More Barriers to Patient Engagement

In attempting to address the barriers to increasing and expanding the ways patients can get involved in their own healthcare, we need to realize that some of these barriers are not just expansions of communication problems that can exist no matter where the healthcare exchange is taking place, but rather as a result of the way healthcare has changed. In this case, we move outside of the patient-provider realm and into the administration elements that drive healthcare. For the purposes of this discussion, administration can include just about any group or factor outside of the provider and clinical staff, including hospital administrators, as well as IT factors such as the EHR.

There are two groups that stand to benefit the most from a system like the ones that are being proposed by the ONC. These are patients, who can see improved health services, and hospitals, who can cut costs and improve services. This is obviously the major reason to pursue these efforts. Unfortunately, it is not that easy. The type of patient who is likely to benefit most from an advanced role in their own healthcare is one with more medical issues. Frequently, this represents both the elderly and more economically deprived who, not coincidentally, are the least likely to be both computer literate enough to handle their new tasks or even have the appropriate computer equipment.

Hospital administrators and payers also need to ensure that their providers are given the proper incentives and training to take part. The fundamental difficulty in implementing a new EHR is training all of the new users and convincing them to ditch old workflows in favor of a system that they may not find easier. In this case, we have heard a great deal from providers who are unhappy with the EHR that has been forced upon them, and likely aren’t interested in exploring the new features, capabilities, or benefits available to them. In addition, many healthcare organizations do not always pass on all the serious economic benefits of change to their employees; meaning change for change’s sake is the only encouragement.

Ultimately, the need for a system of greater patient engagement is like a microcosm of the structure it finds itself within. Like those who both promote change as it comes with EHR use, there is evidence that these changes are important and can be useful both in terms of improving patient health, improving the healthcare system as a whole, and provider a greater business model that can provide economic benefits. In addition, many providers who are given the proper guidance, training and support to switch to a new system

At the same time however, this is a change that requires a great deal of change in methods and basic practices. For a group of people who won’t necessarily see the benefits to this change right away, this change might be a difficult one to embrace.

Further Reading:

Patient Engagement: http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=86

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