I'm a hypocrite (an "enormous" hypocrite, according to my wife).
Since joining H&HN 10 years ago, I've assigned and written a multitude of articles centering on patient engagement. Even in my personal life, I advocate for friends and family members to become more involved — actively involved — in their overall health care. This is/was especially true for those staring down life-threatening illnesses.
Do I apply those same strong-held principles to my own life? Um, ask my wife. To further illustrate the point: In late December, I gave myself a concussion after slipping on ice during a winter hike. I spent the night in a rural Illinois hospital for observation. My discharge instructions were very clear — upon returning to Chicago, I was to follow up with my doctor within five days. A nurse from the hospital even called three days later to see if I was engaged in that part of my care. I let the call go into voicemail. No need getting yelled at by her, too. My wife's scowl was enough.
Oh, there's more. I should be in regular contact with my doctor for a couple of other issues, to see if my normal meds need to be adjusted. The last time I saw my doctor? I think it was Obama's first term.
Yet on different fronts, I'm extremely engaged in my health. Last month, I downloaded an app that helps me track my calories and exercise. I'm pretty religious about inputting data on a daily basis, even the handful of peanuts I snack on while making dinner or that Oreo I sneak before bed. During cycling season, I actively track my miles, both cumulative and per ride.
So what gives? For starters, consumer technologies aimed at fitness and wellness continue to outpace patient-facing medical technologies. It's so easy to log what I ate for breakfast, lunch and dinner and instantly get a calorie count. Can we say the same about getting access to my medical records? Stage 2 meaningful use regulations require hospitals to give patients access to their health information within 36 hours of discharge. Really, 36 hours? Within a handful of hours, Zappos sends me an email notification with the exact shipping number of my order.
Another roadblock to greater patient engagement is more difficult to overcome, largely because it is entrenched in the delivery system.
"We have positioned patients as passive recipients of care, not fully recognizing that they have tremendous insights, expertise and experience that can help us build cost-efficient, high-quality, safe systems of care," says Bev Johnson, president and CEO of the Institute for Patient- and Family-Centered Care.
Staff writer Marty Stempniak interviewed Johnson for the kickoff of his quarterly series on patient engagement. The article, starting on Page 57, highlights an assorted collection of initiatives that, when woven together, create a compelling case that progress is being made, but challenges remain.
As the series continues — in print and online — we'll unearth those opportunities for improvement and shine a light on the bright stars. Involved patients are central to curing many of the delivery systems' ailments. Medication adherence, readmissions, wellness, prevention, chronic disease management — improving performance in any of these categories hinges on patients becoming more engaged in the care process.
— You can reach me at firstname.lastname@example.org.