The fact that healthcare delivery, compared to other industries in the United States, is behind the times when it comes to digital advancements is certainly not breaking news. Nowadays, the healthcare industry is trying desperately to, or being forced to, catch up and employ more digital programs in order to meet the needs of patients and their families. Patient access has been at the core of these advancements. In select health systems today patients are now able to search for providers and book appointments via digital means, making it easy and convenient for their patients to see their providers. These self-service capabilities have revolutionized patient empowerment, giving them more freedom to be active participants in their healthcare, but a key to maximizing their impact is involving patients in the development phase.

A recent survey of 1,000 healthcare consumers showed that patients are increasingly choosing providers and services based on convenience. The survey found that 50% of consumers who prefer to book online would actually switch providers for the ability to do so. However, the data also showed that patient ratings and reviews are increasing in importance—the share of patients considering them extremely important rose from 26% to 32% from 2017 to 2018—and that clinical expertise is the number two factor in provider selection, second only to insurance accepted. Thus, patients are not sacrificing their desire for healthcare quality when making decisions about where to receive care.

Getting patients into a system and meeting with a provider is only the first step though. Long-term patient retention and positive patient engagement ultimately leads to healthier patients and drives patient loyalty. Industries outside of healthcare have quickly adapted to digital engagement strategies for consumer retention over the past several years. It would have been difficult to imagine that simple things like shopping, travelling, communicating, and engaging with businesses would be totally transformed by digital programs a few short years ago, but today this is a reality. Advances in other industries have certainly helped move the healthcare agenda along. According to the Pew Research Center, in 2011 only 35% of Americans owned smartphones, but that number increased to 77% in 2018 and computer tablet ownership increased from only 3% in 2010 to 53% in 2018. The rapid expansion of these technological platforms has set the stage for the advancement of healthcare digitization.

Today digital programs are being deployed to patients and families to manage chronic illness and avoid unnecessary hospitalizations, to help patients and families manage self-care at independent living, to promote preventative health to a variety of populations, to reduce health service utilization through remote monitoring, to give patients access to their own data through apps, and to support healthcare treatment and maintenance in a multitude of other ways. Digital health application options are seemingly endless, which makes creating a meaningful and sustainable digital strategic plan for any health system a significant challenge. However, health systems can leverage the voices of patients and their family members to help them develop an impactful strategy—one that will not only attract patients to the system, but also help keep them engaged and loyal.

The Institute for Patient and Family Centered Care has been leading the movement to promote empowering and collaborating relationships with patients and families for almost 30 years. Their work is centered around four core concepts of Patient and Family Centered Care: Dignity and respect, information sharing, participation and collaboration. These are important to consider when developing plans for digital innovation within a health system when the end goal is improving the overall care and outcomes of the patients they serve. Purposefully involving patient and family advisors in the development of digital strategy and selection of modalities will help boost digital utilization and engagement. As opposed to when they participate in one-time focus groups, when advisors are involved in decision-making about how health systems create services, policies, and operations, they have a vested interest in helping improve healthcare in their communities and in the overall success of the organization.

Using the introduction of a new cardiovascular app as an example, below are some steps healthcare leaders can take to include patients and their families in that process.

Identifying patients and families

Leaders spearheading digital initiatives should begin by exploring the current structures that may exist within their health system related to the involvement of patient and family advisors. When applicable, engaging the person responsible for patient experience will provide some helpful insight into current structures in place along with advice on how to best engage either a formal Patient and Family Advisory Council (PFAC) or, in the absence of a PFAC, how to engage patients and families from the cardiovascular clinic where patients will be exposed to the app.

Collaborating with patients and families

Leaders of the new initiative should involve patients and family advisors in all discussions, when possible, around it. They should treat them like any other member of the team involved in developing the plan. Team members will quickly come to appreciate their commitment to improving care and their truly unique perspectives that comes only from having real experiences with the organization. Leaders could focus on the following sample questions for the advisors to help shape the plan:

● Do you think patients will embrace the app?
● Is there anything about the functionality that would prevent a patient from using it?
● What do you think about the digital presentation of the app?
● What is the best way to introduce new patients to the opportunity to use the app?
● What are the barriers to patient adoption?
● Do you think the app will improve the care of patients?
● Do you think the app will make it easier for patients to manage their health?
● Would you use the app to manage your cardiovascular care?
● Is there anything else we are not considering that could impact patients if we deploy this app?

Deploying the app

After the planning phase is complete, continued involvement of the patient and family advisors could prove beneficial. In some cases within organizations who have engaged PFAC members, they have found it helpful to continue to work with them to help with deployment and adoption by:
● Leveraging advisors as ambassadors not only for patient engagement, but also for healthcare professional engagement around use of the app. Having patient to patient conversations about the benefits of the technology can be impactful, as well as having patients speak directly to leery providers related to the app’s value.
● Engaging PFAC members to help with evaluation of the deployment by serving as “secret shoppers” in the areas where it is deployed or by having conversations with users in waiting rooms. Patients typically feel more comfortable giving their honest feedback to fellow patients than to employees of the organization.
● Identifying barriers to patient and family adoption of the app. Advisor and user connections could help surface common barriers such as lack of awareness of the option, lack of understanding of the value in health management, perceived impersonalization of care, or lack of access to technology.
Healthcare technology leaders nationwide are currently or will soon be grappling with the challenges around deploying meaningful technological programs that effectively attract patients to the system but, even more importantly, retain those patients and support their clinical outcomes. Engaging patients and family members as advisors in the planning, deployment, and evaluation processes around digital initiatives can play a powerful role in helping health systems develop solutions that both serve the needs of patients in new ways and stand the test of time—ultimately driving a better patient experience and long-term patient retention within the health system.

Karen Conley is senior director, clinical services for Kyruus.

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