Patient engagement has a name and a place


On the road to understanding the logistics and effectiveness of the patient-centered medical home, it was only natural that I stop by Mid-State Health Center — New Hampshire’s PCMH and ACO success story that just happens to be located in a scenic town called Plymouth. It was not lost on me how most eminent things usually start in places called Plymouth.

From care negotiations with area hospitals to never-ending discussions across healthcare specialties (with most caretaker types practicing in the same building, this is easier than ever) Mid-Staters know what to talk about and how to talk about it. Thus, there was plenty to say when Bill Sweeney, Mid-State’s Chief Financial Officer, and Sharon Beaty, the Mid-State CEO, broached the topic of patient engagement during my visit.

As with all deliverers, Mid-State acknowledges its struggles with getting patients to take active roles in their care. It’s an ongoing battle, both Sweeney and Beaty said, but one that cannot be pushed to the fringes, especially given the current climate in care.

“We’ve done the patient-centered medical home, we’re part of a primary care/accountable care organization, we’re a pretty progressive practice,” Beaty said. “What we all believe is that where the rubber’s going to meet the road now is in getting the patients involved, getting the patient engaged and keeping them engaged. We’re trying different things to do that and it’s an experiment. We still have to see what works.”

To that aim, Mid-State has some impressive programs worth the grant funding and the extra effort to employ in any type of practice. Maybe the most compelling embodiment of patient engagement consciousness comes in the form of a PEAT (Patient Expert Advisory Team) team for Mid-State, a small committee of patients gathered to relay with unwavering honesty their perceptions and opinions regarding the care they receive.

PEAT takes many forms and implores various degrees of criticism, Sweeney and Beaty noted.

“They meet monthly and will critique our systems and say ‘This is what I experienced that didn’t feel good’ or ‘ Have you thought about doing this?’ And they’ve had some fabulous ideas, from little miniscule things about how signage is or how the building works to how our team interacts with them. They critiqued our brochure and re-worked that. They’re very supportive and engaged about telling us what patients want from their perspective,” Beaty explained.

Sweeney added that PEAT repeatedly rotates its members to ensure that the insights remain fresh and diverse. Although Mid-State was afforded the opportunity to establish PEAT via a Harvard Pilgrim innovations grant, applying for similar opportunities is relatively straightforward. Moreover, practices without such opportunities can utilize a survey system to relay interest in the patient community perspective. Just allowing the option can oftentimes be enough to let your patients know you care what they think and therein, enhance patient engagement.

Mid-State has also incorporated a Communications Committee, comprised of at least one representative from each profession type within the facility, to discuss not only employee concerns, but concerns of the patient as well. Even though these groups provide ample information regarding how the facility can improve its processes from the inside, Sweeney and Beaty still urged that a more patient-run program be implemented alongside.  

“It’s easy for us to sit here and pontificate, but what matters is what they really want,” Beaty concluded.

And what most patients really want is to be heard.