Patient engagement: medical paternalism is over

'You need to be in practice for about five minutes before you realize the evidenced-based fact that patients who are more engaged do better'
By Eric Wicklund
08:06 AM
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University of California-San Francisco

Despite all the buzz surrounding the phrase, the concept of patient engagement is not new. Rather, physicians have been engaging the people they treat for some time. What has changed, however, are the technologies available to take that relationship into a new phase. 

"The era of paternalism in medicine is over," said Seth Bokser, MD, medical director of IT at the University of California-San Francisco's Women's Hospital and Benioff Children's Hospital. "Patients are full partners in their care, and we are using technology to help bridge education and communication gaps."

Bokser will delve into that topic during his presentation "Health 2.0 for Women and Children – Opportunities and Challenges" at the HIMSS and Healthcare IT News Patient Engagement Summit

Whereas Bokser said that previous generations of patient engagement encompassed clinician-facing technologies that were instrumental in making healthcare safer as well as more consistent and efficient, today's incarnation is all about tools that enable patients. 

[Learn more: Meet the speakers at the Patient Engagement Summit.] 

"Many of the young women and children I work with on a daily basis are digital natives. They use, and have always used, IT to empower themselves in new ways, whether it's information about their food on Yelp and OpenTable or the ability to order ground transportation on Uber or Lyft," Bokser explained. "They want to use technology to make their healthcare better – more convenient and more effective."

When he hands patients a Windows tablet with the Oneview program on it, for instance, many adults politely wait for instructions – but kids start touching icons right away and figure it out quickly enough.

Which is not to say that patient engagement is a distant future state waiting for those digital natives to grow up or one without obstacles. Privacy and personalization are atop Bokser's list. Privacy because parents and children share almost everything and that gets particularly thorny when adolescents reach the age at which they can legally consent for their own care independent of parents. And personalization because every patient's needs can be composes of various pieces, including literacy level, language, income, and other resources.

On the provider side, many are still working to determine which technologies are effective to not only engage but also activate patients, Bokser said, as well as how to incorporate those tools into their daily workflows.

Bokser envisions new models of reimbursement really accelerating these changes on both the and provider sides. 

"You need to be in practice for about five minutes before you realize the evidenced-based fact that patients who are more engaged and activated, on average, do better," Bokser said. "The most activated patients have better outcomes and lower costs and are more satisfied. Most providers know that from experience." 

Register for the Patient Engagement Summit here. The event takes place Oct. 12-13 at the Manchester Grand Hyatt in San Diego. 

Related Patient Engagement Summit articles: 

Patient engagement advice? Expect irrationality

Patient engagement tips from the pros 

Docs need to make patient engagement a priority