Patient Experience and Patient Engagement – Is one more important?

Limited Patient Parking - Jason EppinkBlog post by Colin Hung

This past week I had the good fortune to attend Day 1 of the National Forum on Patient Experience for Healthcare (#px14) here in Toronto. Now in its second year, this event is an opportunity to hear about innovation and best practices in patient experience from healthcare organizations, government agencies and for the first time – actual patients. Kudos to the organizers for waiving the registration fee for patients who wanted to attend and for providing me with a press pass so that I could live-tweet Day 1 alongside #hcldr and #hcsmca friends Annette McKinnnon (@anetto) and Paul Gallant (@HealthWorksBC).

During the conference, Pat Rich (@cmaer) tweeted a question to Annette and I – a question that stuck with me for the entire week:

Pat’s question started me down a mental rabbit hole: What is the difference between patient experience (#ptexp) and patient engagement (#ptengagement)? Is one a subset of the other? Does one lead to the other? Or are they completely separate? Does one have a greater impact on patients? This week on #hcldr I thought we’d explore these two concepts.

Charles Webster MD (@wareFLO) provided a succinct answer to Pat’s question during #px14 – and personally I think it’s one of the best responses:

The Cleveland Clinic defines patient experience as:

…more than world-class clinical care – it requires care that addresses every aspect of a patient’s encounter, including the patient’s physical comfort, as well as their educational, emotional, and spiritual needs

The Beryl Institute, a recognized thought leader on improving patient experience in healthcare, defines patient experience as:

The sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care

In his most recent blog post on Hospital Impact, Jason Wolf (@jasonawolf) the head of Beryl Institute went further and offered seven tips to healthcare organizations looking to focus on improving their patients’ experiences:

  1. Acknowledge the need for a definition (of patient experience)
  2. Cover the continuum of care
  3. Look beyond survey results
  4. Focus on expectations
  5. Align with patient-centered care principles
  6. Recognize individualized care
  7. Address more than satisfaction

Remarkably, definitions of patient experience are fairly consistent. The same cannot be said for patient engagement. A simple Google search yields over 50 different definitions – each slightly different than the last. I think Dan Munro (@danmunro) put it best in his 2013 Forbes article:

Over the course of the last two years, ”patient engagement” has mushroomed into a lead topic for speakers, conferences, trade shows, pitch decks, analyst reports and countless headlines (now including this one). But like much of our evolving experiment with healthcare’s reformation, it’s also cloaked in a nuanced, often contradictory (and now legally mandated) meaning. The trouble is, much like the phrase “consumer directed healthcare” before it, there’s sufficient ambiguity to make it malleable and customizable to fit multiple constituents – and agendas.

So what is patient engagement? One of my favourite definitions comes from #hcldr friend Leslie Kernisan MD (@GeriTechBlog):

Supporting patient engagement means fostering a fruitful collaboration in which patients and clinicians work together to help the patient progress towards mutually agreed-upon health goals.

I love how Leslie incorporated “collaboration” in her definition, because to me engagement isn’t a solo activity. True patient engagement is only possible when both the patient AND their care providers are both actively working together to achieve positive health outcomes. Collaboration can take many forms: sharing data, joint decision making, providing health education, personalized tracking & analytics, mobile health apps, etc.

Interesting questions to ponder: Are these tools and experiences prerequisites for patient engagement or can one be engaged with them? Chicken or egg? Furthermore, can I have a “bad” patient experience yet still be an engaged patient? If you had to choose, would you rather go to a healthcare institution that has poor “customer service” during your visit, but allows you to see all your results and diagnosis online in a manner that is clear and understandable and makes their doctors available to you via secure messaging?

Join us on Tuesday September 30th at 8:30pm Eastern (for your local time click here) as we explore the nature of patient experience and patient engagement.

  • T1. How would you describe #ptexp vs #ptengagement? Use examples if possible
  • T2. Which is more important #ptexp or #ptengagement? Why?
  • T3. What strategies would you suggest for improving your choice in Q3 (#ptexp or #ptengagement)?
  • T4. People, organizations and technologies to watch in the next 2yrs in the #ptexp & #ptengagement space?

Resources

“Hospitals must define patient experience”, Jason A Wolf, Hospital Impact, September 25 2014, http://www.hospitalimpact.org/index.php/2014/09/25/hospitals_must_define_patient_experience, accessed September 27 2014.

“Defining Patient Experience”, Jason A Wolf et al, Patient Experience Journal, September 2014, http://pxjournal.org/journal/vol1/iss1/3/, accessed September 27 2014

“Patient Experience vs. Patient Engagement”, Ian Worden, Better Patient Engagement Blog, July 15 2012, http://www.betterpatientengagement.com/2012/07/15/patient-experience-vs-patient-engagement/, accessed September 27 2014

“Why Patient Experiences Should Foster Engagement”, Ian Worden, Better Patient Engagement Blog, September 2 2104, http://www.betterpatientengagement.com/2014/09/02/patient-experiences-foster-engagement/, accessed September 27 2014

“The Many Faces of Patient Engagement”, Jennifer Gallivan et al, Journal of Participatory Medicine, December 26 2012, http://www.jopm.org/evidence/research/2012/12/26/the-many-faces-of-patient-engagement/, accessed September 27 2014

“Patient Engagement: On Metrics and Meaning”, Leslie Kernisan MD, The Healthcare Blog, September 12 2013, http://thehealthcareblog.com/blog/2013/09/12/patient-engagement-on-metrics-and-meaning/, accessed September 27 2014

“Patient Engagement: Blockbuster Drug or Snake Oil”, Dan Munro, Forbes, August 17 2013, http://www.forbes.com/sites/danmunro/2013/08/17/patient-engagement-blockbuster-drug-or-snake-oil/, accessed September 27 2014

“What is the difference between Patient Experience and Patient Engagement?”, PFCC Partners, October 17 2013, http://pfccpartners.com/2013/10/17/what-is-the-difference-between-patient-experience-and-patient-engagement/, accessed September 27 2014

“Connecting Patient Engagement and Patient Experience”, Michael Zeis, HealthLeaders Media, August 11 2014, http://www.healthleadersmedia.com/page-1/MAG-307263/Connecting-Patient-Engagement-and-Patient-Experience, accessed September 27 2014

Office of Patient Experience at Cleveland Clinic – http://my.clevelandclinic.org/patients-visitors/patient-experience, accessed September 27 2014

Image Credit

Limited Patient Parking – Jason Eppink

https://www.flickr.com/photos/jasoneppink/6947550955/in/photolist-bzW1Ri-6j772N-6ck9tu-fqUJk-9EeRrq-f1zovJ-btSUkV-hmA3T2-9ModLK-eCjgf6-bn4WpX-9ovkRk-dwoUzc-c3FjXU-c3Fjr5-c3FjMf-c3Fkwu-c3Fk7G-c3FjvU-c3FkbS-9naLqx-3VC8Y-igQ2-9terEJ-7tu7is-9uTsgf-bUB3ro-9tbtcM-fKHxft-c3Fkfb-7hd1LT-dRHBt5-9u2ERm-8FAFoW-73aYuM-c3FjfG-c3Fjnh-c3FjH7-c3FjUS-c3FiYj-c3Fk4f-c3Fjyh-c3FkoW-dZkY63-5Zu3s7-snVbY-9zPHvt-bEgURW-bTbDL4-goStrY/

3 comments

  1. It’s interesting to see how the topic in this review on the CFHI-FCASS site slips back and forth between patient engagement and patient experience. http://www.cfhi-fcass.ca/sf-docs/default-source/reports/evidenceboost-rossbaker-peimprovedcare.pdf?sfvrsn=4

    I also note that the Picker Institute aspects of patient-centeredness on page 2 do not include an aspect that engaged patients feel is crucial to acknowledging their role as stakeholders. That is an involvement in the decision making process in all levels of the healthcare process. I get the feeling that these 8 areas are coming from above, from the position of power and the “with patients” seems strangely absent, maybe because these attributes were developed in 1993.

    Should be an interesting discussion

    Annette

  2. Thanks Colin for citing me!

    I’ve been meaning to write a blog post about the term “engaged patient,” but haven’t gotten around to it. The problem is that it’s a passive voice construction, so you don’t know who has engaged the patient…specifically you don’t know if the patient is feeling interested/activated/empowered to take action for her health, versus the healthcare system insistently pinging the patient and trying to get him to take the action they want so that their metrics look better.

    When as providers we talk about engaging patients, I would like for it to mean actions we take to ensure a collaboration that helps the patient with mutually agreed on goals. The mutually agreed on goals part will be tough…instead I think many patient engagement activities are basically about getting patients to do what we think is good for them…there’s actually a role for that too (am thinking of those patients who come in to the ER with their health wildly out of control, but they take minimal steps, usually because we’re doing a bad job of reaching out or because other “unmentionables” in their life are their priority).

    Anyway, not sure I’ll be able to join the discussion, but so glad you are addressing this topic!

  3. […] Engagement – Is One More Important?”, Colin Hung, HCLDR Blog, September 27 2014, https://hcldr.wordpress.com/2014/09/27/ptexp-and-patient-engagement/, accessed April 1 […]

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