Lynda Rowe

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	“Consumer engagement,” “patient engagement,” “patient activation”–these are all terms found quite often in today’s healthcare journal headlines. The premise is that, in order to improve the health of our nation’s citizens and lower the cost of care, patients (or healthcare consumers) need to be much more involved in their care. Thus, both the performance of specific behaviors relative to health-as well as one’s capacity and motivation to perform those behaviors-constitute the underpinnings of an engaged and activated patient.

	Behavioral change is complex and influenced by a number of factors, including one’s awareness of the need to change and the ability to make those changes. For example, most people know that they should eat more greens and fewer starches-but knowing and doing are very different things.

	When it comes to health, there are only one or two key motivators or influencers that can change a thought into an action. These people are called healthcare influencers. For some people, a physician or caregiver might play that role, but for most, there are key non-clinical individuals that ignite our change. In a 

 citing a global study, researchers discovered that after “themselves,” nearly half (43%) of respondents believe that their friends and family have 

 as it relates to health, and more than a third (36%) believe friends and family have the most impact on personal nutrition.

	The Institute for Healthcare Improvement (IHI) created the Triple Aim, a framework for Healthcare Improvement that describes an approach to optimizing health system performance. The key elements of the framework include improved patient experience, improved health of populations and lower cost per capita of healthcare. The new payment models and models of care strive to achieve this “triple aim.” However, in order to achieve the framework’s goals, the patient must become involved and take more control of their health.

	Historically, most healthcare consumers have not taken an active role in their health, as evidenced by the increasing prevalence of behavior-based, complex, chronic conditions such as type 2 diabetes. A recent report by the 

 in the UK highlights the lack of patient accountability in their own health and wellness, and cites this as a barrier to the long-term sustainability of the National Health System. To improve the outcomes and cost of our systems, more people will need to change behaviors to stay healthy, or if diagnosed with a disease or illness, take an active role in self-management of their disease. Moving from a system of healthcare to a system focused on health will require an enormous change in the behaviors and attitudes of our population.

Identifying influencers who ignite change

	Each person has a different set of key influencers, and those might change over time. For some, it might be a family member or close friend, while for others it could be their religious leader, an influential public person (think Oprah) or even an on-line community. Two weeks ago, while at a conference, one of the speakers talked about his very ill child and some of the serious decisions he and his wife needed to make about the needed treatment. They had done all the research and made a decision to see a specialist at a top academic medical center to treat their child. A few weeks prior to their first visit to see the specialists, the wife engaged in an online support group with other parents of children with a similar chronic illness. The message from one of the parents in the group – do not use the doctor you selected, go to doctor “Y!” The consensus was that the treatment with doctor “Y” would be less invasive and would have better outcomes. The parents took the advice, changed to doctor “Y”, and their son’s health continued to improve to a point where he could regain most normal physical activities previously impossible.

	The point is that we hear anecdotes like this all the time. A physician friend and colleague recently noted that many patients have ended up in his office because the key influencers in their life encouraged, urged and even physically brought them to his office. While my father was alive, he was my mother’s influencer, motivator, and supporter as she battled cancer. My mother would not have been as compliant with her treatment plan had he not been there to encourage her.

Using technology to expand the patient’s care team

	So what does this mean for better health outcomes and the healthcare system’s role in patient engagement? Our healthcare system needs to tap into this powerful network of influencers. One place to start is through the use technology. Technology systems can help providers to identify who those key influencers are in their patient’s lives. Here are three key actions executives should consider as part of their influencer engagement strategy:

. Now that we have access to a wide range of data, not just data from electronic health records (EHRs), but from patient portals, social media, and publically available socio economic sources such as the U.S. Census, the opportunity to use analytics to look for these relationships is possible. More importantly, healthcare providers should start to ask patients to identify their influencers as well as their caregivers (they may be the same) when a provider or hospital starts collecting information at the beginning of an encounter.

Make those influencers a part of the care team. 

As the healthcare system continues to expand its reach to non-traditional care providers and care settings, the technology to engage more than just the patient will be critical. By making those influences critical members of the care team-assuming the patient agrees to this-healthcare providers will be able to fill the gaps of where care delivery ends and day-to-day life beings for patients.

The future will need to make it easy to communicate with and educate the patient and the influencer simultaneously. Expanding communication beyond just a portal to include messaging and text, as well as opening up systems to allow patients and their caregivers to see and contribute to the health record, will incentivize and ignite influencers to have the information needed to change patient behaviors. Capturing input (Influencer Generated Data, or IGD) might gain better results than just getting feedback from the patient. Influencers rely on information; providing them with trusted and accurate sources of information will arm them with the information needed to encourage patients to make good choices.

 speaks extensively about the use of technology to engage and educate consumers. In a guest blog post on Dave’s site, Patti Brennan writes about “

Patients + Providers + Technology = Engagement

.” Influencers should be included in the equation as well. Ms. Brennan speaks about patients tracking and sharing with their care team daily observations of daily living (ODL). Some patients are capable of doing this, but others might need help or support to be able to track these activities. Having the ability to submit your weight daily through technology is important. Knowing how to motivate the patient to do it is the other part of the equation.

	The key will be to uncover those people who will have an impact on your patient’s healthcare decisions and healthcare behavior change. Creating both the technical means as well as the processes to adapt to this new model of “engagement” will require new ways to capture and explore data. The information is there and the potential is great-now executives need to tap into these key influencers so that they can play their important roles.

Lynda Rowe is senior advisor, Value Based Markets, 

Articles

Here are 3 ways that technology can tap into the powerful network of non-clinical patient influencers who will ultimately impact a patient’s healthcare decisions and behavioral changes.

Lynda Rowe

Articles

Three ways health execs can tap into the powerful patient influencer network