Patient Engagement Index Methodology

 

What is Patient Engagement?

Patient engagement is the process by which patients become invested in their own health. Health systems with effective patient engagement programs provide patients with the information and tools needed to take control of their care. From Meaningful Use to Accountable Care Organizations, patient engagement is a key feature of payment reform. Achieving excellence in clinical outcomes is dependent upon superior patient engagement. 

 

Why a Patient Engagement Index?

For 23 years, US News and World Report has produced its popular hospital rankings, but Axial has confirmed the US News rankings don’t include patient satisfaction.  Why does it matter what patients think about hospitals? Because patients are consumers.  Over the last 15 years, consumers have begun to rely on each other for advice for everything from restaurants and hotels to lawyers and professors. Consumerization in healthcare is driven not only by the transparency brought about by the internet, but also by rising deductibles and a boom in patient engagement. Finally, patient enagement is increasingly at the center of health reform as highlighted by the recently released Patient Engagement Framework from ONC and the eHealth Collaborative. 

 

Methodology

I. Personal health management (max 50 points):

 

Definition:

Health systems support personal health management by providing patients with information and tools needed for self care such as patient portals and electronic libraries of health content. Maximum points are awarded to health systems that not only offer electronic access to patient health records, but also provide resources needed for the day-to-day management of disease. The best health systems offered these tools via the device of the patient's choice: desktop, tablet, and mobile. This information was gathered from publicly available websites and mobile applications.

 

Rationale:

Resources for health management are the cornerstone of patient engagement. How can patients engage in their health care without the information to understand what is going on with their health and the tools to manage progress against health goals?

 

Supporting Research:

Simon, G.E. et al., “Randomized Trial of Depression Follow-Up Care by Online Messaging,” Journal of General Internal Medicine, July 2011: 26 (7) 698-704.

Hibbard, J.H, Greene, J. and Overton, V., “Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores,’” Health Affairs, Feb 2013: 32 (2):216-222.

Karman, K.L. et al., “Patient and Family Engagement: A Framework for Understanding The Elements and Developing Interventions and Policies,” Health Affairs, February 2012: 32 (2), 222-231.

 

II. Patient satisfaction (max 25 points):

 

Definition:

This category is based on response from public patient satisfaction data collected by Centers for Medicare and Medicaid (CMS) that is available at www.medicare.gov/hospitalcompare.  The survey is called the Hospital Consumer Assessment of Health Plans Survey (HCAHPS). The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care.  The points awarded in this category are directly driven by HCAHPS performance.

 

Rationale:

In May 2005, the National Quality Forum (NQF), an organization established to standardize health care quality measurement and reporting, formally endorsed HCAHPS. The NQF endorsement represents the consensus of many health care providers, consumer groups, professional associations, purchasers, federal agencies, and research and quality organizations. According to one study, higher patient satisfaction via the HCAHPS survey is associated with improved guideline adherence and lower inpatient mortality rates.

 

Supporting Research:

Glickman SW, Boulding W, Manary M et al. "Patient satisfaction and its relationship with clinical quality and inpatient mortality in acute myocardial infarction," Circ Cardovasc Qual Outcomes 2010;3:188–95. 

Boulding, W., Glickman, S.W., Schulman, K.A., and Staelin, R., “Relationship Between Patient Satisfaction With Inpatient Care and Hospital Readmission Within 30 Days,” American Journal of Managed Care, 2011 Jan: 17 (1): 41-48. 

 

III. Social media engagement (max 25 points):

 

Definition:

Social engagement is the the extent to which health systems engage with their communities via social networking channels. Maximum points are awarded to health systems that not only have a social media presence, but also have engaged a relatively large audience that expresses positive sentiment towards the health system.

 

Rationale:

Two recent studies have underscored the importance of hospital’s social media engagement with overall patient satisfaction and quality. Commercial websites that post consumer ratings of businesses are popular.  Yelp.com is in the top 50 most popular websites in the USA. By contrast, only 6% of Americans have heard of the US Centers for Medicaid and Medicare Services’ (CMS) national hospital public reporting website, hospitalcompare.hhs.gov. According to one study, among hospitals with more than five Yelp ratings, there is a high correlation with lower readmission and mortality rates. A similar study showed a positive correlation between Facebook likes and care quality and patient satisfaction. 

 

Supporting Research:

Bardach, N.S., et al., “The Relationship Between Commercial Website Ratings and Traditional Hospital Performance Measures in the USA,” BMJ Quality & Safety, 2013. 2-“194-202 doi:10.1136/bmjqs-2012-001360 

Boulding, W., Glickman, S.W., Schulman, K.A., and Staelin, R., “Relationship Between Patient Satisfaction With Inpatient Care and Hospital Readmission Within 30 Days,” American Journal of Managed Care, 2011 Jan: 17 (1): 41-48. 

Timian, A. and Kachnowski, S., “Do Patients ‘Like’ Good Care? Measuring Hospital Quality via Facebook,” American Journal of Medical Quality, February 2013, 10.1177/1062860612474839