A note on the SPM member listserv from Alexandra Albin, frequent guest
contributor here –
———- Forwarded message ———-
From: Alexandra Albin
Here is an article I came across with some relevance to S4PM.
4 Reasons why Patients aren’t managing their care
The two pieces that caught my attention:
1-patient engagement theories have not been proven.
2- The technology has to support the engagement. VERY True
“Generally, this idea (patient engagement) has been proven difficult because, what we’ve found through research is, a majority of patients don’t have interest in being engaged.” Instead, Krupa continued, patients remain unmotivated. He added although social media can be enticing, it’s only a small part of the patient engagement pie.
“One of the unintended consequences of health reform is consumers are actually going to begin to actively engage in the market of buying health insurance for themselves”
I’d just add – was it UNINTENDED that the reform bill would lead to consumers being actively involved in the insurance market?
At a summary level, this article carefully and see how he goes back and forth between two very different concepts. He is talking one moment about patients and the next about health care consumers. As this group knows better than anyone, there is a large difference between managing your health care and being involved in purchase decisions about health insurance (which, in any event, may not be much of a decision for many employed individuals).
Have “patient engagement” theories been proven? Yes. There is a great deal of evidence in the medical literature and perhaps even in the financial literature read by the folks who do interviews for Healthcare Financial News that patient engagement leads to better outcomes of care across a variety of measures. For a summary, see this Health Affairs article from 2010. If you’re talking about consumer engagement by health plans reducing costs, whether through disease management or better shopping decisions, that is another matter and remains unproven.
Similarly, the “technology” to support patient engagement with clinicians could be a lot better if you’re talking about shared decision making and the like, but the basic rules for engagement that improves outcomes, decisions, etc. requires little to no technology.
Yes, the framework for management of health needs better definition and yes, the “market” is changing. Some of that has to do with health, some of that has to do with health care and some of that has to do with health insurance. They are not the same thing.