Expanding Patient Engagement Overseas

By David Wright, Senior VP, Government Services, GetWellNetwork
Twitter: @GetWellNetwork

An effective approach to patient engagement must consider not only the patient’s condition, but their demographics, health literacy, support system, family structure, personal goals and “capacity to engage.” Since a successful strategy involves a complex mix of medical and cultural understanding of the patient, the idea of expanding patient engagement best practices to countries with different social, religious and family culture may seem daunting.

But the reality is that there are many universal tenets of effective patient engagement that can easily be exported and replicated, even to cultures that are far different from our own. We know that many elements of patient care are universal and extend beyond geographic and cultural boundaries. Things like person engagement, access to information, and patient education are core concepts that pertain to any demographic around the world. Improved person engagement through technology is applicable regardless of market.

The convergence of global health trends
While different parts of the world have very different health care systems, in addition to divergent cultures, there are a few themes that remain consistent.

  1. The need to reduce costs — Whether a foreign country has a health care system that is paid for exclusively by the government or whether they have a hybrid system, as in the US, where costs are borne by both public and private payers, costs are becoming increasingly unsustainable.
  2. The growing burden of disease — Lifestyle factors are driving the burden of disease. While a handful of countries—such as those in Scandinavia—are known for their health-conscious populations, many countries find growing disease epidemics due to poor diet, smoking and inactivity or lack of exercise. As developing countries become more industrialized, their burden of disease related to lifestyle factors and the cost to care for populations is predicted to grow.
  3. The link between a healthy workforce and healthy economy — An expanding number of countries now recognize that they cannot grow their economy without a healthy workforce. Many governments have core goals to improve population health to increase productivity and healthy longevity, especially as the population ages.

These unifying themes provide a great foundation for U.S.-based patient engagement solution providers to branch out to international markets.

Case study: Patient engagement in Saudi Arabia
Saudi Arabia has an advanced, patient-centered health care system that is focused on improving population health. While most hospitals are government owned, there are a growing number of private facilities. The population is young, but due to limited exercise, rich diet and high rates of smoking, the government is concerned about the growth of diseases such as Type 2 diabetes, cardiovascular and lung disease. These high-cost chronic conditions may need to be treated for decades if developed early, so Saudi Arabia has a critical interest in preventing and/or managing these conditions aggressively.

Patients travel from throughout the region to visit some of Saudi Arabia’s premier hospitals and healthcare systems. With differences in cultural norms and religious beliefs particularly related to women, one might assume that these norms would influence a different and corresponding restriction on how health care is accessed, delivered and decisions made. On the contrary, there are more similarities than there are differences. The respect for individual decision making within the healthcare sphere is widespread and in fact, there is significant freedom in choosing and accessing health care as needed. There are practices and systems in place to accommodate religious norms while allowing for individual decision making regarding health care choices and care management plans. For example, the prohibition on women driving in Saudi Arabia does not impact their ability to set their own schedules or have decision-making freedom when it comes to health care choices and services used because it is common for women to have a driver. Despite living a very different lifestyle from Americans, Saudi Arabians may have an excellent capacity to engage in their own care. This capacity will differ from patient to patient, but is supported by a forward-thinking government.

For Saudi Arabia, many of the health care improvement goals are similar to those in the United States. For instance, there is a similar recognition that engaged patients are healthier patients. Saudi Arabia has also made significant investments in health care devices and technology, and want to extend their benefit beyond the providers to the patients.

Extending the value of technology
Premier hospitals in Saudi Arabia have made significant investments in the latest technologies and medical devices to serve their patients. Many of these technologies are designed for use by clinicians to improve processes, advance quality and safety and better leverage data for clinical decision support. As here in the U.S., however, international hospital leaders are eager to extend the value of these technologies to patients as well. Increasingly, these hospitals are investing in patient facing, interactive care technology solutions as a means to leverage clinical data to customize care plans based on what is known about the patient, or engage the patient in better safety practices or trigger automated interventions at the right time for the patient resulting in greater workflow efficiency. In short, interactive patient care technology brings the value of these advanced clinical technologies right to the patient. For example, using an RFID remote tracking technology system interfaced with the patient’s TV monitor, the patient receives a prompt when a staff member enters their room identifying who they are and their role. With additional integration with the hand cleansing devices, the patient may also be prompted to remind the staff member to wash their hands if they have not done so within 30 seconds of entering the room. These simple uses of advanced technologies serve to engage the patient in safety management and result in significant improvements in hospital safety performance.

Customizing for the locale
Patient engagement technology is also being deployed in Saudi Arabia to bridge the language barrier between patients, 95 percent of whom speak only Arabic, and the vast majority of caregivers are from outside the Middle East and don’t speak Arabic. It’s key for technology solutions to be able to support multiple languages, and to be able to easily toggle between languages, to smooth communications and deepen opportunities for engagement. In some areas, both literacy levels may be uneven, creating an opportunity for video-based education.

The Takeaway
If we are serious about our mission to engage patients to improve outcomes and lower costs, then our efforts should not stop at the U.S. border. Many countries, whether industrialized or developing, are serious about pursuing a better patient experience at a sustainable cost, and using patient engagement technology to reach that goal. These patient engagement solutions can be used to glean more value from high cost medical technology, and they can also be used to bridge language and cultural divides that may exist in countries with large expat/immigrant communities.

Patient engagement efforts can also help hospitals and health systems overseas to distinguish themselves in increasingly competitive environments. Overall, extending American-style patient engagement approaches to countries that welcome it should be a win-win for both patients and the healthcare organizations that serve them.