- To create an industry filled with robust patient engagement that builds to quality healthcare, leaders will need to focus on care coordination and integrating the patient into the care team.
How to develop that engagement was the hot topic at the Council of Accountable Physician Practices’ forum, “Better Together Health: Patient Expectations and the Accountability Gap.”
The forum included an introduction from CAPP’s chairman, Robert Pearl, MD, who opened the conversation about how lacking care coordination, or teamwork, on the part of patients, providers, and caregivers leads to gaps in care and preventative engagement.
“When physicians don’t work together as one, patients fall through the cracks,” he told the audience.
The healthcare industry needs to work toward integration and work together as teams, Pearl argued, in order to fully achieve quality healthcare.
“Quality is too important to leave to luck,” he asserted.
An expert panel, comprised of three healthcare professionals specializing in patient engagement and one patient advocate, echoed those sentiments.
“We do hope that having patients involved in the decisions and as a part of care coordination will drive us to better outcomes in the future,” said Karen Cabell, chief of quality and patient safety at the Billings Institute.
The problem, however, is that conversations seldom involve the patient, said panelist and patient advocate Regina Holliday. All too often, providers do not have time to fully incorporate the patient into the care coordination plan, and instead they see patient engagement as a “check box.”
This causes a gap in perceptions of patient engagement – providers often believe they’re engaging the patient, but the patient doesn’t feel the same.
Holliday says this is a key cause of low quality care.
“In an encounter with the physician we don’t have time for those conversations,” she explains. “The referral doesn’t happen. The secondary conversation doesn’t happen. It just falls through the cracks. So if we utilize an integrated system,” people get the help they need.
The forum centered on results from a recently-released Nielson survey, which CAPP commissioned.
The survey consulted over 30,000 healthcare consumers and over 600 physicians, finding that there is significant room for improvement in the patient engagement arena.
Too few patients are able to access healthcare without restrictions Only about one third of patients get 24/7 access to healthcare outside of an emergency department.
Healthcare is also behind on keeping up with patient information. Only approximately one half of patients report visiting a physician who knows their whole health history, or have their health data stored in an EHR.
Things don’t look much better for patients managing chronic illnesses, even though they arguably benefit from their providers keeping adequate track of their health data.
According to Nielson, the rate of patient engagement among the chronically ill is only marginally higher than their healthier counterparts. This population sees slightly more follow-up appointments and care management compared to other patients.
Providers also have room to grow when it comes to using technology to communicate with their patients. Despite the oft-cited evidence that patient portals boost engagement and care outcomes, only 20-30 percent of patients reported communicating with their providers digitally.
Less than half (44 percent) have access to their digital health information, like appointment scheduling programs, lab results, or patient portal data.
Similarly lackluster was the prevalence of preventative care guidance. Although 89 percent of providers reported that they advise their patients on important preventative screenings and treatments, only 14 percent of patients get the message.
Most starkly, data shows that nearly two thirds of patients are obese. However, the survey shows that only 5 percent of patients receive weight loss guidance from their providers.
Further, very few patients and providers engage in informed and shared decision-making. Only 65 percent of providers report using evidence-based guidelines to determine treatment plans, and only 39 percent of patients recall discussions about treatment plans.
Despite these less-than-stellar survey results, CAPP leaders remain somewhat optimistic about the direction in which the industry is moving. Care coordination and is on the rise, and as providers continue to further engage with their patients, other aspects of patient experience will ideally improve over time.
“Our survey found that while it is encouraging that the use of care teams and care coordination seem to be increasing, access and the effective use of technology still need improvement, and tactics that help to prevent illness are still woefully ineffective,” CAPP’s executive director Laura Fegraus said in a press release.
Pearl says these results present an opportunity for significant growth in the nation’s healthcare system, and CAPP hopes to be at the helm of that.
“This survey is evidence of the failure of American health care to provide coordinated, technologically enabled, high-quality health care to the majority of people,” he said in the release.
“We know that CAPP members, all committed to the multi-specialty medical group model, are best positioned to deliver superior outcomes to the patients they treat. CAPP stands ready to help others improve their care delivery systems, and to work with policymakers to facilitate these changes. These findings reinforce CAPP’s long-held belief that patient-centered care models are critical to closing the gaps between what patients need and what they are currently receiving.”