One Size Doesn’t Fit All: The Challenges of Patient Engagement Across the Generations

patient engagement

Patient engagement is a tremendously important task for healthcare organizations—it improves patient satisfaction, patient safety and quality of care, and even has financial benefits.

“If we successfully address patient needs, then their clinical outcomes will be better,” says Vinitia Mathews, Ph.D., director of Patient Experience for LifePoint Health.

But improving patient engagement can be enormously challenging, she adds. Patients’ health literacy, their fears and their lack of knowledge about how the healthcare system works are among the biggest obstacles.

While patients of all ages have some things in common—such as wanting to be well and pay the least amount possible for healthcare—some experts believe each generation approaches the healthcare system with different attitudes and mindsets.

A Shift in the Overall View of Patient Engagement

Physicians’ attitudes toward patient engagement have shifted significantly over the past decade or two, Mathews notes. In the past, they approached patients from the vantage point of all-knowing experts as if to say: “We are going to make you feel better. We are going to heal you. We know what is best for you clinically.” Today, however, patients and their families are welcomed into the healthcare decision-making process as partners. Research from the New England Journal of Medicine (NEJM) and other sources demonstrate that when patients understand what is happening, and why, and are encouraged to participate in their own healing process, their health outcomes improve.

In May, NEJM’s Catalyst blog published the results of the first NEJM Catalyst Insights Council survey on patient engagement. An analysis of the results suggested that, while patient engagement does indeed produce better outcomes, better tools are needed to make that happen.

“This is a rapidly evolving field, and what is regarded as ineffective today—such as remote monitoring devices—may be viewed very differently in the future as new technologies and service models emerge,” wrote survey authors Kevin Volpp, M.D., Ph.D., and Namita Mohta, M.D.

Experts suggest that organizations reconsider how to reach patients and take generational characteristics into account to boost engagement.

A Snapshot: Four Major Generations

Because organizations may be caring for people from multiple generations at any given time, it’s helpful to understand some general and differentiating characteristics:

Silent Generation, or Traditionalists. Born before 1946, people from this generation tend to be deferential to physician authority. They’re also among the highest users of healthcare, along with some baby boomers.

Baby Boomers. Baby boomers—born between 1946 and 1964—are known to prefer individual engagement during their healthcare system experiences. They like interacting with their providers and value their opinions, but also want to do some of their own research.

Generation X. Born between 1964 and 1980, Gen Xers are willing to assume their providers are knowledgeable, but also tend to actively pursue more information about their own health, according to a presentation on generational patient engagement at the Healthcare Information and Management Systems Society 2016 summit. They tend to have more in common with millennials than they do with baby boomers.

Millennials. Members of this generation were born between 1981 and 2000. They’re often referred to as “digital natives” for their tech-savvy natures. They like to use technology as part of their healthcare experience, and they value efficiency and convenience. Right now, they tend to be the lowest utilizers of traditional healthcare.

habitsMillennials_chart

Because of these generational differences, it can be difficult for organizations to reach patients using a one-size-fits-all approach. Healthcare providers that instead tailor communications to particular audiences are often rewarded with greater patient satisfaction.

Cam Marston, author of Generational Insights and founder of a consulting firm of the same name, explains that the different ways of viewing the healthcare system must be taken into account. What works with older patients is not likely to appeal to younger ones.

“The doctor of an elderly patient needs to say, ‘Here is what I think …’ at the end of the appointment,” he says. “The doctor of the younger patient needs to say, ‘Tell me what you think’ at the beginning of the appointment.”

Likewise, Marston adds, “The organization that advertises itself by saying ‘100 years of combined experience’ will not effectively target youth.” Organizations that tout “connected healthcare” will get their attention.

Connected healthcare can refer to everything from wearable fitness trackers to the ability to email providers with simple healthcare questions. Providers need to understand what drives their patients toward better health so that they can adapt and provide more individualized care. Wearables are one example of a technology that “underscores that the requirements for personal health are to be connected with providers and payers,” especially as usage of wearable technology will double over the next few years, according to Linda McCracken, senior principal of Provider Consumer Engagement at Accenture, in a 2015 interview with Hospitals and Health Networks (H&HN).

Taking a Good Look

askbeforebuysing_chartMany healthcare systems are finding they need to better identify the patients they serve and make sure staff understand their specific needs and language. HCA is looking at the generational issue on a variety of levels, according to Lyn Ketelson, MBA, RN, vice president and chief patient experience officer. In addition to age or generation, sometimes it makes sense to refine engagement strategies based on criteria such as diagnosis or cultural diversity.

LifePoint uses the TeachBack method to ensure patients understand the care they are receiving, and what to do once they get home from the hospital or doctor’s office.

“Patients don’t intentionally disregard medical advice, but they may not fully comply with a treatment plan if they don’t clearly understand it,” Mathews notes. “LifePoint’s patient-centered approach focuses on meeting patients where they are, ensuring they understand their role in the care process, and empowering them to be advocates for their own health.”

McCracken also points to the aging boomer generation as one area of significant change for healthcare organizations. “We’re not going to have a docile senior population in another 10 or 15 years,” she told H&HN. “They will argue with absolutely every caregiver, and it’s going to be much more exhausting” for healthcare providers.