoring use. But on May 11, 2023, the public health emergency that enabled those flexibilities ended. That has caused hiccups in how providers can bill for the services.

Social Determinants of Health Screening Tools

Understanding social determinants of health is integral to population health management. Defined by the World Health Organization as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life,” understanding and accounting for SDOH is critical to population health.

After all, healthcare stakeholders can’t improve clinical outcomes when social factors are in the way. That’s because clinical care accounts for only around 10 or 20 percent of outcomes; the rest depends on social determinants of health.

Having SDOH data on hand is key to designing population health management programs. Stakeholders who learn that their population has significant transportation access needs, for example, can embed those resources into their programs. But doing so starts with data.

Healthcare organizations have access to some broad data sets, like County Health Rankings or the Social Vulnerability Index from the CDC, but it’s becoming more common for providers also to uncover SDOH needs at the population level. They do this through social determinants of health screening.

SDOH screenings are usually optional, meaning patients can decline to complete them or part of them. There are some standardized screenings available on the market, but some providers also choose to write their own or adjust those standardized screenings based on what they already know about their population via community health needs assessments.

These screenings can be paper-based, but using digital SDOH screening has also become more common. Digital surveys are usually accessible in either the patient portal, the EHR, or at patient intake kiosks.

Patient Self-Management Apps

Self-management apps are smartphone applications that help guide and support patients as they adopt healthy behavior change and manage their health. These apps may include weight loss apps, medication adherence apps, or niche apps that help support a specific illness like heart disease or diabetes.

The best patient engagement apps will use strategic nudges that do not create notification fatigue in users, will consider patient health literacy levels and language preference, and allow patients to share their health data in a private and secure way.

And in turn, these apps can improve patient engagement and activation, a key ingredient in population health management programs.

In one 2021 study, researchers found that patients using a self-management app were around three times more likely to demonstrate high levels of patient engagement compared to those who don’t. These patients were also more likely to use other patient engagement technologies, like personal health records, and communicate with their providers.

But self-management apps are useful for more than just influencing patient behavior change. A byproduct of app usage is the PGHD they can create. This creates yet another data source from which providers can track outcomes and steer population health programs.

Digital Health Literacy & Tailored Solutions

Importantly, healthcare organizations considering patient engagement technologies for their population health management programs must acknowledge the different needs and preferences of their populations. Those needs and preferences could refer to digital health literacy or language access as well as individual patient preference.

As noted throughout the article, using patient engagement technologies relies on patients to understand how to use the technologies. A 2022 survey from the All of Us Research Program showed that, despite patient interest in using engagement tools like wearables, there were some barriers in the way.

Some of the patients demonstrated limited digital health literacy, the researchers said, while many expressed interest in more support like instructional pamphlets or in-person training sessions for using the tools.

Others simply expressed little interest in using the tools, the survey mentioned. This could be a generational divide, or else a cultural competency issue—the researchers mentioned the verbiage of “fitness tracker” not being well-received by Hispanic populations concerned the tools would track their locations.

There’s some room for healthcare providers to spend time with their patients to explain the benefits of using patient engagement technologies and answer privacy and security questions. However, it would also benefit organizations to ensure there are also low-tech options for these more hesitant populations. In doing so, organizations can ensure equitable inclusion in population health programs.

The personalization does not start and end with high-tech versus low-tech population health. Even if a patient is open to using digital health, they may not want to use it the same as their peers. While some patients will want high-touch communication and nudging from their technologies, others will want technology to play a smaller role in their healthcare.

Being able to personalize technology offerings will be key to ensuring patients actually use the tools.