Author:
Di Tosto Gennaro,Hefner Jennifer L.,Walker Daniel M.,Gregory Megan E.,McAlearney Ann Scheck,Sieck Cynthia J.
Abstract
Abstract
Background
Patient engagement is seen as a necessary component in achieving the triple aim of improved population health, improved experience of care, and lower per capita health care costs. While there has been a substantial increase in the number of tools and patient-centered initiatives designed to help patients participate in health decisions, there remains a limited understanding of engagement from the perspective of patients and a lack of measures designed to capture the multi-faceted nature of the concept.
Methods
Development of a concept map of patient engagement followed a five-step modified Group Concept Mapping (GCM) methodology of preparation, generation, structuring, analysis and interpretation. We engaged a Project Advisory Committee at each step, along with three rounds of survey collection from clinicians and patients for element generation (272 clinicians, 61 patients), statement sorting (30 clinicians, 15 patients), and ranking and rating of statements (159 clinicians, 67 patients). The survey of three separate samples, as opposed to focus groups of ‘experts,’ was an intentional decision to gain a broad perspective about the concept of patient engagement. We conducted the structure and analysis steps within the groupwisdom concept mapping software.
Results
The final concept map comprised 47 elements organized into 5 clusters: Relationship with Provider, Patient Attitudes and Behaviors, Access, Internal Resources and External Resources. There was considerable agreement in the way elements in each cluster were rated by patients and clinicians. An analysis of the importance of the constitutive elements of patient engagement relative to their addressability highlighted actionable items in the domain of Relationship with Provider, aimed at building trust and enabling patients to ask questions. At the same time, the analysis also identified elements traditionally considered barriers to engagement, like personal access to the internet and the patient’s level of digital literacy, as difficult to address by the healthcare system, but also relatively less important for patients.
Conclusions
Through our GCM approach, incorporating perspectives of both patients and clinicians, we identified items that can be used to assess patient engagement efforts by healthcare systems. As a result, our study offers specific insight into areas that can be targeted for intervention by healthcare systems to improve patient engagement.
Funder
National Institute on Aging
Publisher
Springer Science and Business Media LLC
Reference46 articles.
1. Chase D. Patient Engagement Is The Blockbuster Drug Of The Century [Internet]. Forbes. 2012 [cited 2022 May 28]. Available from: https://www.forbes.com/sites/davechase/2012/09/09/patient-engagement-is-the-blockbuster-drug-of-the-century/.
2. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging patients in decision-making and behavior change to promote prevention. Stud Health Technol Inform. 2017;240:284–302.
3. Bodenheimer T, Sinsky C. From Triple to Quadruple Aim: care of the patient requires care of the provider. Ann Fam Med. 2014 Nov;12(6):573–6.
4. Kimerling R, Lewis ET, Javier SJ, Zulman DM. Opportunity or Burden? A behavioral Framework for Patient Engagement. Med Care. 2020 Feb;58(2):161–8.
5. Sieck CJ, Walker DM, Retchin S, McAlearney AS. The Patient Engagement Capacity Model: What Factors Determine a Patient’s Ability to Engage? NEJM Catalyst [Internet]. 2019 Mar 13 [cited 2022 Sep 26]; Available from: https://catalyst.nejm.org/doi/full/https://doi.org/10.1056/CAT.19.0001.