4 reasons patients aren't managing their care

It's no secret successful healthcare only works with well-engaged patients. But, whether it's a lack of useable technology or unproven theories, recent research has shown patients are still not interested in managing their care. 

Steve Krupa, managing member at healthcare investment firm PSILOS, outlines four reasons why patients aren't managing their healthcare.  

1. Patient engagement theories haven't been proven. According to Krupa, being able to engage patients is a largely unproven theory. "And the second piece [is that] health plans will be able to reduce their costs and improve the usability of care that’s out there,” he said.  “Generally, this idea has been proven difficult because, what we’ve found through research is, a majority of patients don’t have interest in being engaged.” Instead, Krupa continued, patients remain unmotivated. He added although social media can be enticing, it’s only a small part of the patient engagement pie. “It’s dealing with a small percentage of the population who do care, in the same way people are engaged in their fitness,” he said. “And that’s a small portion of the population. In general, people tend to avoid managing their healthcare.”

2. A framework needs to be established. First and foremost, said Krupa, a framework needs to be established to engage patients, even, he argued, before technology. “What we know for certain is, if things are left the way they are, it’s going to be difficult to engage patients in the management of their health,” he said. “And principally, the way things are with regard to insurance, is most people get it from their employer and most don’t realize how much of their salary goes into paying for insurance,” he said. Instead, patients only respond to the financial aspects of care after service is delivered. “They don’t know how much it’s going to cost, but with an insurance card, they know in some way, shape, or form, it’s covered by insurance,” he said. “And until that part of the system changes, it’s going to be difficult to engage patients.”

[See also: Patients want more engagement with doctors.]

3. The market is changing. “One of the unintended consequences of health reform is consumers are actually going to begin to actively engage in the market of buying health insurance for themselves,” said Krupa. Since health reform was designed, essentially, to make healthcare affordable for all, “we’re going to be heading there quickly,” he said. “Instead of your employers providing you with insurance, they’ll give you the money to go out and buy it yourself.” And that’s when a lot of these value-based ideas will become more prominent, since once the consumer starts paying the bill, they’ll feel as if it’s their money.  “And people talk about the health insurance exchange world,” added Krupa. “In reality, there will be an environment of guaranteed health insurance—anyone who wants to, can. It’ll be a price-controlled environment, where companies are better off from their bottom line perspective.” 

4. Technology needs to support patient engagement. When thinking about the transition into more patient-centered technology, Krupa said that’s the last part of the puzzle. And he added the most beneficial technologies will be those similar to those found in the financial services sector. “I can transfer money to my savings account, pay credit card bills, etc.,” he said. “I have all that information available to me, as a consumer, pretty much in real time. If you want me to be engaged in my healthcare, even if I wanted to, it’s not there yet.” The first thing, he said, companies should consider is real time data availability, so not only can the consumers access the information, but also the providers. “And brand new enterprise solutions for those companies,” he said. “New investments on their part in the market place. Once that’s being done partially, you can begin engaging consumers through care management practices, where nurses who work with health plan use care management workflow software to program care plans and manage compliance.” Lastly, Krupa looked to current IT trends in the healthcare space and said the transition to better patient engagement is the most important thing. “A lot of the conversation is what is the mobile phone going to do for healthcare, and I would argue it wouldn’t matter that much,” he said.  “It isn’t going to make a big difference until all these issues are dealt with.” 

Follow Michelle McNickle on Twitter, @Michelle_writes

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