Deborah Wells is an IT strategy consultant at The Children's Hospital of Philadelphia and a member of the HIMSS Connected Patient Committee, has been working toward a technology strategy at CHOP to optimize its engagement initiatives on the way toward value-based healthcare.
[See also: Patient engagement means 'attitude adjustments' on both sides]
On Feb. 9 at the Healthcare IT News and HIMSS Media Patient Engagement Summit in Orlando, Wells will be speaking on a panel titled "Best Practices and Lessons Learned – Or How Not to do Patient Engagement."
Children's hospitals have a unique perspective on patient engagement, says Wells. The role of the family members in a child's health means that outreach and open lines of communication are key.
[See also: Smart data key to patient engagement]
"We have been involved with patient and family engagement probably longer than most adult facilities," she says.
Along the way, Wells has gotten some good perspective on what works and what doesn't.
"There's a tendency in lots of organizations to implement patient engagement piecemeal," she says. "You start at the bottom: 'Here's a great app that's going to help patients with asthma.'
"They'll propose a project and it gets approved. You do the software, the purchasing, the licensing; you work out the privacy and consent issues. You implement it, and it may even be a very successful project."
But what often happens, she says, is that it soon becomes apparent that all that effort was a waste of time: that specific technology or outreach initiative ends up running counter to this or that larger organizational imperative.
Especially with providers' strategies these days evolving so quickly, "you may have to do some reworking," says Wells. "Maybe later on the organization institutes a new marketing plan; then they want to brand things a certain way. Or maybe it just doesn't fit in – maybe it's not one of the priorities."
With patient engagement – "as with pretty much any technology implementation" – a healthcare provider first "needs to figure out what it wants to accomplish," she says. "How does it fit in with plans? If you don't have that overarching strategy, you're going to run into all sorts of problems."
Patient engagement strategy "needs to come way up at the leadership of the organization," says Wells. "It's such an important part of value-based healthcare, and of the transformation and ultimate success of the organization – it needs to be a coordinated effort across the organization.
"You need finance involved because you want to have tools," she explains. "You've got your primary care aspect. With inpatient there's a lot around discharge and how you're going to handle that.
"Because of CHOP being an academic medical center, we have a lot of complex pieces," says Wells. "There are programs around care coordination, and engagement is an important piece of that. There's the marketing piece – how do we want to put this together in a package to draw patients in and keep them with us? – that wasn't always addressed at the time. There's a need to bring everyone into it, rather than just a group of PCPs."
The challenge isn't always organizational. Part of the problem is that the IT for patient engagement, by and large, still isn't where it needs to be.
"The technology right now is so immature," she says. "There are hundreds of vendors out there. They've got all of these claims; some of them may be true, but most probably aren't. You don't know which vendor is going to last – who will be here in two or three years and who will not."
And there's another big, rather fundamental, question: "We don't even really know whether patient engagement is going to work," says Wells. "How do you change people's behavior? Can you? There's all this hype. People want to focus on the technology rather than what you want to accomplish."
There's the key point, she says: "Patient engagement is not an app. It's a new way for patients and providers to get together for better health. Once you've worked all that out you need workflows, adoption, culture change.
"Once you've worked all that out, then you look at the technology to figure out what will enable you to be successful right now we get so many people coming to us with this really cool thing."
She recalls one colleague coming up to her and saying, "We need an app."
For what? They weren't sure, exactly. They just figured they needed one. That's how patient engagement starts, after all, right?
Nope.
"Don't do one offs," says Wells. "Have a plan. Don't get focused on the technology before you decide what you want to accomplish. Decide what you want to do, then come up with some requirements. And then choose the technology. There are so many cool things out there. But you really want to take a step back."
