Mayo Clinic is struggling like everyone else to meet the Stage 2 thresholds for engaging patients. The health system has had a patient portal online for more than three years and has 240,000 patients signed up for online accounts. But getting 5 percent of patients to use online services to view, download or transmit their information is tough, said Eric Manley, Mayo’s product manager of global business solutions, during a presentation at HIMSS13 in New Orleans.

“We have the information online and available, but when we start looking at the numbers in terms of patient engagement, we realized we weren’t hitting that 5 percent,” he said. “Making online services available just doesn’t cut it.”

The problem, Manley said, is that patients want to engage the health system online, but the health system hasn’t been meeting them there. Patients who e-mailed a practice typically got a phone call instead of an electronic reply; clinicians considered the phone to be their first option to communicate with a patient--even if they had that patient’s e-mail address--and a secure message a second or even third option. “We’ve learned that secure messaging has to be part of the practice, not something that was considered when other options didn’t work.”

Mayo also has learned, via patient surveys and other studies, when not to try to engage patients.

Like check-in: Mayo used to ask patients to sign up for online accounts during check-in, but since it didn’t actually improve the check-in process or provide any other value at that point to the patient, it didn’t work. In fact, asking them to register for an online account at check-in and during certain other points during a patient encounter just made patients mad, Manley said. Posters, handouts and other advertising touting the benefits of using Mayo’s online and mobile apps proved equally ineffective, he added.

What has worked, and increased patient engagement significantly, is putting online services in context, Manley said. For example, when patients are getting labs drawn, they’re now told they can get the results immediately—Mayo sends test results to patients when the results come back, with no delay—if they sign up for a patient account. When a patient calls in to make an appointment, they’re told they can do that online and save themselves the headache of playing phone tag. When patients come in for follow-up visits, they’re told they could have exchanged online messages with the physician instead of taking time off work, driving to the doctor’s office and finding parking.

“When we’re talking about the patient portal and mobile apps amongst our staff, we know what can be done with them and what the advantages are—but our patients didn’t know that, because we never put it in context so they could understand how so many interactions can be done electronically,” Manley said. “Patients don’t want to come into a doctor’s office unless they have to—they want to get the information they need about their health and digest it where and when is best for them. That is really what engagement is—putting people in charge of the information not only for themselves but in many cases their kids, their elderly parents and other family members.”


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