Research Article - Journal of Experimental Stroke & Translational Medicine (2021) Volume 13, Issue 2

How patient engagement has evolved in the last 10 years

Asif Rashid* , Mutaharra Ijaz

Executive Management, WellWink LLC, Hackensack, United States

*Author for correspondence: Asif Rashid, Executive Management, WellWink LLC, Hackensack, United States, E-mail: asif.


Due to the evolution in technology since the last decade, healthcare dynamics have also changed which has led towards a great impact on patient engagement. Affordable Care Act (ACA) also known as Obama Care has been a great initiative taken by the government. However, (ACA) mainly benefited healthcare providers and not the patients. A successful healthcare implementation depends on the involvement of both patients and providers. As patient awareness increases, the requirement for valuebased healthcare follows suit. Keeping patients healthy and engaged through transparent care proves to provide higher outcomes with a proactive approach, rather than a reactive one. Thus, it’s important to focus on the areas in which patients are lacking to have control over their own health. Patients deserve to be actively involved in their healthcare and have better outcomes, resulting in lower costs. By providing them with appropriate tools and engaging with their own healthcare, patients can get the most value clinically and financially..

Keywords: Patient Engagement, Affordable Care Act, Electronic Medical Records, Electronic Health Records, Disease Management, Patient Portal


Affordable Care Act (ACA) 2010 was aimed to provide affordable health insurance coverage for all US citizens. The Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS) issued regulations for EHR use and EHR certification.

To encourage successful implementation of EMR throughout the nation, Incentive programs were proposed by federal government. Healthcare providers meeting federal requirements for EMRs can get up to $44,000 through the Medicare Electronic Health Records Incentive Program.

In 2008, only 17 percent of physicians were using advanced electronic health records and just 9 percent of hospitals had adopted electronic health records [1]. Electronic medical records made practices physicians’ offices more efficient by making patients medical history available to any healthcare provider treating them.

However, the implementation of EMR only benefited healthcare providers and no system was created to support patient engagement. It’s not wrong to state this was a physician’s orientated approach, thus leaving patient underpowered regarding their own healthcare.

Requirements for Patient Engagement

Patient engagement is the involvement of patients, families, and caregivers in improving health care and health care safety [2]. Patients have very little access to information and knowledge that can help them engage in their own care. Ideally patients should have shared knowledge and a hassle-free flow of

information. Therefore, they need access to information from their healthcare providers’ EHRs, such as their diagnoses, medications, lab test results, visit summaries, allergies and other findings. The key towards a continuous healing relationship is a healthy twoway interaction between patients and their healthcare providers. Patient and family engagement also appeals to principles of equity, by recognizing patients as valued partners in developing safer health care systems [3]. Patients should be able to send instant information to their doctors and receive advice, reminders, and alerts from them. Such seamless information could prevent deterioration in a serious condition or eliminate an unnecessary visit. Healthcare providers to be successful in chronic disease management must strongly employ patient engagement strategies.

A successful EHR system should include continuous healing relationships between physicians and patients in order to help patients stay active and participate in their own care, which is currently lacking. Promotion of patient engagement in an EHR system is still unexplored. In this era of patient-centered care, EMR and EHR systems should be efficacious in order to involve patients and in their own health care leading towards a transparent transition of medical care. No comprehensive and standardized patient relationship platform is available which can complement and extend any EHR and PMS system to provide real-time communication with patient using various easy to use integrated methods. Despite having many certified EHR vendors available in the market and ONC Certification Criteria, there is a need for a centralized body to come up with a manifest for patient relationship management technology on similar grounds like EHR.

Feature set should include but not limited to:

Online appointment booking for an office visit and video consultation

An online appointment booking is one of the best convenient tools as patients just need to visit the online portal to book an office visit or video consultation. Patients’ satisfaction with appointment booking is influenced by their ability to book at the right time with the right health service providers [4]. For an office visit, patients don’t have to go to the medical centers and wait for long hours for their turn to come. In the case of video consultation, the patient can speak to a doctor or healthcare professional using the video camera on mobile, tablet, or computer. This saves plenty of time as the patient wouldn’t need to travel for a face-to-face appointment. Online appointment booking is a great convenience to make appointments and decide the time which is suitable for the patient.

Patient Portal

Patient Portal gives patients higher access to their own health data including medical records, lab results, physician notes, health histories, discharge summaries, and immunizations. It tends to be an essential part of patient engagement, since portals are evolving and are beyond a one-way street where patients can also access their data. Communication is a key element of any relationship. Through the patient portal, patients are able to connect with their healthcare providers. This type of bi-directional messaging between patient and provider accelerates patient satisfaction and patient engagement. Studies examining secure messaging specifically are limited. One large-scale study found that the majority of patients used secure messaging and felt it was helpful in managing their care [5]Patients engaged in an ongoing conversation with their healthcare provider are more likely to take ownership over their own wellness, helping educate patients and make them more informed regarding their future care.

Patient Communication

By providing healthcare consultancy via video conference and using other communication tools on a smartphone or a computer, accelerates healthcare to patients in innovative ways while extending the meaning of patient engagement. Therefore, the usage of automated multiple channels to communicate with patient is necessary, allowing patients to interact with physicians in ways that they weren’t able to before. “With respect to engagement, I think the task for us as a healthcare system is really to think about what barriers exist for patients to get the type of care they need and how to remove those barriers.” [6].

Integration with PMS/HER

When PMS and EHR systems are not integrated, information may be duplicated or might be missed out which can lead to error. Therefore, updating information in one system will automatically update information in the other system when systems are integrated, thus eliminating the risk of duplication error and maximizing the value of each system. PMS can help direct daily functions while EHR handles the essentials of storing essential patient information. Electronic health records (EHRs) can help facilitate this exchange of information and support clinical activities that have the potential to improve care quality and reduce costs [7].

Integration of PMS and EMR with Patient Engagement Tools is vital for Patient Satisfaction as less valuable time is spent on administrative duties allowing you to devote more of your day to patient care. When patient satisfaction improves, it will lead towards better Patient Engagement and receive positive feedback which may bring in a higher number of patients who want to receive the best care around. Hence, more patients mean more growth and larger revenue.

Other features include Instant messaging via build in messenger, Text Message, and via third party messaging services, unified patient portal, Patient master index, provider master index, Preventative care, Disease management, Health maintenance alerts, Appointment and recall reminders, Mediation adherence, Care plans, Health summary transmission, Patient centric mass outreach via email and Text, Registered providers and medical center listing, Patient online reviews, integration with social media for effective outreach, Remote patient monitoring and other care programs, mHealth, Patient education, Patient health support tools etc. .


Having patient-centered requirements and standards, ultimate beneficiary of certified PRM should go to the patient; therefore, the system should tend to improve physician‐patient and all other caregivers communicating with patient as well instead of supporting only physicians, leading towards a standardized patient engagement system for an aggregated oversight of their care. No one cares more about the quality of healthcare than patients and families. What this convening has shown is that patients are ready, willing, and able to be partners with healthcare professionals to achieve better quality both in our personal care and in the improvement of healthcare [8].

By pursuing and executing these tactics, caregivers can begin to educate and provide health foresight to their patients, allowing them to make smarter and timely decisions that have the best return for their health. When patients make informed decisions about their own health, it results in easier access to care and better health outcomes driving health costs down. This is how the Obama care Law succeeds, focusing on preventative care and utilizing patient engagement initiatives to improve outcomes. A centralized body like ONC should be formed to provide with requirements for the standardization of patient engagement system.


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