Improving services through greater digital engagement with patients

When Andrea Tait thinks of patient engagement, she thinks of the next frontier of healthcare digital transformation.

“A lot of healthcare systems and healthcare providers have worked for a long time on electronic health records – so getting information to clinicians to help better inform clinicians as they treat patients,” says Ms Tait, vice president of client value at healthcare technology company Orion Health.

“But what we haven’t done, especially in single-payer systems, is as much around patient engagement in the digital health sense.”

Ms Tait is based in Canada, where in one province work is already underway to change that. The aim is to introduce a “digital front door” for patients. This is a platform designed to bring new and existing patient engagement technologies together in a single user-friendly hub. It’s centred on an aim to make the majority of initial patient interactions with healthcare services digital.

It’s a goal familiar to the English NHS via the long-term plan. That document committed the service to offering a “digital first” option for most and for digital-first primary care to be in place by 2023-24.

Uniform strategy

Of course, that was before the pandemic hit. More services than ever before offer virtual means of consultation. But for Ms Tait, the trick now is for healthcare to unite all its patient-facing digital capacity in one uniform strategy.

“I think certainly components of what we call the digital front door have been accelerated by the pandemic, like the telehealth and video conference component,” she says. “And what we always say is: ‘Don’t rip and replace everything, use what you have.’ That way you get to leverage the adoption that already exists around video conferencing, but bring it together in a digital front door strategy so that you get the best of both worlds.”

“A patient engagement set of tools is not just software. It’s a strategy and it’s a set of tools that support that strategy for the long-term”

In the current Canadian province project, the plan is to unite a few different elements. Key among them will be a symptom checker which, when appropriate, directs a patient to a nursing call centre for further advice.

According to Mary Lou Ackerman – vice president of innovation and digital health at Canadian not-for-profit enterprise SE Health – that sort of approach is one which has become increasingly familiar since March 2020. The organisation focuses on delivering care closer to home, and she says the means of meeting that mission has transformed during the pandemic.

“It has been a humongous challenge in so many ways. But at the same time, it’s been a huge opportunity to modernise how healthcare’s been delivered. For years we’ve been trying to offer virtual care to our clients but there was never the appetite to change the mechanism of care delivery, nor the funding models, to support ongoing virtual care.

“I think that the concept of intelligent risk-taking has really been grounded now in the pandemic simply because we’ve had to just do it. The right information to inform decisions, actions to mitigate risk and then the confidence to take that step, is changing how healthcare delivery is happening.

According to Ms Tait, the digital front door concept espoused by Orion Health aims to build that “right information”. “We actually pair our digital front door with a full machine learning and analytics platform, and we do that so we can make good evidence-based decisions about the kinds of things to do next,” she says.

Were the symptom checker showing a high level of mental health need in a particular area, for instance, then additional targeted services could be commissioned.

“The analytics and the evidence will drive that decision-making around priorities,” says Ms Tait. “We think an important part of these solutions is to ensure that we pair that artificial intelligence and analytics platform with those tools so that we can continue to be informed by good decision-making.

“A patient engagement set of tools is not just software,” she emphasises. “It’s a strategy and it’s a set of tools that support that strategy for the long-term. Digital front door and full patient engagement strategies can take years to fully implement, so you want to tier the way you approach it.”

Ultimately, Ms Tait argues, developing a cohesive approach to digital patient tools yields multiple benefits. That’s in part because healthcare systems can operate more efficiently, and clinicians intervene at the times that make most difference, but also because of increased patient satisfaction.

“When we survey patients post- a digital front door encounter – asking them ‘What was your experience? Do you feel that you are better informed to engage with your clinicians on tracking your care, or providing input to your care? Do you better understand steps? Did you feel that services were more available to you in this method?’ – over 90 per cent of the time, those responses are favourable.

“The overwhelming response is that this experience improves patient engagement, and patient reported outcomes. They feel better supported by the healthcare system. They feel better in control of whatever their experience is, whether that’s chronic or episodic.”