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Provider money, time barriers in promoting patient engagement

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Providers say they want more patient engagement but they don’t think that they’ll get paid enough for promoting it and they worry about the time needed to design patient-engagement systems that would improve care delivery, says a piece in NEJM Catalyst.

The underlying issue is reimbursements,  Bertrand Ross, M.D., medical director at Virginia-based Optima Health, a subsidiary of Sentara Healthcare providing coverage to more than 450,000 members, told NEJM Catalyst. “The problem is that incentives [for patient engagement] are not aligned. The time and effort to educate, motivate, and troubleshoot issues regarding patient engagement are not recompensed very well at present.”

“Doctors to some degree worry the changes will be too disruptive. How will physicians blend patient engagement into their [care delivery] workflow?” he asks. Consider, for example, that telehealth and telemedicine may be crucial in the  future of care delivery. But  valuation of such services is still unknown because of the workflow changes that likely required to fully integrate them into healthcare.

Kathryn Duevel, M.D.,  medical director for quality and innovation at ACMC Health, a multi-specialty health network with 100 physicians in Minnesota, told NEJM Catalyst that she agreed that fear of lower pay slows  physicians more deeply involved in improving patient engagement.

But Dr. Duevel expects the national shift to value-based payment to help. “Larger organizations have the capacity to invest in other processes, such as patient engagement, that don’t contribute directly to the fee-based system. As we transition to a value-based system, the value of patient engagement starts to pay off and organizations with fewer resources can make the financial equation necessary to fund patient engagement work.”

Marjan Bahador, M.D., a critical-care physician at Johns Hopkins Medicine, a part of Johns Hopkins Health System, in Baltimore. “Bringing health to the hands of patients and looking at health problems from patients’ eyes is a new concept for medical professionals.”

Before joining Johns Hopkins, Dr. Bahador studied patient engagement for a large healthcare software company. There she observed that physicians aren’t trained — either in school or on the job — about why patient engagement is important, and at the same time patients aren’t incentivized to be active participants in improving their own health.

She warns against handing over too much design responsibility to patients, because of their lack of expertise. “Patient engagement design and build should be very much according to patients’ needs and the way patients want it to be done, but healthcare professionals and IT engineers need to be the ones to build it.’’

To read the piece, please hit this link.






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