mHealth and Patient Engagement; The Message Matters
(This article by Eric Wicklund originally appeared July 13, 2016 in MHealth Intelligence).
Sometimes technology is the last thing that matters in an mHealth relationship. Healthcare providers shifting to value-based care are looking for platforms that extend the conversation beyond the doctor’s office. More importantly, they want the conversation to resonate with the patient, and that won’t happen if the patient isn’t comfortable.
“It’s all about long-term empathy,” says Jocelyn Sivalingham, MD, FACP, a medical director for West Health’s Health Advocate business who deals with chronic care treatment plans. “It’s about having the (doctor) pay more attention to the person at the other end of the stethoscope.”
Treatment plans “sound really autocratic,” she adds. “To the patient, it’s an external force imposing a rigid set of rules on a person – and usually that won’t work. What it should be about is a focus on patient-centeredness and collaboration.”
As evidenced by the Centers for Medicare & Medicaid Services’ recent decision to green-light digital health and wellness channels for providers engaged in pre-diabetes care, healthcare is finding value in conversations, even if the two parties aren’t in the same place. With its ruling, CMS is saying it will reimburse doctors who can create a platform that reaches out to a patient, talks about health and health management, and demonstrates measurable engagement.
That might be through a video connection on a laptop or tablet, home health monitoring devices or smartphones.
“Consumers now expect to have their choice” of communication channels, says Kathleen Ellmore, vice president of engagement sciences for Silverlink, which was acquired by mHealth engagement provider Welltok last year. “They have it with Amazon, Google, even Starbucks. And when you’re trying to engage with them in a meaningful fashion … you need to reach out to them” rather than waiting for them to reach out to you.
That’s especially true, she says, in patients with chronic conditions, where “their normal is daily management.” Providers should be giving them a range of options for collaboration, so that they can pick what works best and fit it into their lifestyle.
“Technology is merely the tool; it’s never the solution” to engagement, says Colin Roberts, senior director of healthcare product integration at West Health and a type 1 diabetic for 10 years. “It enables those frequent nudges (between provider and patient), but if you sit back and expect the technology to do the job, you’re missing the connection.”
Sivalingham says providers have to “understand the patient’s needs and preferences” in order to create and maintain engagement. Simply telling a diabetic patient that a lower a1C level is better won’t work; offering advice before meals on what foods to eat, illustrating how even moderate exercise affects one’s blood-glucose levels, and providing real-time links to resources stand a better chance of gaining the patient’s attention.
“The best medication is the medication the patient will take,” she says.
To that end, says Ellmore, the provider may first want to lay out all the mHealth options available to the patient – one might want to stay in touch via text message, while another might prefer e-mail and a third still prefers a phone call. Make sure the patient is on board with whatever channel you choose, and then go about creating a care plan that makes the best use of that platform.
“People respond differently to different channels” of communication, she says.