It has been almost 20 years since the Institute of Medicine report, “Crossing the Quality Chasm: A New Health System for the 21^st Century,” which set the stage for a patient-centered healthcare system. The report calls for a system that acknowledges, respects and responds to patient preferences, needs and values and allows for the patient to lead their own healthcare journey—to engage in their own care.

In the two decades since the report was published, there have been countless documents, reports, studies and surveys focused on the term “patient engagement.”

What is patient engagement? Some use it as a catch-all phrase that encompasses patient experience, patient activation, patient safety, shared decision making, patient portals and other healthcare technology as well as shared decision making. In its broadest form, it does include all of these components.

At the heart, though, patient engagement is focused on helping patients engage in their own care as a way to improve outcomes and reduce costs—both for the individual and for the healthcare system at large.

How did we get here?

For decades, patients deferred and demurred to healthcare providers. After all, physicians went to school and completed training in some cases for decades. Surely, they in collaboration with other healthcare providers, should be the ones to determine the best course of treatment for their patients.

As medicine and technology evolved, so too has our society and our ability to gather information—healthcare-related and otherwise. As people were able to access healthcare information more easily, they started realizing that their involvement could impact their health. Eating right, exercising and not smoking could greatly improve health, for example.

Still, there are patients who resist to engage in their own care and some experts say these are the patients we need to take an active role the most.

How can we encourage patient engagement?

There are strategies that can encourage or motivate patients to take an active role in their care. Some include:

• Make sure healthcare information is understandable. If patients don’t understand what is happening with their health, they won’t be able to get involved in their own care. Avoid jargon and acronyms. Use videos to explain or teach as appropriate. Some patients can learn by reading but others do better watching instructional information.
• Be specific. Giving general information such as, “Lose weight” or “Stop smoking” is easier said than done. Patients need concrete steps or instructions—“Limit carbs to X servings a day,” “Walk XXXXX number of steps daily,” “Try X medication to help curb nicotine cravings.”
• Collaborate, don’t dictate. Patients who take part in setting their goals are more likely to achieve them. Even if you don’t think you’re dictating, be aware that your tone can impact a patient’s listening and success.
• Follow up. Don’t expect patients to make changes overnight. They need support and encouragement. Set up systems for check ins by coaches, navigators or advocates, if possible. Use technology to facilitate check-ins but don’t expect the technology to take the place of a personal connection.
• Consider using social media or games to encourage participation in health-related challenges. When people feel like they are cared for and part of a larger community, they are more likely to participate.