Question

A description of the audience(s) that will be interested in or benefit from this research ( improvment of healthcare system and decrease the costs) and Indicate how this research will potentially benefit these audience(s)

Answer 1

Engaging consumers more fully in their own health and health care not only improves the experience of care for patients and their families, it also improves the quality and costeffectiveness of care. More engaged patients have better outcomes in terms of both cost and quality, which is why consumer engagement is such an essential element of new delivery system and payment reforms now emerging to address the significant challenges facing the U.S. health care system. Online and electronic tools that play such key roles in many other aspects of American life—from how people manage their finances to how they shop for goods and services—can be leveraged to accelerate and support patient engagement efforts in health care.

Greater engagement of patients and their families supports better health system performance across all six attributes of high-performance in health care. It focus on the needs of the patient; strong organizational and clinical leadership; access to information to support efficient, coordinated care; timely access to care; emphasis on prevention, wellness, and healthy behaviors; and accountability, alignment of incentives, and payment reform.

Patient-centered communication and engagement drive lower costs, better outcomes, and better patient experience in health care. Patients involved more closely in clinical decisionmaking report less pain and faster recovery, are more likely to adhere to medical recommendations, and carry out more health-related behavior change. Patient-centered communication and engagement are also associated with fewer diagnostic tests and referrals. Informed patients are less likely than other patients to choose elective surgery.

Electronic tools boost consumer engagement by giving users easier access to patient education and self-care information, interactive self-monitoring and tracking tools, and online communities of peers. Electronic tools also help patients interact more effectively with the health care system, enabling them to access and download information from their electronic health records (EHRs), securely communicate with their providers from remote locations, and manage health care transactions online. Electronic tools have been shown to reduce costs, improve quality and improve the experience of care for patients, yet adoption of such tools among clinicians, hospitals, and other providers is not widespread.

Barriers to more widespread use of electronic health-related tools among consumers include lack of awareness of availability of such tools; lack of access to such tools, either through lack of access to the Internet, low health literacy, or unmet technical or information support needs; current usefulness and usability of many of these tools; and some concerns about privacy and security. Barriers among providers include the need for more training and support; perceived lack of a business case given current predominant reimbursement models which reward volume over outcomes; required work flow changes; liability concerns; and some concerns about privacy and security.

To accelerate the adoption of electronic tools to increase consumer engagement and improve health and health care, following are the recommendations:

• Build Awareness of Benefits of Electronic Tools for Patient Engagement Among Clinicians, Hospitals and Other Providers
• Develop and Disseminate Principles, Standards, Policies, Strategies, and Best Practices for Using Electronic Tools to Engage Patients
• Build Awareness of Benefits of Health Care-Related Electronic Tools Among Consumers
• Increase Federal, State and Private Sector Incentives for the Use of Electronic Tools to Support Engagement of Patients in Their Health and Health Care

Challenges to Increasing Patient Engagement
While there is very strong and widespread support for patient-centered care and patient engagement, clinicians, hospitals, health plans, employers, and other health care organizations face several challenges in successfully developing and executing strategies to support such engagement. These challenges include:

• The need to further expand education and training on patient engagement and patient-centered communication in medical schools, residency programs, and continuing medical education programs.
• The need to further embrace the importance of patient-centered care and engagement in organizational culture.
• Physician-patient interactions that are still confined largely to traditional office visits.
• The limited amount of time in a traditional office visit—due largely to current predominant methods of payment, which reward volume over outcomes.
• For those who have introduced communication with patients between visits, the cost and complexity of reaching out to and engaging individuals outside of the office setting.
• Addressing the unique communication needs of underserved populations who often have a broad range of health literacy. (It is particularly important to address this challenge because lower levels of health literacy are associated with increased hospitalizations, greater use of emergency rooms, lower use of preventive services, and limited ability to manage complex regimens.)

To help reduce costs and to improve outcomes in health care through increased patient engagement and activation, health care organizations can leverage electronic tools to expand the reach and effectiveness of consumer engagement strategies.

Electronic tools can accelerate the adoption and improve the effectiveness of patient engagement and activation strategies employed by health care organizations to improve the quality and cost of care. Such tools fall into two main categories: tools that support consumer education and self-care, and tools that support patient interactions with the health care system. This section examines each category separately: the types of tools available, their benefits and current demand, current levels of adoption, and barriers to wider use.

Electronic Tools That Support Consumer Education and Self-Care
Electronic tools that support consumer education and self-care fall into four primary categories:

1. Electronic educational resources that offer users online access to information that helps them self-diagnose, manage symptoms or conditions, share in decisionmaking, and improve their health.
2. Interactive electronic tools that enable self-monitoring and tracking to support health management and improvement.
3. Online communities that enable individuals to share experiences and gain advice from others with similar conditions or experiences.
4. Personal health records (PHRs), which are online health records created and maintained by patients themselves.

These tools can be effectively leveraged to expand and increase the effectiveness of patientengagement strategies.

Electronic Tools That Help Individuals Interact With The Health Care System

Electronic tools that help patients and their families as they navigate the complex health care system can also expand and increase the effectiveness of traditional patient engagement and activation strategies.

Electronic tools that support patients as they interact with the health care system enable patients to:

1. Access information contained in their EHR and, in many cases, download or enable the transmission of that information to a third party.
2. Communicate with their clinicians and care teams through secure e-mail.
3. Engage in remote monitoring or access clinical care remotely to facilitate greater access to and coordination of care.
4. Conduct online health care transactions or evaluation of health care options, which can make scheduling appointments and renewing prescriptions more convenient and can enable comparisons of health care options based on cost and quality.

Conclusion

Patients are at the center of new models of care that are improving the cost, quality, and outcomes of care. Engaging consumers more fully in their own health and health care is critically important to this progress. Giving consumers better access to electronic tools that help them manage their health and interact with the health care system results in better outcomes and lower costs.

Many government and private sector organizations are showing significant leadership in this area, recognizing the important role that engaged consumers play in the health system’s pursuit of the triple aim. As electronic tools have become the norm in so many other industries, from banking to travel, so too will these tools begin to transform the way individuals and families partner and interact with their health care providers. Clinicians and health care organizations that are prepared to help patients adopt and adapt to these tools will lead the way.

Policy makers must address the barriers to more widespread use of electronic tools, and both public- and private-sector entities must help by raising awareness among consumers and providers about their value, by improving the usefulness of the tools themselves and by aligning incentives to support their use.