As our country takes on the paradigm shift from fee-for-service to value-based care, we have come to see the phrase patient engagement over and over again.
Conceptually, the phrase seems refreshing because for many years the physician has taken the driver’s seat; therefore, putting the patient in the rear seat in the car of their own healthcare decisions.
In truth, however, there seems to be some confusion as to what patient engagement truly means.
The Center for Medicare and Medicaid Services (CMS) has adopted the idea of patient engagement and has placed it right at the heart of value-based medicine via a patient survey. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) is the CMS patient experience survey, which is the best source of patient-reported data available today.
So how does the government define patient engagement anyway?
They use the phrase “shared decision making” in one of the survey questions, which may sound foreign, but at the root of it comes an entirely new way of practicing medicine. By asking the question, “did your physician partake in shared decision making?,” we are forcing physicians to allow patients to have a voice in clinical decisions so as to take ownership of their healthcare, therefore creating greater overall perceived satisfaction.
The next question that arises is, “as a physician, how do I engage the patient enough to make these shared decisions?”
The answer has many parts, but to start, how about conducting the annual wellness visit (AWV)? This free Medicare benefit offers a comprehensive face-to-face visit covering topics from depression to family history to fall risk and beyond; not to mention it pays physicians at a higher compensation than a standard visit. The AWV is not comprised of entirely yes/no questions, which lends itself to discussion and adds depth to a patient’s records. Additionally, the AWV creates the foundation for a care plan, which is the perfect environment for the physician to provide clinically relevant guidelines for the patient to use in deciding what form they’d like their care to take.
Whether it is by means of the AWV or asking the patient “what questions do you have?” rather than “do you have any questions?,” the patient engagement must become a top priority, because value-based medicine is making head way, physicians are taking on more and more financial risk, and it is all in an effort to ultimately support the patient.