Patient engagement is in search of a definition


Ask anyone connected with health care these days to provide a definition for patient engagement and you will likely receive as many answers as there are agendas surrounding the discipline.

While patient engagement has evolved as a critical strategy in support of the ultimate goal of creating improved health for a total population, you would think that a mandate for a unified definition would be embraced by all involved. Yet it is not.

Not unlike the lack of interoperability guidelines established for HITECH — six years and 29 billion dollars ago — patient engagement sits at a tipping point of being the next commercially controlled and competitively dysfunctional process in a health care system where patients, providers, and payers cannot afford another misstep.

Our health care system cannot afford another process that allows competing commercial interests to derail and hold hostage physicians and patients in the delivery of affordable patient care designed to improve outcomes, enhance patient experiences and reduce costs.

A key point to note is that patient engagement is a strategy, not a tactic. Whereas, there are many tactical components to patient engagement, it is and of itself a strategy.

In a recent article, Ian Worden made the following astute observation: “One significant challenge with improving patient engagement lies in the lack of a standard and correct definition for the term ‘patient engagement.’  How do you go about improving patient engagement if you cannot effectively articulate what patient engagement means?”

The current lack of a unified definition for patient engagement has already created significant confusion and dysfunctional initiatives due to the fact that a myriad of definitions referenced place a disproportionate degree of responsibility on the patient, while being tactical in their execution.  This might help set a lucrative target for a commercially based agenda, but it does little to add clarity and direction for the strategic goals of patient engagement’s intended purpose. The health care industry already has an overabundance of examples where the pursuit of market share has threatened patient care.

Although, highly supported by technology and its significant innovative leadership contributions, patient engagement is not an IT, HIT, regulatory, or vendor-driven initiative, but rather it is a patient-facing, patient driven strategy. It is misplaced, in my opinion, that the technology sector attempt to drive the strategic component of this critically important clinician and patient-centric agenda.

For a better part of the past twelve months, I have had the privilege of participating on the task force of a major national organization’s study of the patient engagement issue. I found it troubling when I learned that we were not operating under a defined definition for the subject of our task.

In an attempt to provide positive input, I submitted the following definition for consideration and further discussion: Patient participation at every touch point in the health care delivery process.

Following my input, I learned that some involved with the process commonly reference a definition prepared by the Center for Advancing Health that defines patient engagement as: “Actions individuals must take to obtain the greatest benefit from the health care services available to them.”

Not unlike other informal definitions that exist for patient engagement, I am concerned by what I believe to be an unrealistic and inappropriate level of responsibility such a definition places on the patient. Without question, the patient must be an active participant in every step of the patient engagement process, but certainly the patient should not be expected to serve as the initiating lead in that process?

Unfortunately, I fear that patient engagement, as a discipline, will be unable to achieve a level of credible impact equal to its significant potential without a universally adopted definition firmly in place.

The definition need not require pages of text to explain its purpose or meaning. The definition need only be succinct in its presentation, clear in its understanding and universally achievable in its expectations.

Richard Upton is president, UPTONGROUP.

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