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Exploring Basic Patient Engagement Technology, Health IT

Patient portals, telehealth, and mHealth are all core patient engagement technologies to know.

Clinicians must understand basic patient engagement technology and health IT.

Source: Thinkstock

By Sara Heath

- As healthcare takes a digital turn, it will be important for industry professionals to understand basic patient engagement technology. Health IT is a core aspect of federal incentive programs, and is becoming the future for patient activation in healthcare.

Amidst numerous tools to activate smaller subpopulations, there is a nearly agreed upon set of core patient engagement technologies fundamental to most clinicians. Between patient portals, telehealth, and mHealth tools, clinicians have a set of technologies available to them that have proven to help patients better participate in their own care.

Below, PatientEngagementHIT.com outlines the most standard patient engagement technologies and how they can shape patient care.

Patient portals as core engagement tools

Patient portals have long been promoted as the core of all patient engagement efforts, and for a good reason. These tools, which are usually tethered to the clinician’s EHR, allow patients to access their own medical records, securely message with providers, digitally schedule appointments, and request prescription refills online.

At this point, it seems as though every doctor’s office offers a patient portal. The ONC reported in 2015 that about 70 percent of hospitals let patients view, download, and transmit their own health information. AHA published a 2016 report that found that patient portal adoption had surged to 92 percent.

READ MORE: How Patient Portals Improve Patient Engagement

The rise of the patient portal is largely credited to federal incentive programs such as meaningful use and the Quality Payment Program under MACRA. Under either program, eligible clinicians and eligible hospitals must leverage the tools to engage with a minimum benchmark of patients.

ONC has also advocated for robust patient portal usage as a part of overarching patient engagement strategies. In its 2016 Patient Engagement Playbook, the agency said that patient portals are fundamental to activating patients in modern healthcare.

The functions offered on patient portals are essential to involving patients in care, according to then-ONC head Karen DeSalvo, MD, MPH, MSc, and previous OCR Director Jocelyn Samuels, JD.

“Providing individuals with easy access to their health information empowers them to be more in control of decisions regarding their health and well-being,” DeSalvo and Samuels wrote in a 2016 blog post. “Individuals with access to their health information are better able to monitor chronic conditions, adhere to treatment plans, find and fix errors, and directly contribute their information to research.”

Patients also appear to like using the patient portal. Alongside anecdotal evidence offered by individual clinicians, research has suggested that patients like to receive notifications and lab results via email and over the patient portal.

READ MORE: Patients Want More Access to Telehealth, mHealth Treatment

A study published in the American Journal of Managed Care found that 98 percent of patients preferred patient portals or digital tools for communicating health information with their doctors.

Using telehealth to conveniently serve patients

Telehealth opens doors for patients to access clinicians and other medical professionals when it otherwise would have been prohibitively inconvenient. Patients who live extraordinary distances from clinics or hospitals can leverage telehealth to conduct an examination. Patients with restrictive work schedules or children can also use the technology to fit a visit into a busy day.

All of this serves the patient where he or she needs, supporting broader healthcare access and patient satisfaction.

Florida-based Nemours Children’s Health System uses telehealth extensively. In addition to delivering more care to pediatric patients who need it, telehealth has driven parent caregiver satisfaction, said Nemours Chief Information Officer Bernie Rice in a previous interview with PatientEngagementHIT.com.

“The patient would show up at the clinic two hours away from the hospital, the doctor would have their visit with the patient via telehealth, and it was great,” Rice said. “Mom loved it because she didn’t have to pack up all the kids and drive two hours north for an appointment and then two hours back home. So it was much more convenient for the patient and the family.”

READ MORE: 77% of Patients Want Access to Virtual Care, Telehealth

Survey data published by the American Telehealth Association (ATA) showed that telehealth use is increasing, likely due to its convenience. Of 429 patient respondents, the survey showed that 22 percent had used telehealth before. Fifty percent of respondents had actively requested remote care options from their providers.

There are two important considerations healthcare experts must make with regard to telehealth. First, patients must have access to broadband to leverage telehealth. Patients in rural areas disproportionately struggle to access strong broadband, a discouraging fact considering rural patients are some that can benefit most from telehealth.

Second, patients and providers must ensure patients do not overutilize telehealth. While the technology can cut healthcare costs, its convenience leads to overutilization and thus higher healthcare costs. Researchers say patients should only use telehealth to replace a visit they otherwise would have had. Patients should not use telehealth to seek care when symptoms could otherwise mitigate themselves.

Utilizing mHealth, wearables

The sky is the limit for how mHealth can support patient engagement and self-management efforts. mHealth apps intrinsically activate the patient in her own healthcare because most mHealth apps are patient-facing. From medication adherence and management apps to mHealth gamification, these tools largely help patients manage treatment plans and their own symptoms.

Medication adherence and management apps are some of the most prevalent on the market. Some apps simply remind patients when it is time to take their daily medication, while others outline medication directions.

Some technology developers have created Bluetooth pillboxes that record an entry into the patient portal and EHR every time the patient opens the pillbox. This motivates the patient to remain adherent and gives doctors an idea of how often patients take their medications.

Research shows that medication adherence apps and tools are effective when used consistently. Recently, a study published in the Journal of Medical Internet Research showed that mild prodding from an mHealth app can boost medication adherence in patients.

The study explored a tool that targeted messages to non-adherent patients based on their reason for not taking their meds – anything ranging from “I forgot,” to “out of drugs.” The platform drove an 86 percent medication adherence rate.

At the core of patient engagement mHealth for any purpose is a functional design. Research shows that apps with low navigability result in low patient engagement.

mHealth also largely suffers from a lack of prolonged engagement. While some patients may use a tool when first adopted, engagement usually falls off over time. Digital health experts have yet to determine a solution for this phenomenon, however.

Ultimately, the role of patient engagement technology is to offer the patient a more convenient pathway for becoming involved in her own care. Using patient portals, patients can keep track of their health data and maintain better communication with their providers.

Digital health, ranging from telehealth to mHealth apps, can further activate patients in their own care. Technology has the potential to integrate patients as key players in their own treatment by offering more treatment access as well as self-management tools. 

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