Patient engagement is one of the pillars of population health management and value-based care, but traditional, print-heavy attempts at engagement have failed. That’s because an estimated 90 million adults have low health literacy, and printed brochures and flyers are often lengthy and confuse them with a lot of medical jargon. That makes it difficult for many patients to remain adherent to physicians’ treatment plans, especially the millions of Americans who have chronic conditions like COPD, diabetes, hypertension and depression.
A recent study conducted by the Council for Affordable Health Coverage found that two-thirds of patients in the United States do not adhere to their medication treatment plans. Nonadherent patients cost the U.S. healthcare system an estimated $100 billion or more each year. Given they don’t stick to the treatment plan, these patients usually have poor outcomes – and that costs physicians money because of Medicare’s Value-Based Payment Modifier and value-based contracts with private insurers.
Most patients aren’t being lackadaisical about adherence. It’s a difficult task, even for the highly motivated. Here are some reasons why it can be challenging:
- CMS estimates that 25 percent of Americans have multiple chronic conditions (MCCs); in patients 65 and older, 75 percent have MCCs, often requiring multiple medications throughout the day.
- Patients with MCCs have many things to simultaneously accomplish in order to achieve adherence. For example, a COPD patient must manage multiple medications and monitor outdoor air quality. If that person also has diabetes and depression, adherence becomes extremely difficult to achieve without engagement aids.
- The severity of the condition doesn’t automatically ensure adherence. One study in the New England Journal of Medicine found that fewer than half of the patients who survived a major heart attack were adherent to their medication plans in the months following the attack.
- Most patients still receive treatment instructions verbally or on paper. Research shows that more than half of what is communicated verbally is forgotten immediately – and almost half of what is remembered is incorrect.
- Nearly 40 percent of the people in charge of adherence are not the patients themselves, but the people caring for the patient (parents caring for children; adults caring for aging parents). A lot of the treatment information gets “lost in translation” or is communicated poorly.
Traditional ways of promoting adherence like handouts, brochures or having staff make frequent reminder calls are expensive, time-consuming and ineffective. Digital engagement tools provide greater convenience and functionality at a lower cost. These tools give patients the right information at the right time (like text reminders to take a medication), which improves patient adherence to treatment plans and drives better outcomes.
Advantages of mobile device engagement
- Widespread mobile device adoption – A recent Pew Research study found that more than 90 percent of Americans own a cell phone – and 64 percent own smartphones.
- Communication with patients is easy and inexpensive, in the manner they’re used to receiving consumer information (text or email)
- Patients can electronically schedule their own appointments and set reminders to ensure they get the care they need.
- Frees clinicians and office staff from having to make time-consuming reminder calls
- Patients stay better informed because they get brief messages that they’re more likely to read
- Digital engagement reduces the likelihood of unnecessary appointments or ED visits. When the city of
Baltimore tracked its most frequent 911 callers, officials there discovered that almost all of them had two or more chronic conditions that were being poorly managed.
Self-scheduling improves adherence
Some digital engagement tools also include self-scheduling capabilities that make it easier for patients to connect with primary care physicians. Patients who use cloud-based scheduling tools are seen much faster and have higher show rates:
- 20 percent of them get same-day or next-day appointments – and more than half receive appointments within a one-week window.
- Patients prefer choosing their own appointment time, rather than working with someone over the phone and being given a time. They can schedule at their own convenience, not just during the physician’s office hours.
- By receiving confirmation and reminder texts and emails, patients are up to five times more likely to show up for their scheduled appointments.
When patients receive verbal instructions in the doctor’s office, they forget about half the information immediately. The smart alternative is to reach them on their mobile devices – with the right information at the right time. Digital engagement tools are proving to be highly successful in ensuring patient adherence to treatment plans, which in turn produces better outcomes at a lower cost.