Measuring Patient Engagement

Patient engagement has one primary goal: to assist patients in making decisions about their health. This is the crux for all engagement, but there are three additional aims: 

1. To educate patients about their healthcare 
2. To improve care outcomes 
3. To reduce costs from inappropriate, ineffective, or repeat treatment 

These objectives are all connected, which helps healthcare organisations in their care evolution. Helping patients make better healthcare decisions is demonstrably improving care outcomes. An article from 2003 by Judith H Hibbard titled “Engaging health care consumers to improve the quality of care” states the following: “Engaging patients in collaborative care, shared decision-making with their providers, and chronic disease self-management have improved health outcomes and lead to increases functioning, reduces pain, and decreases costs.” Educating patients in addition to this is reducing readmission, but also avoiding unpopular treatment approaches. 

Patient engagement goals are often conflated with patient goals discovered during the engagement. These are also important, because a patient’s desire to achieve a goal is a strong form of patient activation, which leads in to better patient engagement.

Measuring patient engagement is done through a variety of methods. Patient engagement metrics include: 

• Surveys 
• Questionnaires 
• Interviews 
• Data analysis 

These patient engagement types are applied to the patient experience and patient feedback, but also the performance of emails sent out to patients, usage of the patient portal, and the overall activity of a patient within the healthcare system.  

These last three points fall under the data analysis umbrella. Healthcare software and email programs can be used to extrapolate data and statistics about performance, namely the rate of interaction between the patient and the document. For emails, this will typically entail the open rate of actually looking at the email, as well as the click through rate (CTR) should links be opened, and then perhaps the Report Spam numbers. For the patient portal it’s similar, but instead building up a pattern of how regularly a patient might log in, how long they stay logged in, how long within that period are they active, and which pages get their attention. 

As mentioned in our previous patient engagement blog, these measurements are then put against the core four tenets of patient engagement: 

• Control 
• Maintenance
• Informed
• Support 

Patient and family engagement measures must primarily be about giving the patient agency or control of their own care plan and ultimately their own wellbeing. The correct measures will also activate patient engagement, which gets the person onboard with their own proactive self-preservation. Education also plays a part; ensuring that a patient understands their health, their ailments, and the best channels to engage with healthcare professionals when they have questions or concerns. 

One of the staple strategies is using PDSA to measure patient engagement; plan, do, study, act. This is a guideline for both the engagement and then testing the engagement meets the four tenets.

This leads nicely into tools to measure patient engagement. Patient portals (personal logins for GP practices or hospitals) and email management software (such as Mailchimp or Salesforce) are patient engagement measurement tools.  

Another, dedicated solution is our very own Rio Mood Diary. There will be some differences when considering how nurse-patient engagement can be measured in mental health wards due to the often vulnerable nature of patients, but simple solutions such as Rio Mood Diary can help encourage engagement without inappropriately burdening the patient.  

Similarly, Rio Virtual Assistant is a chat messenger designed with a natural language processor to improve patient engagement, support appointment management, request a call back from the healthcare provider, or handle form filling. The interactions can be observed and managed on the back end, providing usage data that can be assessed to determine which functions are popular and what people want from the service. 

Many healthcare solution providers will offer electronic patient records and electronic health records, as well as patient management tools. Some of these will have options for patient engagement, but others will operate more for data purposes and evaluation of trends.  

It’s important for patient engagement tools to recognise privacy and data protection, but especially patient safety. The Patient Measure of Safety is a point-based assessment comprised of 30 or 10 key criteria to adhere to. 

PMOS30, alongside a Patient Incident Reporting Tool (PIRT), are additional assessment structures to engage with patients to get their take on the care or treatment they are receiving. The British Medical Journal has several articles that talk about the important of incorporating patient safety safeguarding measures into patient engagement tools, to ensure compliance with medical best practices, duties of care, and legal requirements from clinicians.

The final piece of the patient engagement measurement puzzle is to establish an action plan. This will draw on the patient data surveyed, as well as the recorded activity data, to highlight both positives and negatives. Whilst the positives are worth exploring, it’s the negatives that pose a risk to health and wellbeing, so that has to be the priority for a healthcare provider.  

Dia Global, as part of their Summer 2022 forum, cited seven key points for a patient engagement action plan: 

• Meaningful involvement of patients 
• Find and share examples of good practice and existing tools 
• Promote patient engagement training 
• Measure patient engagement to learn how to do it better 
• Agree on a common language and terminology for patient evidence 
• Collaborate on guidance to help sponsors understand what patient evidence to generate, and review tools to determine what process works best in which circumstance 
• Communicate on whether and how patient input and experience data have been or will be used in decision-making processes. 

An action plan or improvement plan will help a healthcare provider self-assess its own performance. Patient engagement requires patients to be involved, and measuring patient engagement seems obvious too, but not all trusts or providers are fully transitioned to the digital approach which can provide so much data. 

Instead we should focus on encouraging organisations to follow these simple but effective guidelines as they go through this transition and introduce new digital tools like the patient portals. This will have healthcare professionals all on the same page when it comes to expectations, and this will improve the patient experience through engagement, interaction, and new understanding of what’s working and what isn’t.