Axial Exchange Inc. today debuted the Patient Engagement Index (PEI), a groundbreaking ranking of US hospitals based on the perspective of a hospital's patient community and how deeply those patients are engaged in their own care. The first such Index ranks the top hospitals in Florida – a state chosen because its demographics frame a bellwether for the rest of the nation - according to independent third party metrics on parameters that have been proven to lower costs and improve outcomes. Future indices for other US regions will debut throughout the coming months.
As patient satisfaction and engagement become important elements in payment reform, comprising 30% of Medicare’s newly enacted Value-Based Purchasing (VBP) program’s score, the Patient Engagement Index represents an important comparative measure. For hospitals, top quartile PEI ranking can spotlight patient-facing initiatives that are succeeding, while lower ranking can incentivize institutions to boost efforts at enlisting patients more fully in their own care. For patients, the PEI ranking can indicate those hospitals that are most likely to support them in their aftercare.
Patient engagement is the concept that patients take ownership of their own health care. Study after study show that patient engagement makes for higher quality care or enables lower system costs – or both. A Commonwealth Funds-supported study showed that patients with the highest engagement had significantly lower costs and that the least engaged patients in the study generated 21% more health costs. In another study, patients suffering from depression were given interactive engagement tools. These patients showed a 33% increase in antidepressant medication adherence, decreased overall depression scores, and a 61% increase in satisfaction with treatment.
Yet to date, major US rankings of healthcare systems such as that from US News and World Report do not include metrics of patient engagement.
The Patient Engagement Index ranks 74 major Florida hospital systems based on three metrics that research indicate can lower costs or improve outcomes:
- Personal health management (comprising 50% of score): based on an aggregate score for hospitals that provided any of the following: read-only Internet access to health information, mobile applications, or interactive tools for managing ongoing health. Studies show that hospitals that offer each of these types of personal health resources are more effective at reducing costs and improving outcomes than are hospitals that do not. For example, in one study, patients who received care from providers with whom they could share in decision-making showed a 12.5% reduction in hospital admissions as well as lower costs.
- Social media engagement (25% of score): based on a weighted score of hospital ratings on leading social media and consumer ratings sites. A recent study showed a correlation between Facebook likes and care quality and patient satisfaction, while another study showed that among hospitals with more than five Yelp ratings, there is a high correlation with lower readmission and mortality rates.
- Patient satisfaction (25% of score): as measured by an annual Centers for Medicare and Medicaid (CMS) patient satisfaction survey called the Hospital Consumer Assessment of Health Plans Survey (HCAHPS), a standardized instrument for measuring patients' perspectives on hospital care that has been endorsed by the National Quality Forum (NQF). According to one study, higher patient satisfaction via the HCAHPS survey is associated with improved guideline adherence and lower inpatient mortality rates.
Detailed methodology of the Patient Engagement Index is published here. All Florida hospitals were sent a letter informing them of their ranking, providing PEI methodology and links to the published data for consideration in their own initiatives toward Meaningful Use and heightened reimbursement levels.
"Patient engagement is important because management of chronic illnesses involves action by both patient and provider. Patients should feel empowered to be part of the medical plan, because research shows that active engagement can lead to improved outcomes and increased satisfaction,” said Paul Y. Takahashi, MD, Associate Professor of Medicine at the Mayo Clinic and a board advisor to Axial Exchange.
“Patient engagement matters to hospital success and to our nation as a whole,” said Joanne Rohde, CEO of Axial Exchange, a provider of health IT solutions that drive patient engagement and improved patient outcomes. “It’s time we put a stake in the ground that patient engagement is core to the quality of health care and the success, both financially and in terms of outcomes, of healthcare providers.”
“In an Internet era where rising deductibles are driving patients to closely examine health care choices – and where consumers rate physicians online like they do with restaurants and plumbers – we believe that publishing a quantitative measure such as a Patient Engagement Index can spotlight those forward-thinking healthcare systems that are succeeding in empowering patients to get well – and point the way for others.”
Joanne Rohde, CEO and Founder
Mary Kae Marinac, PR Representative for Axial Exchange
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