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Patients engagement

Patient Engagement: a broader concept that includes activation; the interventions designed to increase activation; and patient's resulting behavior

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Patients engagement

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Albert T

Patience engagement is participation beyond getting a treatment, it’s getting to know your symptoms and using the necessary tools to be an active learner around engaging in the education of health

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1. To me, patient engagement is making sure that your patients are comfortable with you and their medical needs, so that they can talk and act along with you so that they can get proper care and treatment.

2. Patient engagement is not telling patients what they need to improve their state.

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1. As the ability to help and understand the patient in their difficulty to improve their stay by the medical center and not make their trauma there so traumatic.

2. It is understood as the inability to favor the patient by not offering optimum comfort for their improvement or behavior.

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Patient engagement in simple words is

1. Patient can communicate with the doctor or the hospital staff about what the patient wants

2. Patient can choose the most comfortable form of treatment he wants to receive, allowing the patient to have more options.

3. Making sure if there is anything else you or the organisation can do for the patient .

Patient engagement is not

1. When the patient feels the healthcare provider is not welcoming , friendly or informative

2. When doctors and nurses do not spend enough time time with patient and ask them for their needs

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Patient engagement is make patient part of their own treatment. Patient engagement should encourage patient to take initiative to read about their illness, make appointments and follow up with doctors at appropriate times. Discuss the progress or decline in their current state.

Patient engagement is not to give patient complete authority and leave him blindly to chose as he likes, but rather should have some form of appropriate measures with the current standards and protocols of medicine. In addition to it, new treatments should be a fair game if patient chose to bring something forward.

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patient engagement is treating patients as the ones who make decisions. You help them, treat them as partners but they make the final deicisions about their way of life and treatment

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Patient engagement is not being the "good pupil" in a care system "class" as you sometimes hear in hospital for example ( he/she is a good patient ie an easy one, expressing trouble or pain but not questionning or discussing treatments , physical check-up or costs.

Patient engagement has or should be a response not a problem. It needs co-knowledge and pro-active attitude from patient but also from the care provider towards a co-decision making. Patient engagement is the meeting point between medical expertise and patient values (personnal, ethical, religious..) to get the best result and acceptance. But a continuous dialogue is necessary to adapt to changes when possible : this also means Time.

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Patient Engagement is

To empower patients (educate, give confidence and motivate) to take ownership of their own well-being and

help them cope with motivational collapses along the way and empower them back.

Role of Caring Team will be to track if right decisions are made and educate if a patient is going in wrong direction, yet not deciding for the patient as it would take his ownership and empowerment away.

graphican.com

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I believe that patient engagement is that where the patient is in control of her care, preventive approach, and all aspects of that what refers to her staying well. Once a patient has decided that she doesn't want to relinquish her say in the management of her care, she has also acknowledged that she wants to be proactive in deciding what steps she will take to overcome any illnesses or bad habits in order to get better/well.

Care providers, at this point, become active listeners with the expertise to assist in approving or recommending changes to what the patient has decided. Of course, as matter experts, the care team will indicate what is the extent to which a decision will affect the quality of life, and with that in mind, it should give all information to the patient in a manner that the patient can decide for herself what's really important (extreme example): quality of life vs. length of life - keep alive with treatments that will debilitate her and, thus, limit her activities; or, treatment that will allow her to remain as active as she was before, but with the knowledge that the length of such lifestyle will not be for as long as if a more aggressive treatment were chosen.

What patient engagement is NOT, is that where the patient is informed of what he will have to do to stay "well." It is not telling the patient that in order to offer the best care available, he will have to remain in the hospital where the best care can be provided, but without regard to his wishes or emotional well-being. It is also not where he is presented with a couple of options that will help with the ailment, but not a third one that, although experimental, may work for him.

Best,

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patient engagement is to motivate patients to be interested in their own wellbeing. to feel that they are the ones who are in charge of making the right decision about their health and their body because noone else knows them better than themselves.

pateint engagement is patient understanding their condition, have knowledge about it, knowing how the condition affects their body and the impact and how they can hlp themselves to minimise the impact of the illness on their health. it is not compliance , it is not patients doing as they are told, it is patient wanting to know and wanting to understand the process of the disease and making their choice based on that understanding.

the new model of care is  about patients taking responsibility for their own health and wellbeing.

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To me patient engagement is make patients the start point of the health therapies, they must be involved in monitorize their health, and in simple cases they can change their medication under medical guide. this serve us to monitorize our patients with less costs , from their homes, and using social media to create comunities and involve even more the patients

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Patient engagement is different from the patient's perspective as it is from that of a provider. Some patients may feel that they are engaged simply by seeking medical attention and going through the steps; whereas, a provider may see it as medication compliance and a willingness to adhere to clinical recommendations.

I think true patient engagement is the action followed by the willingness to actively participate in the improvement and maintenance of one's health. It includes, and is enhanced by provider engagement.

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Patient engagement in the context of changes to health care in the US to me means involving the individual (even before he or she becomes a "patient" in need of health services) in maintaining his or her own health by providing information and desire to maintain health through use of  technology.

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Patient engagement is about practicing humanity in daily
medical practice.  Patient is not an
object or a case; he/she is one of the most important aspects in the healing process. Assuming that there would be guidelines and step by step plan to do so is not logic because of human diversity and culture background. It is an
interactive process that could be changed or redirected at any level upon observing patient response and cooperation.

Nice article about the subject with the following link

http://engagingthepatient.com/2013/05/28/does-patient-engagement-need-a-definition/

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Ali Darcy - It's all about (em)POWER(ment)! 

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Ali Darcy - It's all about (em)POWER(ment)! 

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Patient engagement is all about re-balancing the power differential that exists in the typical doctor-patient relationship to recognize that both are experts. The doctor is expert in physiology, presentation, course and outcome of illness, and the patient is an expert in the systems in which it manifests i.e., the person and the context of their lives. Patient engagement is not consulting with the patient for the sake of it, but a genuine recognition of the expertise that they bring to the table to facilitate a collaborative partnership.

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Patient Engagement is not something you see a lot of.

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Patient Engagement is not something you see a lot of.

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Rebecca - Patient Engagement as an Education Problem

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Rebecca - Patient Engagement as an Education Problem

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In looking at the topics for the Patient Engagement Design course, one sees patient engagement as a design problem, a cognitive psychology problem (study of motivation more specifically), a behaviour change problem, and a measurement problem. However, that isn't how I see patient engagement. Upon reflecting on it, I immediately saw it as an education problem - in that medical staff need to be educated about the patient experience and patients need to be educated about the medical system in which they are suddenly becoming a key component.

I find it interesting that in all the readings, we don't see anything from the realm of adult education. There are overlaps with cognitive psychology and behaviour change (after all, a bit part of education is behavioural psychology), but the focus of cognitive psychology and behaviour change in the course doesn't really approach the problem from an educational perspective.

Perhaps it is because of my background as an educator that I see the problem as one of education - and as such - I see solutions that involve education. Immediately upon exploring patient engagement, I find areas where education could be used as a means to help better define the problem, and help lead to better collaboration between patients and their care teams.

From the patient perspective, I find the first challenge in patient engagement is a lack of understanding of the medical system. How can I, as a patient, advocate for myself with the system when I do not understand who all the players are and what their roles are? The medical professionals in the system have lived and breathed the medical system throughout their academic and professional careers. They are so 'inside' the system, that they often forget what the system looks like to an outsider. The patient who is suddenly diagnosed with a critical illness is lost. They don't have a context for understanding the medical system. They don't know who does what, and why. They have no sense of the different scopes of practice and expertise. In addition to learning what it means to have a critical illness, they also need to figure out who to talk to, and who to trust. The medical system is a massive collection of specialist nurses, nurse practitioners, doctors and other specialists - each with their own roles and scopes of practice. Those who are 'in' the system have had years to figure out how the different people work together. As a patient, it is often expected that if someone is introduce by title or role, that I will know what that role means. I should just understand the different functions of the oncology nurse, versus the oncology nurse practitioner.

To me, it all comes down to a lack of education. This problem could be solved by a simple web-tutorial (or PowerPoint slide deck for that matter) that outlines who does what within a given organization. Rather than hiding behind the titles, and assuming that patients understand the titles, it would be more beneficial to outline the different medical professionals who might be called upon to provide care. This tutorial would go a long way to helping patients engage the right people when they need assistance.

I find it interesting that at Stanford there are many different workshops and tutorials to help you understand your disease (e.g. lymphodema) or help you understand your treatment (e.g. intro to chemo), however, I haven't seen anything that tells me what the different medical staff do, and who is responsible for what. For example, take a look at the patient education center - http://healthlibrary.stanford.edu/patient/ - there is nothing to help educate the patients about who the different medical professional are. As a patient, how I am to ensure that I'm collaborating effectively with my care team if I have no idea who should be on that team, nor do I know who should answer what type of question?

So, for me, I'd like to see patient engagement start with some education to help patients engage - and that means knowing who to engage with!

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Patient engagement - what type of problem is it? #medx

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In looking at the topics for the Patient Engagement Design course, one sees patient engagement as a design problem, a cognitive psychology problem (study of motivation more specifically), a behaviour change problem, and a measurement problem. However, that isn't how I see patient engagement.

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Patient engagement means belief in reaching an improved state or outcome. It is founded on trust and sufficient knowledge to support the belief and form new habits. It is not telling someone to do something through superior knowledge or authority, or offering extrinsic rewards.

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Patient engagement design empowers the patients because it allows patients more control over how they view and use their medical records. Through the use of technology and the internet, patients can now fulfill certain clinical needs such as ordering prescription drugs and interacting with their doctors from the convenience of their home. Routine reminders can be worked into this design to save time for the medical staff, while keeping the patient feeling like they are well cared for.

Technology certainly drives patient engagement design, but this type of design is about strengthening the relationship between the patient and the health care provider.  We want the patients to become an active participant in their own health care routine, while being able to provide superior care to a large number of patients. By finding ways to keep patients interested in their own health care, such as enabling them the information and rights to make decisions about their own health, we will end up with happier and healthier patients.

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Very informative, for a clinician/data scientist like me, to read all your posts. Expanded my understanding of patient engagement as:

Autonomy

Collaboration

Communication

Convenience

Decisionmaking

Design Process

Dialogue

Disengagement

Education

Effective

Efficient

Empathy

Empowerment

Experience

Independence

Interdependence

Involvement

Listening

Participatory

Satisfaction

Support

Sympathy

Teamwork

Understanding

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To me, a person living with a chronic disease, patient engagement means the level to which I’m allowed to be involved in my own care.

But Patient engagement is not quite as important to me as it may be to my providers. I want the least amount of engagement possible, because every interaction with health care is an unwanted reminder of my condition. What I really want is autonomy.

Engagement is a means to an end, not an end in itself. But autonomy is true empowerment.

And to empower someone is to enable them to decide how much they wish to engage with health care.

It is, in the end, more important to find an engaged doctor than it is to to become an engaged patient. An engaged doctor values and encourages my contributions and understands what it means to work together as partners in health.
—hugooc

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Patient engagement to me would appear to be the active involvement of the patient in their own care in collaboration with those in the medical profession. It is not compliance.

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Rebecca's thoughts on patient engagement definitions

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Rebecca's thoughts on patient engagement definitions

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I've been thinking about how I will be blogging as I work through the Patient Engagement Design MOOC. I'll be posting on this blog my general comments on the MOOC, and my feedback on the MOOC itself as I progress through it. I will be blogging at http://bcbecky.com my specific experience as a patient that is undergoing treatment for bilateral breast cancer.

The first question asks that we reflect on what patient engagement means. I had also seen the term "patient activation" which was completely new to me. As a Canadian, I'm more familiar with the term "patient advocacy", which isn't really the same thing (seems to be more about empowering patients to advocate for themselves or have caregivers advocate for patients, so not completely dissimilar). I've sent a query to some of my Canadian physician friends regarding the term "patient engagement" within Canadian Medical Education. I'll be curious what they have to say. I'm wondering how "international" the concept of patient engagement is? Or is this mainly a phenomenon brought out in the US by the insurance companies who are seeing patient engagement as a way to reduce healthcare costs (patients who are more actively involved in their treatment incur fewer healthcare costs)? If you have thoughts on these questions, please leave a comment!

Under the video in the course, there were two definitions provided:
Defined by Professor Judith Hibbard
Patient Activation: emphasizing a patient's willingness and ability to take independent actions to manage their health and care

Patient Engagement: a broader concept that includes activation; the interventions designed to increase activation; and patient's resulting behavior

Personally, I had a very negative reaction to the term "patient activation". To me, this is exactly what is wrong with the physician view of patients. It makes me, as a patient, feel like a robot that needs to have some 'feature' or 'function' turned on. I so dislike the word "activation" ...

Actually, I find both of these definitions to be rather 'clinical' feeling (perhaps because of the strong positivist nature of medicine?). I find that the definitions are treating the patient as a "subject" in a research study, rather than a "participant" in a collaborative activity. To me this highlights how we need to shift paradigms in order to truly appreciate the topic.

For me, the first step in patient engagement is an educational activity. Patients need to be educated more about their medical diagnosis, but also about the medical system that supports their diagnosis (patients don't know who should be on their care team!). I'll blog more specifically about how this relates to being a breast cancer patient on my other blog. Being thrown into a whole new medical system (I moved from Canada only a month before diagnosis), as well as navigating a whole new diagnosis (I knew nothing about breast cancer), while also having to make some pretty serious treatment decisions (chemo or surgery first, which type of chemo, which type of surgery), requires a lot of learning. I was fortunate to be well educated, and familiar with medical research, so I could learn how to navigate some of the waters. I can only imagine how difficult this is for something who isn't a life-long learner and who hasn't been in school in the last 10, 20, 30 years... So, step one in patient engagement when dealing with a serious diagnosis should be to educate patients about the healthcare system, including who makes up (or should make up) your healthcare team and the different roles of each person on the team, who to ask which questions, etc. When I asked the folks at #bccww (breast cancer chat world wide - twitter chat) about what they wished they learned at diagnoses and through treatment, they commented that they got most of their information from face-to-face and online support groups (specifically from other patients) rather than from their healthcare team. If patients are not well connected to support groups, how can they possible navigate the system?

I like the idea of patient engagement as patients collaborating with their healthcare team. But I also find that physicians can act in silos, which makes it more difficult to be a patient. If the surgeon doesn't interact with the medical oncologist then how do I know I'm getting treatment that is looking at all aspects of the disease? One of the things that drew me to the Stanford Women's Cancer Center for treatment was that the first physician I saw (breast surgeon) brought in the medical oncologist during my appointment. At one point both doctors came into the room at the same time (actually all three doctors, as I first saw a breast surgery fellow, then breast surgeon, then medical oncologist). As a new patient, it was comforting to know that my medical team were located in the same space and actually talked to each other. Note that I didn't do the 'tumor board' at Stanford, as I learned later through another patient in a support group that I could self-refer, and it was moot at that point as I had already begun treatment.

Another aspect of patient engagement that I personally have found to be rather positive with my move to the US is that my medical team is available to me via email. This has been a huge improvement in my care, as often I have simple questions that shouldn't require a trip to the doctor's office to get answered (or I'm having side effects that don't allow me to drive, such that an office visit isn't feasible). Being able to send an email and get a response in a reasonable amount of time (I'm a big fan of same-day turn-around), means that I don't need to waste office time for questions that can easily be answered. It also means that I get the answers when I need them - while I'm having the side effect, not a week later when my condition has changed. As a Canadian, the whole idea of being able to email my physician is foreign. As is the idea that when I visit my primary care physician I can ask about more than one issue in a single visit (but that is a whole other thing to rant about, perhaps in another blog post later)...

My questions to you are:

If you are a patient, how do you feel (what is your emotional reaction) about the definitions provided?

If you are physician educator, what does 'patient engagement' mean within your context (what country/speciality makes your context)?

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My thoughts on patient engagement definitions - #medx

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I've been thinking about how I will be blogging as I work through the Patient Engagement Design MOOC. I'll be posting on this blog my general comments on the MOOC, and my feedback on the MOOC itself as I progress through it.

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Hello everyone.

Excellent All.

Thank You.

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Patient engagement to me is about putting the patient at the center of their experience with healthcare - and it also means creating space for patients to support and learn from each other, help each other take decisions, etc., and it means healthcare professionals who listen with care

Patient engagment is NOT simply "humoring" the patient or giving them information (important though that is) - it requires some humility from the doctor's side as well, to putting the patient's experience before their own

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Patient engagement is about giving people the tools and information they need to make better health decisions for themselves. It's about empowering them to voice what they want their care to be.

Patient engagement is not about compliance, subservience to providers or blindly doing as you are told. Sometimes non-compliance is the best decision and an informed, empowered patient will know when or if that is the right choice for them.

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Patient engagement from a patient's prespective

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Patient engagement from a patient's prespective

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Patient engagement is design process that aims to improve healthcare outcome by acknowledging and involving patients as active co-creators of positive health outcome. It reduces cost, helps physicians, hospital management and patients. It improves efficiency, equity and population's well being.

A crucial component of patient engagement is patient empowerment through education (about diseases, treatments options and medical settings). Patient engagement process celebrates human uniqueness and utilizes to encompass a patient’s social, family, educational, religious/spiritual,cultural, professional background into healthcare design.

Patient engagement incorporates cutting edge neuroscience to create behavioral change programs. Patient engagement is also a continuous process to incorporate technology to enhance collaboration, patient satisfaction, and flow of timely and predictive data.

Patient engagement incorporates positive psychology and designs programs based on empathy, compassion, reciprocity and to prevent diseases as well.

What it is not… Patient engagement is not the imposing of mechanized jargon-abundant medical advice on passive patients to complete medical treatment with disregard to patient’s emotional, spiritual and social well-being. Patient engagement is not the patient's responsibility only.

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Patient engagement is addressing the underlying motivations of the patient hidden beneath the social interaction level. It's also not dictating action.

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...has nothing to do with compliance...

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The treatment of the patient as a person with needs, fears and emotions, able to manage their own health and illness, within a framework of understanding and sympathy (which means the empathy plus the assumption of therapeutic responsibility)

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Patient engagement is a mutual collaboration between patient and physician to improve patient health.

Patient engagement is not and should not be a one way lane that allows one member of the duo to have an absolute say over anything and everything.

Patient engagement is not self-sacrifice.

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What Patient Engagement is:
-A doctor working with me as a patient in partnership

Working with me on the goals that are important in my health; asking me my priorities in health and coming up with shared decision making

-Listening to my concerns as a patient and asking what I would like to work on

-The quote (not sure where it comes from) 'Nothing about me without me' Do things with me. Not to me.

-Understanding that patients are experts in their own experiences of health

What Patient Engagement is Not

· eg. If a doctor says, "I know best and do it this way and if you don't like it, go elsewhere' ~ this negates the relationship and partnership with the patient and is stuck in very paternalistic, doctor-knows-best type of thinking

· Dismissing info about my health that I have found in online communities that is more up to date than the knowledge the doctor has

· Be unwilling to partner with the patient

· Giving one option for treatment and not be willing to look into other options when they exist

· Refusing to acknowledge the knowledge a patient brings to an appointment

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Patient engagement is about collaborating with patients. It is about providing them with the resources necessary to feel empowered to participate in the management of their own health and wellbeing

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An engaged patient is active and not passive. It means taking a leading role in the design of their own treatment

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An engaged patient is active and not passive. It means taking a leading role in the design of their own treatment

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Patient Engagement is Co-Designing Healthcare Solutions with Patients

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Patient Engagement is Co-Designing Healthcare Solutions with Patients

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(IDEO design challenge at Stanford Medicine X conference)

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Patient Engagement is to facilitate their participation  on taking  control of their health and behaviors either to prevent disease or manage it for positive outcomes.

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Patient Engagement is to facilitate their participation  on taking  control of their health and behaviors either to prevent disease or manage it for positive outcomes.

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Consumer engagement involves interaction, listening, and learning in a relationship with another person.  Engagement is not a strategy, it is care that is provided and involves all aspects

Patient engagement is not about the health worker dictating what the care is about

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Patient engagement is in the eye of the "beholder"

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Patient engagement is in the eye of the "beholder"

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Patient Engagement is not enforcing a one size fits all approach and limiting engagement to short-term adherence.

Rather it should be many short-term wins in adherence,compliance and activation that amalgamate to engagement.

Patient Engagement is empowering a patient to take a role in his or her own health and to activate an innate drive to take action for health maintenance and become the primary stakeholder in his or her own health.

-TD

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Patient engagement is placing the patient or health consumer
at the centre of their care. This includes making information more appropriate
for consumers and increasing consumers health literacy so they can make
informed decisions about their care. For
organisations patient engagement means shifting the power dynamic to include
the patient or health consumer and wider community in differing levels of organisation
structures and decisions e.g. a consumer consultative committee, including consumers
in program design and in the development of staff training.

Patient engagement is
not tokenism

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Patient Engagement is about providing patients with the information and resources necessary to make informed decisions about their care path.

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Patient empowerment is about letting a participative part in the care of the patient. We suppose that wtith the help of the new telecare technologies and applications the patient will find a new way of empowerment in his self-care.

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Patient engagement is about creating a collaborative environment with patients so that they are not sitting back and expecting you to fix them up, but working together with you (medical practitioner) in achieving the desired results. It could include the patient learning more about their condition and how to manage it, supplemented by Medical treatment, change in lifestyle or more so that TOGETHER, results are achieved.

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Patient engagement is about allowing the patient to direct rather than receive care

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Patient engagement is motivating and educating patients to be both involved in their care and proactive about their health.