Many doctors and medical professionals consider patient engagement to be an unnecessary increase to the time and effort of running a medical practice. Why spend the money to implement a set of digital patient engagement tools if the managing tools themselves is an impediment to providing health care? The view that patient engagement tools only create more work misses the financial benefits, the improved healthcare outcomes, and also the increased job satisfaction that come as a product of promoting patient engagement. The initial investment is greatly outweighed by the long-term advantages of giving the patient greater involvement in their care, which is another step away from Fee-For-Service (FFS) towards value-based care.
The tools for patient engagement today allow patients to easily execute tasks like scheduling their appointments online, configuring text and email reminders from their patient portal, as well as participating in follow-up surveys. Electronic Health Records (EHR) software has increased the efficiency of medical treatment by eliminating paper and making recordkeeping more efficient, which makes sharing health information easier and much faster than mailing or carrying paper records. The use of these tools creates an environment in which practicing medicine is more collaborative, and streamlines the administrative burdens of today’s medical practices.
Digital healthcare systems benefit doctors just as much, if not more than they benefit the patient. These technologies, designed to increase patient engagement, have been crafted for measurement which has significant financial benefits (as well as penalties) for providers, even though they are only able to influence patient behavior and do not have a formalized authority to mandate patient use of these tools.
Many of the reporting criteria of Meaningful Use (MU), the Merit-Based Incentive Payment System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA) are intended to encourage patients’ interaction with their health information or enhance engagement with the provider. For example, MACRA requires physicians to supply patient-specific educational materials to patients. Physicians who participate can potentially earn a 4% positive Medicare payment adjustment. Doctors who do not participate in these programs have a -4% payment adjustment. By providing tools like telemedicine and patient portals to increase patient engagement, doctors stand to achieve 8% higher Medicare reimbursement.
Provider Benefits from Patient Engagement
Reporting of patient engagement as defined by the CMS delivers positive results for doctors as well as their patients. From both a medical and financial outcome perspective, it makes good financial sense to focus on patient engagement, since the financial incentives of MU and MACRA positively reflect the means to these end points. Medical practices with a positive reputation for patient care should naturally attract more patients in the future.
Additionally, there is strong evidence suggesting that doctors who focus on patient care are more satisfied with their jobs due to the positive results of their work. A 2013 study by the RAND Corporation titled Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy says:
“A great source of satisfaction for [physicians] in their work was being able to provide what they felt was high-quality care for their patients—indeed, that this was central to their desire to practice medicine…Being able to provide high-quality care was commonly equated with having sufficient time with patients.”
Spending more time with patients and planning how best to provide care for them helps doctors feel like they are making a difference in their patients’ health outcomes, and feel more fulfilled by their work.
The benefits of patient engagement, in both financial gains and healthcare reputation, are easy to correlate. In addition to an adherence of medical protocols, patient management requires keeping patients actively involved in order to make the right decisions at the right time. Patients who are engaged with their healthcare provider may be more receptive to carefully following best practices for therapy, medical management for adherence to prescriptions, and other factors which contribute to positive health care results in shorter time. This allows providers to treat more patients and increase the volume reimbursement claims.
As mentioned in the introduction, the financial incentives that of MACRA and MU create a situation where doctors can earn more money by improving patient engagement. For example, in a recent study by Tandigm health, a network of 380 treating roughly 100,000 patients was able to reduce care costs by approximately $15 million through theirs MIPS payment adjustment—nearly $150 per patient—all by focusing on tools that increase quality of care through patient engagement, such as telemedicine applications, patient education, and coordination of patient care.
Efficiently Increasing Patient Engagement with EHR Software
Providers and medical office administrators are often wary of the additional administrative overhead required for increasing patient engagement. The implementation of the EHR and the complex reporting required by MU and MACRA have been considered more costly and cumbersome than their proposed benefits, both financially and in terms of quality of care. The key to extracting the benefit of patient engagement is to find an EHR with the right features to deliver patient engagement with very little administrative overhead.
Mobile applications and patient portals are great examples of technologies that have a high impact and low financial overhead. Used together, they can give patients instant access to their health information and the ability to set appointments and communicate with their primary care physician in an asymmetric relationship. This is efficient and effective for both parties by virtually eliminating active waiting periods on either side of these communications, saving administrative time and money.
Telemedicine is another feature set which can help patients get care in less accessible situations where travel, safety or mobility may be a hindrance to the provision of care. Text, smart phone apps, and email all help practices work beyond the brick and mortar offices and treat even more patients by removing geographical roadblocks from the health care equation.
Of course, it’s important to remember that patients do want to be engaged in their health plans. For example, an article published by Health IT Outcomes shows that “80 percent of internet users seek online health information,” and that “44 percent of internet users look online for information about doctors or other health professionals,” while “77 percent of patients used a search prior to booking an appointment.”
Allowing patients’ access to information which is accurate and well-managed should be an integral part of successful patient engagement and improving our healthcare system. While it is beneficial that patients want to be involved in their healthcare, providers also benefit by proactively distributing the information from valid sources and routing patients to those locations.
The Vision of Perfect Patient Engagement
The intent behind the requirements of MACRA, MU and MIPS is in large part to reward physicians for engaging their patients in the medical process, getting feedback from them, and constantly improving care through collaboration with patients. One of four performance categories in MIPS, Advancing Care Information dictates that eligible clinicians must provide their patients with access to health data, summaries of care, as well as capabilities to view, download, and transmit their data using Certified EHR Technology (CEHRT). With the Quality Payment Program (QPP), the healthcare industry is taking steps to move away from the FFS approach to healthcare and towards a system that places a value on the quality of care.
Whether your practice begins by setting reminders in reception that urge patients to use online patient portals, by proactively letting patients know where to search for information related to their health record, or by encouraging them to review medical insurance plans, it helps patients to avoid larger health problems over time if you keep them engaged in their health care early and often. It leads to better outcomes, and ultimately keeps more money in your pocket as a physician.