Relationships are built on communication and engagement. To engage, you must communicate. To communicate, you must engage. In doctor-patient relationship, this is not a question of the “chicken or the egg.” 

They are both essential in a patient-centered care. The patient can be communicating but not really engaged in his healthcare, or can be engaged but not truly communicating.

As the healthcare system is evolving, it does, and will, require increasing clinical productivity, more involvement of the patient but with even less face-to-face time spent. Where efficiency is demanded, quality care is expected to increase. And that’s where the difference between patient engagement and patient communication comes in. 

In patient care, what does patient engagement do and what does patient communication deliver? Desired patient outcomes come from both. But here’s how the two concepts are connected but not interchangeable:

Patient Communication

It is important that patients are on the same page with their doctors in acknowledging/understanding their health problems, treatment options and medication plans. In healthcare, while it is physician led, it is still ultimately patient-centered. The question is whether the patient is treated as a passive vessel of health data or actively involved through their patient generated data. 

The Patient. What doctors communicate to the patients and how they do it will determine how patients will respond. Patients generally begin to communicate after physicians open that line between them. And when communication lines are free and open, then the relationship tends to begin.

How effectively the patient communicates is just as crucial as how doctor efficiently prompts these communications. It’s a patient’s right to ask and it is the doctor’s duty to respond and inform. Key is the need to get and keep that patient communicating.

There’s more to patient communication than just the sharing of medical history, and reporting of health conditions - mental, physical, or physiological. Patients who communicate openly to their doctors, tend to better understand their health problems, treatment options, modify their behavior accordingly, and follow their medication schedules.

But then again, there’s that need to get that patient communicating.

The Physician. Clinical outcomes depend in part on doctor-patient relationship. One of the key factors is the physicians’ ability to effectively and compassionately communicate what the patients need to know and when they need it.

How to effectively communicate to patients, both verbal and nonverbal, constitute an integral part of clinical practice. Communication skills are being taught in medical schools. According to the Journal of the American Osteopathic Association, various accreditation settings objectively evaluate the training in patient-physician communication as a core competency.

Communication is not only conveying information about diagnosis and therapy options to the patients. The dynamics and methods involved in that communication influence patient outcomes such as emotional health, symptom resolution, function, pain control, and physiologic measures. It is not to be feared by the physician, but when looking to improving outcomes, patient communication should be embraced.

"Most physicians will recognize that these encounters also involve the patient's search for a psychosocial healing “connexion,” or therapeutic relationship.” - Journal of the American Osteopathic Association

Patient Engagement

If communication is a relationship starter, engagement is a patient commitment breeder. In healthcare, a patient’s greater engagement contributes to improved health outcomes. This engagement makes partners out of patients to be involved in their healthcare and have better outcomes.

According to the World Health Organization, patient engagement is about meaningful collaboration. It is increasingly recognized as an integral part of healthcare and a critical component of safe people-centred services. “Resources may be better used if they are aligned with patients’ priorities and this is critical for the sustainability of health systems worldwide,” read WHO’s technical paper on patient engagement in primary care.

Engaged patients tend to work with their healthcare providers closely to improve health. They are better able to make informed decisions about their care options.  WHO also believes that patient engagement promotes mutual accountability and understanding between patients and health care providers.

When patients are engaged in monitoring and updating their medication or treatment plans, they become proactive in that they better understand what is involved in minimizing harm in their own care. This increases treatment concordance, greatly improves the quality and safety of care, and preserves the trust between clinicians and patients. 

But patients can only be truly engaged if they are empowered. This happens when “patients have sufficient information about their health conditions and about health care systems and processes so that they can be a knowledgeable partner in decision making.” WHO sees patient engagement as a promising avenue in the area of health care education.

And because the patients’ care, in many cases, generally include their families, extended family, peers, social workers etc  (all being the Community of Care), engagement should extend to them as well. Engaging patients’ Community of Care is equally important because of the added value of collective support to the patient in terms of treatment adherence, monitoring, and even part of the intervention where necessary.

The added value when patient information and education is shared with the Community of Care is the collective awareness of their health needs and to seek health care in a timely manner. Patient engagement that also involves their Community of Care, adds an element of care that can be compassionate, quality assured and, above all, safe. 

And where engagement extends to patients , the Community, health care providers and policy-makers need to ensure that there is access to accurate, appropriate and up-to-date information and understand how to use this information. The on-boarding of these groups as part of the care team, will better enable health care providers to involve them in intervention protocols, if needed.

Patient engagement in this level where there is a collaboration of many stakeholders, will need relevant tools that will keep the care team in one communication loop. Communication platforms and engagement technologies can support patient communication, but these need to be tied to innovative tools promote patient engagement.

WHO takes a position that the adoption of electronic tools will be critical to improving safety in many ways. It improves the quality of healthcare, and enhances patient experience. 

For patients, communication and engagement with the health care providers do not end when they leave the clinic. It must continue as health issues do not start/stop at the providers door, it is 24/7/365 in their day to day life. So successful communication/engagement must be available and do so as well when needed. And when it does, the communication platform that will enable patient communication, and deepen patient engagement must be personalized for the needs of the patient and Provider. 

A communication platform such as provided by LifeWIRE has been very successful in improving engagement and thereby outcomes. Technology can be used as a key adjunct to treatment but ultimately it is understanding how that technology should be used, what is being communicated and with whom where the technology allows for all the nuance associated with engagement  . #BeLifeWIREd