Save for the occasional curmudgeon patterning himself after TV's "House," most healthcare providers would agree that patient engagement plays a vital role in a hospital's success.
Those who oversee the nation's healthcare industry agree. The Centers for Medicare & Medicaid Services includes patient satisfaction – in the form of the Hospital Consumer Assessment of Health Plans Survey (HCAHPS) – in its formula for determining Medicare reimbursements. And patient engagement plays a prominent role in Stage 2 of the federal government's meaningful use guidelines for ACA benefits.
With that in mind, Axial Exchange, a Raleigh, N.C.-based developer of mHealth tools and services for hospitals, has embarked on an ambitious survey of the nation's hospitals. Using what it calls a Patient Engagement Index (PEI), the company has so far ranked hospitals in three states, and plans to cover the rest of the country by early 2014 at the latest.
Hospital executives "are just beginning to understand the value of patient engagement," said Matt Mattox, Axial Exchange's vice president of products and marketing. But many of those same executives, he said, haven't had the time, money or staff engagement to develop an effective patient engagement platform, so they're either moving slowly or making due with a simple patient portal on their website.
The Axial Exchange PEI evaluates hospitals using publicly available data in three categories and gives each a score of 1 to 100. For example, while a hospital is expected to offer electronic access to patient health records, it would score extra points for offering resources for disease management support, including mobile tools.
The categories are defined as:
- Personal health resources (representing 50 percent of the score), based on an aggregate score for hospitals that provide any of the following: read-only Internet access to health information, mobile applications or interactive tools for managing ongoing health.
- Social engagement (25 percent of the score), based on a weighted score of hospital ratings on leading social media and consumer ratings sites.
- Patient satisfaction (25 percent of the score), measured by the HCAHPS survey, a standardized instrument for measuring patients' perspectives on hospital care that has been endorsed by the National Quality Forum.
Mattox said hospitals generally fall into three stages of patient engagement. The lowest stage involves having some sort of concierge medicine platform, while the next stage would include a vibrant patient portal. The upper-most stage, he said, would include tracking tools for patients, such as apps.
So far, the company has issued PEIs for Florida, Texas and California. In the latter, 135 hospitals were evaluated, with San Diego's Sharp Memorial Hospital gaining the highest score at 90 (in contrast, Riverside County Regional Medical Center scored a 13.) In Texas, Houston Northwest Medical Center achieved the highest score, with an 84, while Houston's Tomball Regional Medical Center scored a 34. And in Florida, Parrish Medical Center topped the list of 74 hospitals with a score of 89 and Saint Vincent's Medical Center came in on the other end with a 32.
"Patient engagement is important because management of chronic illnesses involves action by both patient and provider," said Paul Y. Takahashi, MD, associate professor of medicine at the Mayo Clinic and a board advisor to Axial Exchange, in a statement released after the Florida PEI scores were announced. "Patients should feel empowered to be part of the medical plan, because research shows that active engagement can lead to improved outcomes and increased satisfaction."
"The term 'patient engagement' has been so widely used that its true meaning has been diffused; people talk broadly about improving patient engagement, but have not done the analysis and research to determine exactly what types of patient engagement programs improve outcomes," said Joanne Rohde, Axial Exchange's CEO, in a May 15 press release announcing the Texas PEI scores. "However, we have done the research to determine which programs and tools actually drive more meaningful patient engagement that leads to improved patient satisfaction and clinical outcomes, fewer readmissions and lower healthcare costs. My hope is that these indices we have issued, and will continue to compile and share, will encourage provider organizations across the country to reevaluate their patient engagement strategies and place higher emphasis on the programs that drive real change."
Mattox said few hospital executives have complained about their ranking so far, though one California hospital pointed out that its low ranking didn't account for management's recent decision to overhaul its entire patient engagement platform. ("We didn't see that going in,"" Mattox admitted.)
He said the publicity surrounding the PEI has served to "get the conversation started" with hospital executives who are uncertain or hesitant to adopt a patient engagement strategy. The rankings, he said, highlight the hospitals that are doing it right, while also noting which institutions aren't on the right track.
'When you rank an institution, they start to pay attention," he added.
"Patient engagement is strategic ground that the best health systems will claim in order to thrive in a profit-from-quality world. Mobile devices are quickly making an impact on how patients manage their health," Mattox said in a May 6 blog titled "How to Generate a 15X Return on Patient Engagement." "For a health system, not having a mobile engagement offering in 2013 may be similar to not having a corporate website in 2003. Whether healthcare systems and practices are motivated by higher margin patients, professional reputation, payment incentives – or all three – they have everything to gain from enabling superior patient engagement and everything to lose if they do not."
