Patient engagement is a popular buzz word in healthcare circles right now. Motivation to increase the engagement of a healthcare provider’s patients vary but most–if not all–center on the idea that an engaged patient will be a healthier patient. Employers want engaged patients because employers want to speed-up the role out of consumer driven health plans. Insurance companies want engaged patients because they want to keep down medical expenses (so do employers and the patients themselves). Doctors and hospitals want engaged patients because engaged patients can be marketed to directly regarding one doctor’s or hospital’s strengths compared to another.
CMS has even expanded its focus on the engaged patient with the requirements to meet Meaningful Use Stage 2. As part of MU/S2, patients are required to be given expanded electronic access to their medical records, access I strongly support as this data is owned by the patient, not by the doctor or hospital that provided the care.
The Core Measure relating to Patient Electronic Access has as its objective to “provide patients the ability to view online, download, and transmit information about a hospital admission” and is broken down in to two parts:
- More than 50 percent of all unique patients discharged from the inpatient or emergency departments during the EHR reporting period have their information available online withing 36 hours of discharge.
- More than 5 percent of all patients (or their authorized representatives) who are discharged from the inpatient or emergency department during the EHR reporting period view, download or transmit to a third party their information.
I appreciate and agree with the first requirement. Given the technology of today and the general acceptance of consumer portals, hospitals should be required to give patients access to their healthcare data and it should be available in a timely fashion. The first incarnation of HIPAA provided a common framework for patients to request copies of their data, but the process was sorely outdated and expensive to both parties involved.
It is the second requirement that I take issue with. I am proud to work in healthcare and for a hospital company. I firmly believe that we have a near-sacred responsibility to provide the highest quality of care to the greatest number of patients. We see patients at their weakest and most vulnerable moments. We have a responsibility to give them the necessary care to help them get better. We do not, however, have a responsibility to ensure that they are engaged in their care.
Yes, we have a responsibility to educate them about all of the care options and resources available to them. Yes, we have a responsibility to remove as many barriers as possible when it comes to accessing those care options and resources (see the first part of the requirement above). I fail to see, however, why a hospital should be held accountable for a patient that refuses to actively engaged in their own healthcare.
Where is the personal accountability for ones on health? Why are we not motivating the right party to become more engaged in their own health?