Patient engagement is based on the belief that the actions of physicians are just one part of the healing process. Patients also have an active role to play in their own healthcare.
The aim of any patient engagement strategy is to deliver timely, reliable, effective, and safe healthcare. This means providing the best possible care journey to patients, giving them adequate information, and supporting them to make decisions about their treatment.
This blog outlines some of the additional support required in behavioral health to ensure patients can engage in their care.
1. Appointments and attendance
Non-attendance at appointments is a waste of resources and critical to health outcomes in any healthcare setting. But non-attendance isn’t simply a matter of forgetfulness. Attendance behavior is much more complex than a memory slip. The reasons for non-attendance may be even more complex in behavioral health.
A wide range of studies report a mixture of the following as reasons patients may miss appointments:
- A range of health-related factors from hospitalisation to feeling too unwell or anxious to attend
- Timing, transportation, childcare, conflicting commitments, overslept, or having ‘a lot on their mind’
- Administrative errors, miscommunication, or scheduling errors
- Financial hardship
- Lack of understanding – fear, or not knowing the purpose of the appointment (the source of the appointment may also influence this)
Fear of infection due to COVID-19 can now also be added to that list.
The good news for providers is that all these issues can be remedied through effective patient engagement strategies, appointment reminders being one of them.
Missed appointments are an avoidable cost; appointment reminders have an important role to play in preventing them. Data is also important for identifying trends.
Research shows that simple reminders are effective but one study notes that “more intensive reminder alternatives may be relevant for key groups of patients: deprived, ethnic, substance abusers, and those with comorbidities and illness.”
It’s worth noting that not all appointment reminder systems are created equal. In behavioral health, a more sophisticated system, such as that offered by PatientTrak, is essential.
Using PatientTrak you can create an unlimited number of messaging campaigns and send messages to specific patient groups via text. There is no other communication method that even comes close to engaging more people than text messaging. And additional information can be included in the text for selected groups to provide reassurance and clarity. Virtual waiting rooms are another feature that provide reassurance to patients attending healthcare facilities during the pandemic.
2. Treatment plan decisions; shared decision making
One of the six aims of healthcare quality, as established by the U.S. Institute of Medicine in 2001, is person-centered care. It is defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and cultural values and ensuring that patient values guide all clinical decisions.”
In all fields of healthcare, patient-centred care is now considered important. It means active collaboration and shared decision-making between patients, families, and providers. But there are significant barriers to patient participation in decision-making, especially in behavioral health where decision-making capacity may be impaired.
A recent study showed shared decision making (SDM) in serious mental illness is underutilized, even though evidence proves it still works in this cohort of patients.
Empirical support for SDM has been mixed but generally indicates a positive relationship with symptom improvement, increased patient satisfaction, greater patient knowledge, better provider–patient relationships, increased patient engagement in treatment, and decreased stigma.
In behavioral health it is often wrongly assumed that an incapacitated patient can no longer meaningfully participate in shared decision-making about their health. But many patients with psychiatric disabilities retain capacity for all or most decisions.
There remains a need for change in the professional psychiatric community. A study on the use of SDM in the treatment of schizophrenia found that a surprising 44% of physicians still preferred a paternalistic approach. Attitudes among professionals must, therefore, also change.
3. Treatment engagement
It is well-known that people living with serious behavioral health conditions are difficult to engage in ongoing treatment, and that treatment drop-out rates are high. This is serious because it leads to worse health outcomes for individuals, but also because it has ramifications society-wide.
One of the significant barriers to treatment engagement is a patient’s poor insight into their condition and how treatment will help. And disengagement is more likely during times of symptom resurgence. So, what can be done?
Research into the treatment engagement of individuals experiencing mental illness explored the use of programs using social media or Internet‐based technologies to connect with clients during times of disengagement. It was found that symptom escalation or rehospitalization may be decreased.
Emerging technology is providing hope. Tech such as the Internet and Smartphone Apps are promoting engagement and are proving particularly helpful for supporting treatment engagement in behavioral health.
People can now, for example, find help and support from others via social media groups. Using text messaging, providers can prompt patients to take medication and more information can be shared quickly and effectively with the right group of patients. Family member engagement is also helpful.
Studies also suggest that engagement is correlated with receiving non‐traditional services that support individual goals, such as supported employment and education. These additional services can more easily be shared, recommended and accessed from providers with a complete patient experience platform.
Text broadcasting is also radically changing the patient engagement landscape. Studies to date suggest that SMS behavioral interventions can effectively support health behaviors, and certain features are useful for optimizing user engagement and persuasiveness.
4. Staff engagement matters
One aspect of patient engagement that is often forgotten is how engaged the staff are in their work.
A review of treatment engagement of individuals experiencing mental illness in 2016 concluded individual and systemic barriers may prevent providers from delivering treatment that optimally enhances participant engagement.
“Engagement strategies focus on practical methods and tools, as well as on helping to change attitudes and overall approaches to treatment of people with mental illness. In order to implement these strategies to improve engagement, mental health providers, too, must feel engaged with the work they are doing.”
If any member of staff in the patient journey, from receptionists through to consultants and physicians, aren’t engaged and happy in their work, how can they deliver treatment and a service that optimally enhances participant engagement?
Often, this comes down to them just having the right tools. Patient flow software is just one example. It can save time and streamline processes, providing quick and easy solutions to many administrative headaches. This frees up time for staff to focus on the well-being of patients, which in most cases is why staff are working there in the first instance.
The future of healthcare relies on patient engagement and data. PatientTrak offers innovative solutions for patient flow and patient engagement, and optimizes administration processes in any healthcare setting. Get in touch for a free demo.