Physicians and nurse teams have long recognized the importance in true engagement and activation for higher quality of care. Employers, health plans, and policy makers are also making this shift a high priority.

In order to seek out cost containment and to find improvements in overall quality of care, a commitment to truly engaging and empowering patients is now more critical than ever.

In an atmosphere in which “engagement” has become a buzzword to many, how can we step back and try to define what a genuinely engaged patient means when under our care? 

On a fundamental level, informed patients are able to contribute and act as partners with physicians and care teams. Engaged patients are able to see the value in what is taking place in terms of their health, and they are able to help ensure their own quality of care.

Engaged patients are invested and involved in their health and eventual outcomes.

The National Patient Safety Foundation’s Lucian Leape Institute adds to this vision of the engaged patient:

“They are always ‘present’ in their own care, unless impaired by factors beyond their control; they are the first to know when a symptom changes or about the impact of treatments, and can communicate this to their care team. Their courage and resilience can inspire and energize their care team.”

In order to build an integrated and proactive, practice embedded, nurse-centric program around the idea of genuine patient (as well as team) empowerment, the following issues should be addressed.

Organizational leadership buy-in and support, including: 

  • Leadership Education concerning Patient Centered Medical Homes, Medical Neighborhood and ACO features/benefits.
  • Benefits of care management as a necessary function of the Clinical Provider and not the Payer.
  • Differentiating outdated, ineffective health insurance model of  "Case Management" from Relationship-Based “Care Management"
  • Differentiating EMR from EHR and Relationship Based Care Management tools and functionalities
  • Workflow changes for clinicians (NP, RN, LPN,MA), front- and back-office clerical personnel
  • Reimbursement methodologies impacting embedded care managers
  • Clinical Outcomes and Cost Optimization. 

Patient and family/caretaker engagement must be seen as a core value of the organization.

In addition, there must be physician buy-in and support, including:

  • Leadership Education concerning Patient Centered Medical Homes, Medical Neighborhood and ACO features/benefits.
  • Differentiating EMR from EHR and Relationship Based Care Management tools and functionalities
  • Differentiating outdated, ineffective health insurance model of  “Case Management” from Relationship Based “Care Management”
  • Benefits of care management as a necessary function of the Clinical Provider and not the Payer.
  • Workflow changes for clinicians (NP, RN, LPN,MA), front and back office clerical personnel
  • Reimbursement methodologies impacting embedded care managers
  • Clinical Outcomes and Cost Optimization.

It goes without saying there must be access to organized and relevant information and tools to provide to patients for their well-being, including education- and motivation-based support.

And what do patients and their families need, at the most basic level, to begin the process of being active participants in their own care?

The National Patient Safety Foundation’s Lucian Leape Institute’s paper sums up these core areas appropriately:

·      What’s important: the “why” behind the “what”

·      The possibilities: the pathways possible to take

·      A sense of safety: that they will not be punished, ignored, or made more fearful

Ultimately, it’s essential that the provision of relationship-based care management resides with the physician practice and primary care clinic and not with the payers.

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