Speakers:
Kathy Galia: Chief Clinical Solutions Officer, Paradigm
Tom Schenk, MD: Chief Medical Officer, Paradigm
David Lupinsky: VP, Clinical Product Solutions, Paradigm

There is growing evidence that patients who feel engaged, supported, and educated are more likely to be invested in their care and reach superior clinical and functional outcomes. This has led to increased efforts to drive patient engagement and activation through solutions ranging from expanded health literacy to improving the overall patient experience. With the ongoing integration of technology into health systems, there is also a growing conversation around the role that innovations such as health tracking apps, telemedicine, and medical decision apps can and should play in the sphere of patient engagement.

In a webinar held on Thursday, June 29, clinical and product solutions experts from Paradigm explored this critical topic and its impact on healthcare and workers’ compensation. The panel discussed the fundamentals of patient engagement, workers’ compensation-specific barriers, and specific strategies to increase knowledge around the care process. Highlighting the difference that proactive and technology-assisted patient engagement practices can make were two case studies with patients who achieved improved outcomes with the help of human-focused patient activation and education.

What is patient engagement?
After introducing the speakers, Kathy Galia, Chief Clinical Solutions Officer, turned the discussion to Chief Medical Officer, Tom Schenk, MD, who provided an overview of the concept of patient engagement and its history. Dr. Schenk defined patient engagement as the desire and capability to actively participate in individualized, cooperative care to maximize or improve the care experience. He also discussed the parts of a successful patient engagement strategy and how they impact overall experience, including:

• Health literacy
• Shared decision-making
• Real-time health information exchange
• Patient experience
• Patient activation and empowerment

Finally, he talked about the modern development of patient-centered care, the emergence of patient engagement, and the growing body of evidence showing that engaged patients with a positive attitude about their care were more likely to report better outcomes.

Barriers in workers’ compensation
Kathy returned to discuss workers’ compensation-specific barriers to patient engagement. Common obstacles to engagement encountered by injured workers are the absence of support and resources, lack of understanding about the workers’ compensation system, inadequate access to information, gaps in treatment coordination, inconsistent provider quality, and challenges to data accuracy.

In regard to patient-generated data, Kathy noted the importance of a balance between patient empowerment and accuracy. While patient-generated data, such as health or fitness tracking, is used much more frequently and can empower patients to own their care, there can be concerns around the reliability of self-reported or self-tracking data. This is particularly true if treating providers are using this data to make treatment decisions or recommendations.

Patient engagement strategies
David Lupinsky, Vice President of Clinical Product Solutions covered some of the specific strategies to counter these barriers and increase engagement in workers’ compensation patients. David emphasized that technology can be an important aspect of patient engagement as long as the fundamentals are present. He stressed that despite the growing popularity of technology in healthcare, patients don’t always want an app specifically—instead, multimodal communication including email, texting, web interfaces, and phone calls can be the most effective method.

According to David, an important fundamental idea in engaging injured workers is the extent to which they feel in control of their treatment. Patients in workers’ compensation who feel that care is something that happens to them, or who become cure-seeking because of an overestimation of the role of physicians can be more likely to have poor outcomes. To improve engagement, it’s important to focus on ensuring patients know the benefits of taking an active role in their recovery process early on.

HERO MSK^SM engagement app and case study
In an example of human-focused patient engagement strategies working together with technology, David provided the case of a worker with a shoulder injury requiring surgery. Although this would typically be a routine case, several factors complicated the recovery for the patient, including a strained employer relationship, a history of depression, and substance abuse. Through a combination of proactive engagement combined with the ability of the HERO MSK patient engagement application to identify risk factors and barriers to recovery, the patient was able to successfully manage return to work and achieve maximum medical improvement 130 days sooner than ODG guidelines.

Welvie surgical decision app and case study
Dr. Schenk followed with a look at medical decision applications and how they drive increased patient literacy and informed treatment. Specifically, the Welvie My Surgery^SM app helps patients with a six-step curriculum for elective, preference-sensitive surgeries that ultimately helps to eliminate inappropriate procedures and optimize surgeries that are appropriate. He provided the case study of a 50-year-old man with multiple comorbidities who was experiencing lower back pain and self-referred to a surgeon. Through the use of the Welvie app, he increased his overall health literacy and was able to undergo surgery on an informed basis and with a greater understanding of surrounding lifestyle factors that affect recovery.

In reviewing a long-term study of patient experience and outcomes for Welvie users, Dr. Schenk described how participants decided to have fewer surgeries because they understood the risk. For those who had surgery they had faster recovery times, fewer complications, a lower ER visit rate, and lower rehospitalization. He also discussed how patient decision-making does not have to be reliant on technology either, with a significant portion of participants using offline, paper-based methods.

Use of emerging technology in patient engagement
David came back to talk about emerging technologies and their role in patient engagement, including:

• Telehealth
• Remote Monitoring
• VR Therapy

Benefits of emerging technology include expanding access to providers, helping patients feel more informed and empowered with their health, and changing the medium of care to increase patient comfort.

Q&A and Webinar resources
At the end of the session, Kathy posed questions to David and Dr. Schenk on the best patient engagement strategies to start with and how to ensure and verify that any patient engagement materials are being used.

Download a replay of the webinar and view the presentation slides here. To learn more about upcoming webinars and receive invites, please visit the Paradigm website.