Better health outcomes are certainly a shared expectation among physicians and patients in their interactions. Whatever form they take — whether it be in real time or some asynchronous exchange — the expectation is that the interaction results in some improvement in the patient experience.
That being said, it’s also about the user experience that the physician and her staff must navigate in order to facilitate that better patient experience and health outcome. When it comes to proliferation of health information from so many sources these days, I’m reminded of the saying, “Be careful what you wish for, you just might get it.”
Patient engagement is a popular term these days whenever we talk about better health outcomes, but there is a price to pay for the data stream that occurs from new sources of information and perhaps even a healthy skepticism. For example, consider the patient data generated from home-monitoring devices. In a recent article in Modern Healthcare, Randy Hountz of the Purdue Regional Extension Center stated:
We have more data than the average healthcare organization can manage right now. We’re going to have to be very proactive this year to make sure our organizations are equipped with data governance policies that will serve all aspect of care they are providing to their patient. You’re seeing a lot of care being provided in the home. You talk about consumer engagement and that becomes more important as patients are seeding information into these systems.
In the same article, Dr. Steven Steinhubl, Director of Digital Medicine at Scripps Health added, “I think that once it takes off, it’s going to take off exponentially, but I think we’re still on the flat spot of the exponential curve. I think it’s going to take one or two healthcare organizations to embrace it and provide the data. The journals are full of pilot studies. You’ll really need a large clinic with several hundred if not thousands of patients.”
With regard to health IT evaluation studies, the findings of a systematic review of health IT evaluation literature conducted by the Office of the National Coordinator for Health Information Technology (ONC) were recently published in the Annals of Internal Medicine. The authors state:
Although the health IT evaluation literature base is expanding rapidly, we are concerned that there has not been a commensurate increase in our understanding of the effect of health IT or how it can be used to improve health and health care. Study questions, research methods, and reporting of study details have not sufficiently adapted to meet the needs of clinicians, health care administrators, and health policymakers and are falling short of addressing the future needs of the health care system.
Since patient engagement is a two-way street among physicians and patients, one more report from the eHealth Initiative reveals some interesting insight on the use of social media in the context of chronic disease management. Their conclusion is a continuation of this theme of limited research, but to begin engagement with the simple idea of “fish where the fish are” for a target population. Their summary of the opportunities and challenges show the convergence of empowerment at the patient level with the need to recognize even greater value from these social media interactions:
The incorporation of social media tools into healthcare is expected to grow in practice and importance as more people communicate online. As our society becomes increasingly connected through wireless devices and accustomed to sharing private matters such as health with others online, new challenges and opportunities will arise to leveraging this information in a safe, dynamic, and timely manner. At the time of publication, there is limited peer-reviewed research demonstrating evidence of how social media can be utilized to improve disease management and health outcomes. Because few theoretical or evaluation models for social media exist, the majority of research conducted today are feasibility and pilot interventions that have yet to incorporate standard methodologies for assessing outcomes.
Perhaps an important starting point that one can taken away from these insights is that trust in the patient experience is still important and people will talk. Although health IT has redefined what a “local” healthcare experience can be for physicians and patients, meaning well beyond the clinic visit. One clear need is for all to be involved in this dialogue.
While the patient experience is certainly not limited to the time spent in the clinic, it is critical to build the bridges between all those concerned in this more engaging dialogue. While health IT does create new needs for rules of engagement for both clinic staff and patients, there may be some unrecognized value and even missed opportunities within human interactions that are happening right now.
Digital information and online sharing of both data and personal experiences have changed the context of what a local patient experience may be for all of us. It puts even more emphasis on the value of dialogue and accountability among all concerned in this expanding patient experience.