What is really meant by 'patient engagement'?

  A colleague of mine at Cambridge Management Group (cmg625.com),  senior adviser Marc Pierson, M.D., had some pithy things to say when  the Center for Advancing Health (CFAH) recently interviewed him and other health-reform experts.

Here are some of the remarks of Dr. Pierson, who is also retired vice president for clinical information and quality for PeaceHealth’s St. Joseph Medical Center, Bellingham, Wash.:

 

CFAH: ”Here is the CFAH definition of patient engagement: ‘Actions people take to support their health and benefit from their health care.’ What’s missing from this definition? What would you add, subtract or word differently?”

Dr. Pierson: ”….Defining {patient} engagement is very much the product of who is doing the defining. If from within health care, then the key question becomes for what or for whom is ‘patient’ engagement primarily intended to benefit?…I would prefer thinking of ‘people’ engaged in their health and health care. However, I do like that this definition recognizes that both health and health care require people’s active participation…Medical care is not the same as health. Health is much more than the lack of illness…We need to incorporate more perspectives from real people and ask them what they need to become more engaged with their medical conditions, their health, and their well-being.”

CFAH: ”If a person is engaged in their health and health care, what difference does that make? To whom?”

Dr. PIERSON: “Typically, engagement is defined by health care insiders as paying attention to what you are told to do and being compliant with ‘orders.’ The current non-system of health care plays into this by being disconnected and difficult for people to understand or navigate….

”Health care offers technology and knowledge but is set up for the people that work inside it, not for its clients’ ease, safety, or affordability. Payment for health care is based on professionals managing clients’ ill health, not on engaging with people to prevent illness, create well-being, or for self-care of illnesses and chronic conditions.

”People are scared of what they are not allowed to know or understand. They don’t want to be more dependent. They don’t want to end up going to an emergency room. Their primary relationships are with family, friends, neighborhood, and community — not professional service providers.”