Feedback Loops, Behavior Change and Patient Engagement- what matters and to whom?


I have been thinking a lot about feedback loops and behavior change and wondering whether patient activation is the first step that jump starts the process.

Recently, there has been a lot written about patient engagement. In fact, it is such a popular topic that there was a twitter meetup at HIMMS.

If you too are curious about all the buzz around patient engagement, a good starting point is the National e-health Collaborative patient engagement framework- which describes a continuum which begins with inform me, engage me and empower me. Once these initial goals are accomplished, the reach can be extended via partnering and supporting my e-community.

The February issue of Health Affairs is a gold mine of well-curated information containing articles, slides and videos.  You can access some of the articles here.

Noteworthy, is Julia Hibbard’s  ”patient activation measure” which provides insight into the relationship between a patient’s activation and health care costs. Hibbard finds that patients who are less engaged   about their health circumstance, incur costs of 8 to 21% higher than those with higher patient activation. 


Another view by the Bipartisan Policy Center Health Information Technology Initiative is entitled “Improving Quality and Reducing Costs in Health Care: Engaging Consumers Using Electronic Tools.”

They suggest to accelerate the adoption of electronic tools and increase consumer engagement, we must:

  1. Build Awareness of Benefits of electronic tools for patient engagement among hospitals, clinicians, other providers and consumers

  2. Develop and distribute best practices

  3. Increase Federal, State and Private Sector Incentives for the use of electronic tools to support patient engagement.

A third view of patient engagement is described by the Robert Wood Johnson Aligning Forces for Quality where they are trying a variety of new approaches in many locations and practice settings, including input from patient advisors.

Perhaps it is the divergent viewpoints- as to what the issues are and what is needed-that gives us a clue as to how long it will take for large numbers of patients to be engaged with their health. 

What do you think is needed to get patients activated?


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