Thursday, June 1, 2023

From Inside-Out to Outside-In: Rethinking Patient Engagement – MedCity News

We live in a world in which the patient is empowered like never before.

Think of how your interactions with the brands you love are different from 20 years ago across virtually every sector, from entertainment to transportation. We expect on-demand  services at the touch of a button – how we want it, when we want it.

Yet clearly, the healthcare sector is lagging behind, especially in regard to putting the patient at the center of the experience and empowering them with easy and seamless ways to get the information and services they need. Even something as simple as getting test results is a clear example of needless frustration. Many of us (we’re all patients!) have likely experienced a scenario that goes like this: we go for a medical test; the results are sent to us electronically via a patient portal – a portal intended to facilitate greater transparency, empower patients, and increase healthcare efficiency.  But we have access to the results even before being able to speak to our doctor, leaving us to anxiously (mis)interpret something we might not understand.  While the results are easily accessible, the overall experience is needlessly stress-inducing.

The information provided and housed digitally surely provides an opportunity to better collect and consolidate health data. This portability is a big step in the right direction. But we’re missing the opportunity for greater value when we lack meaningful insight into many of the most important true benchmarks of patient engagement, such as an enabling experience that supports the patients’ ability to self-manage their overall health and wellness, as well as their relationship with the healthcare providers.

We’ve seen firsthand that the industry often takes an “inside-out” approach to patient engagement. Instead of prioritizing the needs and perspectives of patients first, healthcare entities focus on what fits within their existing processes, workflows, and systems. This quickly results in a patient experience that leaves many of us frustrated. For example, even though digital portals are being adopted, we still have to fill out paper forms in the office, which is inconvenient and outdated. Or consider all the points of friction we encounter; digital portals are not always integrated across different offices, making it difficult for people with multiple health conditions requiring different doctors to receive coordinated care.

The digital divide in healthcare also exacerbates the problem, as many patients don’t use or have access to technology, especially in rural communities, and are left at a disadvantage.

The need for fundamental change is clear. It’s crucial for the healthcare industry to adopt a more patient-centric approach, putting the needs of patients at the forefront of any decision-making process.

Embracing a patient-centric approach

In an effort to better support improved patient engagement, we must shift our perspective to a patient-centric understanding of how people manage chronic health challenges on a real-world daily basis (taking an outside-in perspective). This approach emphasizes the importance of appreciating the “patient” as a person first, what their holistic needs are, what works for them in managing their day-to-day, and how they want to engage vs. how the system wants them to engage.

For example, a provider or nurse may have their own perspective or professional bias related to what they think the individual needs based on the treatment protocol for a certain condition or illness. However, for the patient, their condition is just one of the many things they’re managing in their everyday life. Therefore, it is important to work with the patient to understand how to more conveniently integrate a recommended course of treatment into their daily routine and overall lifestyle in order to improve the outcome.

To make this happen, the healthcare system needs to adjust the current ways of working in which procedures and solutions are designed from a business need standpoint rather than from a customer or patient use or experience standpoint.  They need to take into account the fact that a digital divide still exists with many people who may not have access to technology or smartphones.  These individuals (along with those who do have access to technology) may need or prefer live human interaction via the phone vs. being pushed to a portal.  Options need to be made available to meet the needs of the patient preferences.


There are many tech and digital interventions that can facilitate improved healthcare engagement – doctor-patient communication, accurate personal electronic health records, and overall administrative efficiencies. However, to deliver the greatest value, these tools and platforms must be designed for the human user first and not the technological capability.

We really need engagement experiences that are set up with an “outside-in” perspective in which we rigorously assess every program, procedure, and practice from the point of view of a customer who needs options for their care, deserves the dignity of being treated as an individual, and who is looking for clarity in the face of what can be a scary and intimidating process.

One promising example can be seen in HeartSafe Motherhood, a leading intervention developed at the University of Pennsylvania. This initiative leverages text messaging for postpartum blood pressure monitoring, allowing patients to track their blood pressure from home and communicate with their care team without visiting the doctor’s office—a significant convenience when considering life with a newborn! The program has been shown to reduce readmissions and morbidity by 80% – a testament to how the new tools at our fingertips can facilitate quality care and improve health outcomes

We need to keep this outside-in, patient-centric mentality in mind as we continue to apply technology in the healthcare space.  Think of the new possibilities for patient engagement as the metaverse—which is primarily focused on enhanced experiences– grows in maturity. We stand on the brink of what could be an entirely new dimension of improved healthcare experiences. But we must get it right by ensuring that new experiences are designed from the patient’s needs and perspective first.

This shift won’t happen overnight, and it won’t be easy. But by prioritizing and understanding patient needs and preferences, we can build better engagement channels and platforms that deliver greater value for both the patient and the system and ultimately improve health outcomes.

Photo: mathisworks, Getty Images

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