Why aren’t more doctors using patient engagement tools?

A new report reveals that 69% of healthcare providers are using patient engagement to get patients more involved in their own care, but its authors suggest that number should be closer to 100%.

“Nearly half of respondents say their patient engagement initiatives are having a major to moderate impact on quality outcomes,” says study co-author Kevin Volpp, MD, Ph.D., director of the Center for Health Incentives and Behavioral Economics at University of Pennsylvania Perelman School of Medicine. “That’s pretty remarkable considering we are still in the earlier stages of patient engagement and that many potential approaches have yet to be fully scaled and integrated into practice.”

Blog: 4 reasons why online patient communities should be embraced

In the study, Volpp and Namita S. Mohta, MD, clinical editor at NEJM Catalyst, surveyed 350 executives, clinical leaders and clinicians and found the engagement numbers to be smaller than expected.

In fact, the researchers noted that the survey proves there is still big room for improvement in the patient engagement arena.

“Survey respondents clearly think the best is yet to come-Patient Engagement 2.0,” Volpp says in the study. “Many survey respondents comment that we need to engage patients outside the exam room with frequent, creative interactions that do not have to always include their physicians.”

In order to help patients long-term, doctors need to help them modify their behaviors in a positive way, and that is nearly impossible to do in a 15-minute session during an office visit, says Bill Van Wyck, president and chief innovation officer at Zillion, a digital health engagement provider.

“Achieving sustained behavioral change requires doctors to be involved in the day-to-day lives of their patients, not just during the patient’s appointments-and the most effective way doctors can do this is by utilizing patient engagement tools,” he says. “The whole concept of interacting with technology to communicate outside of the telephone is still so new. Educating both doctors and patients on how to best utilize these tools will take time, but it can be done by building simple, easy-to-use tools that ultimately become second nature to those who use them.”

Related: Top 3 tips for successful patient engagement

Evolving patient engagement technologies, such as mobile health or “mHealth” tools have the potential to give patients more frequent guidance beyond the walls of the office visit, offer physicians more data than can be measured in a clinical encounter and observe a patient’s health status in his or her natural setting, notes Dominic Galante, MD, chief medical officer, quality and population health solutions for Precision for Value.

Next: Knowledge gap

“Strategies, such as shared decision-making conversations and use of shared decision-making tools, are receiving additional attention with the goal of improving engagement with patients for better population health,” he says.

While many physicians are using these tools, Galante points out some possible reasons why they have not yet been fully adopted.

“Many practices are still evolving from fee-for-service to value-based models,” he says. “It is anticipated that MACRA, with its emphasis on value-based reimbursement for performance on quality measures and clinical practice improvement activities, will further promote practice transformation.

Further reading: Navigating the buzzwords of telehealth

“Practice transformation is often a necessary step to maximize the adoption of patient engagement tools into practices,” he added.

Instruction, both for the physicians and staff, and guidance with patients and caregivers on how best to use the tools, requires a level of practice transformation that some practices are working toward but have not yet attained.

“For some physicians, there is a knowledge gap about which tools to use and for which conditions,” Galante says. “Data regarding the efficacy of specific tools for patients with specific conditions (including social determinants data and length and frequency of monitoring) is still emerging.”

Other physicians may be unsure how to use the tools, or how to integrate information from the tools into their medical records. Furthermore, some physicians and practice groups have not yet acquired the training in the evidence-based skills that often facilitate the use of electronic patient engagement tools.

The 21^st century physician

Maureen Hennessey, PhD, senior vice president, Director, Quality and Population Health Solutions for Precision for Value, believes the survey results were lower than expected because of the unwillingness of some older physicians to adopt patient engagement methods.

Next: What about younger doctors?

“Younger physicians have been exposed to and socialized around the use of technology in everyday life,” she says. “As such, they are much more technology savvy than their more senior colleagues and looking for ways to adopt technology into the practice of medicine.”

Galante adds that it’s also more likely that physicians who are more recently trained are receiving additional education on patient engagement strategies and on the use of e-health tools.

Hot topic: Telemedicine up for heated debate

Galante notes that older physicians may benefit from additional research summarizing the efficacy of these tools and from support that organizes and communicates to them the financial ROI and clinical efficacy of adoption of patient engagement tools.

Still, some physicians may prefer to spend their time with the patient providing their expertise in management of the patient’s condition, and believe that interpersonal connection and their professional guidance is more important than using an electronic tool. These physicians may never adapt to patient engagement techniques and therefore, future surveys may never approach the 100 percent ideal.