More and more, we are learning that an engaged patient makes a healthier patient. But what makes a patient “engaged?”
Researchers are answering this question and blazing a trail to help health care providers, consumers and advocates better understand patient engagement and how to achieve it. In the September/October issue of Family Practice Management, John Wasson, MD, and Eric Coleman, MD, MPH, posit that the key to unlocking the door to patient engagement is to ask patients directly how confident they are about controlling and managing their health problems. By asking patients this fundamental question, health care providers can initiate a dialogue with their patients about what information, training and/or services they need to better understand and improve their health. Wasson and Coleman call this an “action query” – an assessment that results in more than a number on a scale because it leads patients to perform activities that increase their engagement and ultimately improve their health. These findings are consistent with the research of Judith Hibbard, PhD, who led the development of the Patient Activation Measure, a tool that assesses the confidence, knowledge, and skills needed to manage one’s health and health care.
Essentially, the more patients know, the more skills they acquire, and the more resources they can access to assist them, the more confident and engaged they will be and the healthier they will become. Take, for example, the case of Mrs. M, a 90-year-old widow with congestive heart failure. She had been hospitalized three times and had four emergency department visits, seven office visits and 21 telephone conversations with her primary care physician over a six-month period. Subsequently, Mrs. M’s physician measured her confidence and knowledge related to her condition and worked with her to improve both of these areas. As a result, she went from a 4 to an 8 in confidence and from a 1 to a 9 in knowledge, leading to fewer hospital and office visits and allowing her to resume her usual activities.
Additional questions that patients can answer to gauge their health confidence are available in a free, web-based tool developed by Dr. Wasson and available at Health Confidence.org. Offered by Dartmouth Medical School since 1994, the tool has been used effectively with hundreds of clinics, nationwide and internationally, to better address patient needs, increase patient engagement and improve procedures within medical practices.
In Massachusetts, Community Catalyst’s partner, Health Care For All (HCFA), recently launched a campaign to build health confidence in at least three regions of the state. The first community-based organization to partner with HCFA will be the South Shore Community Partners in Prevention (SSCPP), a Community Health Network Area serving 11 towns in southeastern Massachusetts. SSCPP will promote the use of Wasson’s health confidence tool to its residents through their connections to hospitals, service agencies, schools, businesses and boards of health. Patients using the tool will open up a much-needed dialogue with their providers as they work together to better align patient needs to provider and community resources.
Patient engagement is one of the most successful ways to improve the health, and ultimately the quality of life, of our sickest and most frail citizens, calling on more and more health care providers, delivery systems and communities to say, “Dear Patient: Let’s get engaged!”