Patient engagement

The change from paper to electronic health records (EHRs) can affect the way providers and patients communicate. Adopting EHRs provides more opportunities to exchange information with the patients and for them to take a more active role in their health care. It allows the spread of reliable information from the doctor in a world where the Internet can often direct patients to faulty information. It can allow for easier follow up with acute problems and more regular contact about chronic issues.

Meaningful Use Stage 2 has an increasing focus on patient engagement. Stage 2 measures require:

  • Using secure messaging to communicate with patients about health information
  • Providing clinical summaries for patients after each office visit
  • Providing patients the ability to view online, download and transmit their health information within 4 business days of the information being available
  • Identifying patient-specific educational resources and providing those materials to the patient
  • Using clinically relevant information to identify patients who should receive reminders for preventative/follow-up care

Patient portals

Most doctors adopting certified EHR technology to achieve Meaningful Use have access to patient portal technology, either included with the EHR or available as an add on. Patient portals vary, but most involve patients logging onto the portal through a website and being able to see certain information from their healthcare provider. In turn, they may be able to submit health information. Examples of commonly exchanged information include:

  • Visit summaries
  • Short messages either to or from the patient
  • Requests for an appointment
  • Requests for medication refills
  • Educational materials
  • Lab results

Exchanging patient information quickly and safely is a a good thing. It is often difficult for patients and providers to speak over the telephone because one party is unavailable and sensitive information cannot be left over voice mail. Many clinics are overwhelmed with calls and requests from patients. Certain questions can be resolved without a clinic visit. In these cases, patient portals can streamline practice workflows and improve patient engagement.

It is important to make sure information in the portal is patient friendly. Medical jargon should be removed from documents created by EHRs. Explanations should accompany exchanged information, such as lab results. Increased communication outside of clinic time needs to be included in doctor workflow, and many clinics and insurance companies are still deciding how to bill for these encounters.

Tips for communicating with patients

The government recommends the following standards for communicating with patients:

  • Limit the number of messages (preferably 2-3 main points); “need to know,” not “nice to know” information.
  • Use plain language (familiar, “living room” language; see; avoid jargon and technical language.
  • Use short sentences and active voice; avoid long sentences and passive voice.
  • Reading level should be 5th–6th grade, no higher than 8th grade.
  • “Chunk” information into meaningful sections with clear headings; use bulleted lists rather than large blocks of text.
  • Information should be relevant and timely; do not make assumptions about patient knowledge.
  • Focus on the actions or behaviors you want the patient to take, not medical facts.
  • Use Ask Me 3 (from the Partnership for Clear Health Communication) to help focus and structure information:
    • What is my main problem?
    • What do I need to do?
    • Why is it important for me to do this?