Patient Engagement – the next big thing in healthcare

British Journal of Healthcare Computing

[This interview is part of the BJ-HC Vox Pop: ]

Up to now, it′s been psychologically difficult for patients to say what they want. And threatening for healthcare professionals, even when they do, to take this on board. But now that everyone has a public, but anonymous voice, this is free to change, says Dr Paul Hodgkin, CEO of Patient Opinion, the UK′s leading patient feedback site for the NHS.

How would you define the term ‘patient engagement′ – and what potential does it hold for you within the UK′s healthcare system?
‘Engagement′ is a funny word, isn′t it? Is that engagement as in marriage? Gears? Battle? None are very apt. If engagement means anything, then for me it′s about the fact that everyone in the 21st century (with a smartphone or better) has a public voice. Anyone can blog or tweet or comment on Facebook. This is the end of the patient engagement ghetto - anyone can now get stuck in and every voice matters!

US healthcare IT specialist Leonard Kish has referred to patient engagement as ‘the blockbuster drug of the century′, for its potential to improve the quality of care and lower costs. In what ways do you agree with his assessment?
I think Kish is right – the person with the greatest incentive to get great care to Bed 7 is the person lying in Bed 7. It′s just that up to now it has been psychologically difficult for people in their pyjamas to say what they want. And too threatening (again, psychologically) for healthcare providers to be open to this. So no-one has made any use of this, the last great free resource in healthcare. Now that everyone has a public, but anonymous voice, this can change.

Do you think that technology can play a role in enabling successful patient engagement?
The ‘hard to reach groups′ in this new world are not patients but managers. So the real question is ‘how can technology play a role to help managers engage successfully with what patients are already saying about them?′ There are lots of ways that technology can help. For example Patient Opinion makes it clear how many staff in a variety of organisations have opened one of our automatic email alerts. Making the readership of every story visible increases the pressure on everyone concerned, both to listen and to respond well.

Can you give any examples of where patient involvement strategies are really working to improve patient care?
I think there are lots. Take the most recent story on the Patient Opinion site, for example: ‘Lucy′ has written in on behalf of her friend, who had a difficult experience during an MRI scan at one of the hospitals, due to mild claustrophobia – and has recommendations to make. Just a few hours later, the Assistant Director of Nursing and Care Quality at the hospital has already picked up the comment and passed it on to the relevant department to make changes. And there are many other such cases being reported all the time here.

Does the dynamic between doctors and patients for example need to shift for true engagement and involvement to take place? If so, how can this be accomplished?
Yes, but that will only happen when healthcare professionals see the need. This depends on ensuring large volumes of feedback. One way to do this is to mandate things like the ‘friends and family test ′, for instance, introduced by the DH and being piloted in some NHS trusts. But this is still treating patients as ‘feedback generators′ rather than active participants in their own care. Patient Opinion′s proposed solution is to work with television programmes (Channel 4′s ‘One Born Every Minute′, for example, would be ideal) and to encourage people to share their own stories – and so get into public conversation with local staff from providers, clinical commissioning groups and so forth. Not only would this lead to many service improvements, it also converts viewers into active citizens and would give the NHS free access to an industrial volume of stories.