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    Three ways health execs can tap into the powerful patient influencer network

    “Consumer engagement,” “patient engagement,” “patient activation”–these are all terms found quite often in today’s healthcare journal headlines. The premise is that, in order to improve the health of our nation’s citizens and lower the cost of care, patients (or healthcare consumers) need to be much more involved in their care. Thus, both the performance of specific behaviors relative to health—as well as one’s capacity and motivation to perform those behaviors—constitute the underpinnings of an engaged and activated patient.

    Behavioral change is complex and influenced by a number of factors, including one’s awareness of the need to change and the ability to make those changes. For example, most people know that they should eat more greens and fewer starches—but knowing and doing are very different things.

    When it comes to health, there are only one or two key motivators or influencers that can change a thought into an action. These people are called healthcare influencers. For some people, a physician or caregiver might play that role, but for most, there are key non-clinical individuals that ignite our change. In a 2011 Psychcentral.com article citing a global study, researchers discovered that after “themselves,” nearly half (43%) of respondents believe that their friends and family have the most impact on their lifestyle as it relates to health, and more than a third (36%) believe friends and family have the most impact on personal nutrition.

    Getting the patient involved

    The Institute for Healthcare Improvement (IHI) created the Triple Aim, a framework for Healthcare Improvement that describes an approach to optimizing health system performance. The key elements of the framework include improved patient experience, improved health of populations and lower cost per capita of healthcare. The new payment models and models of care strive to achieve this “triple aim.” However, in order to achieve the framework’s goals, the patient must become involved and take more control of their health.

    Historically, most healthcare consumers have not taken an active role in their health, as evidenced by the increasing prevalence of behavior-based, complex, chronic conditions such as type 2 diabetes. A recent report by the House of Lords in the UK highlights the lack of patient accountability in their own health and wellness, and cites this as a barrier to the long-term sustainability of the National Health System. To improve the outcomes and cost of our systems, more people will need to change behaviors to stay healthy, or if diagnosed with a disease or illness, take an active role in self-management of their disease. Moving from a system of healthcare to a system focused on health will require an enormous change in the behaviors and attitudes of our population.

    Identifying influencers who ignite change

    Each person has a different set of key influencers, and those might change over time. For some, it might be a family member or close friend, while for others it could be their religious leader, an influential public person (think Oprah) or even an on-line community. Two weeks ago, while at a conference, one of the speakers talked about his very ill child and some of the serious decisions he and his wife needed to make about the needed treatment. They had done all the research and made a decision to see a specialist at a top academic medical center to treat their child. A few weeks prior to their first visit to see the specialists, the wife engaged in an online support group with other parents of children with a similar chronic illness. The message from one of the parents in the group – do not use the doctor you selected, go to doctor “Y!” The consensus was that the treatment with doctor “Y” would be less invasive and would have better outcomes. The parents took the advice, changed to doctor “Y”, and their son’s health continued to improve to a point where he could regain most normal physical activities previously impossible.

    The point is that we hear anecdotes like this all the time. A physician friend and colleague recently noted that many patients have ended up in his office because the key influencers in their life encouraged, urged and even physically brought them to his office. While my father was alive, he was my mother’s influencer, motivator, and supporter as she battled cancer. My mother would not have been as compliant with her treatment plan had he not been there to encourage her.

    Next: Technology for patient engagement



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