Many complex industries have a concept they call “the last mile.” It’s that challenging point between the last thing that happens before fulfillment, such as a sale in retail, and the completion of the encounter.
In healthcare, the last mile is engaging patients to actively participate in their plans of care. Providers can do a great job of using their knowledge and experience, along with evidence-based best practices, to develop a plan of care that they know will improve a patient’s health. None of that will matter, however, if the patient either doesn’t understand what he or she needs to do or chooses not to participate.
There is a preponderance of clinical evidence that demonstrates the improved clinical and financial results that occur when patients are engaged in their own care. Basic common sense will also lead you to that conclusion.
Just as there are strategies patients can actively follow to improve their health, there are strategies healthcare organizations can follow to encourage active patient participation. Following are six of the most essential.
1. Keep the information simple
We all know healthcare loves to use jargon and acronyms. If there is a simple way or a complex way to describe something, the healthcare industry always tends toward the latter.
That may be acceptable when healthcare professionals with advanced degrees are communicating with one another, but not when they are explaining the next steps in a plan of care to a patient. To ensure universal understanding, clinicians, care managers, and others should begin explanations at the sixth-grade level, and then determine if the patient comprehends the material. The information may need to be further simplified so that the patient can execute the plan.
The same thinking applies to any written materials or videos that are supplied to the patient. Health literacy in America is all over the map, and even individuals who are well educated in other fields may have a limited understanding of the complex world of healthcare. By keeping materials simple enough for a sixth grader to comprehend and follow, healthcare professionals position themselves and their patients for success rather than failure.
2. Be as specific as possible
As healthcare professionals we often tell patients what to do to improve their health outcomes, but we always don’t tell them how. Providing vague instructions such as “stop smoking” or “you should lose 30 pounds” is like telling someone they should drive from New York to Orlando without providing a map or a GPS navigation system.
Here again, being able to deliver simple information in written, audio, or video form, either in-person or online, will supply the “how.” Make it easy for patients to get there and they will become much more willing to go on that journey with you.
3. Get patients involved in setting their goals
One of the most important changes to patient care over the last 20 years or so has been the move away from the all-knowing physician dictating all care, with patients passively nodding assent. Patients, especially the younger generation, are taking much more interest in their own health. While “Dr. Google” or patients seeking advice from their friends on social media can be an annoyance to physicians, involvement at this level indicates an inclination to be more active throughout the process.
Healthcare professionals can leverage this mindset by getting patients involved in setting their health goals. Patients will be much more likely to follow a plan if they know they are working toward an important goal. For a knee or hip replacement patient, this might mean being able to walk down the aisle unaided at their child’s wedding. For a patient with borderline hypertension or diabetes, this might mean avoiding the start of diabetes medication, either for personal or financial reasons.
The more concrete and personal the goals are, the more likely the patient will be to follow the plan of care to achieve them.
4. Ensure everyone is on the same page
George Bernard Shaw once referred to Britain and America as “two nations divided by a common language.” The same can often be said for healthcare professionals and their patients. Although you may both think you understand what’s being said, your understanding may differ.
Take a simple goal of “eating healthier.” Early in my career I was working with a Medicare population. At one point I asked one of my patients if she ate a healthy diet and she responded “yes.” After a bit more discussion I discovered that while I was thinking healthy meant fruits and vegetables with every meal, she thought healthy meant meat and bread since she grew up on a farm where meat was very valuable.
Avoid basing assumptions on your experience and training. Probe to ensure that when you’re saying “X” your patients are hearing “X” and not “Y.” Otherwise they may end up adhering to a plan of care that’s nothing like you intended.
5. Make information sharable
Another change that has occurred over the last five years has been the concept of developing a longitudinal plan of care. Rather than working in isolation, clinicians and care managers can work across settings to ensure patients are receiving consistent direction and encouragement throughout their patient journey. Some provider organizations are even collaborating with payers to take advantage of their resources and work toward a common goal.
The electronic medical record (EMR) is the ideal setting for sharing plans, goals, support information, and whatever else is needed. Making everything accessible in a single location enables clinicians throughout the continuum to see what the plan is, track progress, and present a consistent message to the patient. Payers, for example, can to bring additional resources (such as their case managers and wellness coordinators) to bear to help patients achieve their goals.
Patient portals are great places to share goals, action items, reminders, information, etc. with patients. The availability of a single access point for obtaining information enables patients to determine how they want to consume the data and share it with their other providers, if needed.
6. Create accountability
There’s nothing like having a deadline and measurable accountability to encourage active participation in a plan of care. It is the basis of groups like Weight Watchers (which offers weekly weigh-in checks) and wellness fitness challenges (wherein a large group is divided into smaller teams that compete to determine who can walk the most steps, run the furthest distance, lose the most weight, etc.).
Helping patients track progress toward goals, either individually or as part of a group of like-minded individuals, can be extremely valuable in driving engagement. Keeping tangible reminders of those goals handy will also help–especially if the patient begins to waver.
Ensure engagement
Having a great plan of care is important to helping the sick get well and the healthy remain so. However, the plan only has value if it is followed.
By taking care of these six engagement essentials, healthcare organizations can ensure the last mile of care is as strong as all those before it. It’s the key to a happier, healthier patient journey.
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