Patient engagement to become key in compliance efforts
Today, on the CareAnyware home health software blog, attorney and home care legal expert Elizabeth C. Hogue shares details about the concept of “patient engagement”. As the screws tighten and CMS looks to cut costs, healthcare providers, including post-acute care and home health, have a responsibility to work with patients in a manner that enables compliance with treatment plans, med adherence and symptom management.
It is clear that providers will be held responsible for patient compliance concerns — and that means complete documentation to describe the when, where and how regarding patient engagement. Now is a good time to consider these points and the tools your organization may need to address them, such as an EHR or home care software. This post on InformationWeek HealthCare highlights how technology can help.
What’s New? “Patient Engagement”
There is a new buzzword for healthcare providers: “patient engagement.” The application of this concept to relationships between patients and providers, including discharge planners, is becoming more prevalent. In the commentary to final regulations governing the establishment of accountable care organizations (ACO’s), for example, CMS responded to comments about the inability to control patients’ behaviors so that monies are saved, including for the benefit of participants in ACO’s. CMS responded to these comments by emphasizing that it is the responsibility of providers to “engage patients” so that patients follow their recommendations.
In 2011, the Center for Advancing Health (CFAH) published an “Engagement Behavior Framework.” Below are some of CFAH’s recommendations for patients that require involvement by providers:
– “Ask questions when explanations or next steps are not clear and express any concerns about recommendations or care experiences.
– Ensure that relevant medical information is conveyed between providers and institutions.
– Negotiate a treatment plan with provider(s).
– Learn about any newly prescribed medications and devices, including possible side effects or interactions with existing medications and devices.
– Monitor symptoms and conditions (e.g., for diabetes – monitor glucose regularly, check feet; for depression – medical medication and/or counseling and monitor symptoms; for hypertension – measure blood pressure regularly maintain blood pressure diary), including danger signs that require urgent attention.
– Set and act on priorities for changing behavior to optimize health and prevent disease.
– Identify and secure services that support changing behavior to maximize health and functioning and maintain those changes over time.
– Manage symptoms by following treatment plans, including diet, exercise and substance use agreed upon by them and their provider.
– If diagnosed with a chronic disease, understand the condition(s), the risks and benefits of treatment options and personal behavior change(s) by seeking opportunities to improve health/disease knowledge.”
This concept of “patient engagement” is not only increasingly important to payors, but is also significant from the perspective of risk management. When patients are non-compliant or not engaged, it is difficult to separate non-compliance from poor quality of care. Providers must take steps to get patients engaged and to document that they have done so. It is not enough for providers to simply throw up their hands and bemoan the fact that patients will not do what they recommend. It is the job of professionals to utilize their expertise to engage patients in a way that will likely support compliance.
Providers have a history of concerns about non-compliance or non-adherence by patients. The tendency has been for providers to complain that patients are non-compliant. It is clear that a different “wind” is starting to blow now. Providers must prepare to take on more responsibility for patient engagement, including involvement in all of the activities described above and more.
©2013 Elizabeth E. Hogue, Esq. All rights reserved.