Here to Stay

Throughout 2013 and early 2014, the Center for Advancing Health interviewed key health care stakeholders to gather their perspectives on patient engagement.

The purpose of our study was to explore both how different health care stakeholders describe "patient engagement" and what strategies each stakeholder uses or promotes to support (or facilitate) engagement. We conducted interviews with 35 key informants from seven groups with an interest in patient engagement: patients, clinicians, employers, health plans, community health programs, governments, and health care consultants and contractors.

Informants were asked to discuss patient engagement definitions, behaviors associated with engagement, the impact of patient engagement on various stakeholders, organizational and stakeholder credibility to facilitate engagement, barriers that hinder people's engagement, interventions to overcome engagement barriers, overall support for engagement by their stakeholder peers, and ways to build more support for engagement.

The following six key themes emerged from our discussions:

Engagement is active.
Informants agreed that the core of patient engagement is individuals' active participation in their health and health care.

The health care system doesn't make engagement easy.
Even the most active, capable individuals require support from other people and health organizations to engage in their health and health care.

Everyone benefits from engagement.
Patient engagement makes a positive difference for all seven stakeholders: patients, clinicians, employers, health plans, community health programs, governments, and health care consultants and contractors.

Engagement is demanding, and many are unprepared.
Many consumers have only a partial understanding of what it takes to be actively engaged and how their engagement would make a difference in their health and health care. Many are also unprepared to be active in their care because they lack the basic building blocks of engagement (such as health literacy).

Partnerships are required.
Patient engagement is a shared responsibility that requires ongoing partnerships among different sets of stakeholders.

It's like the Wild West.
In part due to the depth and breadth of behaviors that represent engagement, no single strategy can boost engagement. Each stakeholder representative noted that they use a variety of interventions to encourage patient engagement. However, their efforts to promote engagement often lack a systematic approach to ground their investment of time and resources. Even so, informants called for all stakeholders to do more. 

The results of our study, which was supported in part by the Robert Wood Johnson Foundation, are summarized in the following report:

Here to Stay: What Health Care Leaders Say About Patient Engagement
Released June 30, 2014