Tom Daschle (D - S.D.)
A report from the Bipartisan Policy Center's Health Project, led by former Senate majority leaders Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.), says that mobile health is a promising avenue for increasing patient engagement, which should be one of the major goals of health care reform. But barriers to mobile adoption and increased engagement include lack of awareness, lack of innovation, and privacy concerns. The BPC was founded by Daschle and other former Senate Majority Leaders Bob Dole (R- Kansas), Howard Baker (R-Tenn.), and George Mitchell (D-Maine) in 2007, and its mission is to "drive principled solutions through rigorous analysis, reasoned negotiation, and respectful dialogue."
The BPC Health Project highlighted patient engagement as a key goal in their January report "Transforming Healthcare: The Role of Health IT." By reviewing a wide range of available literature, they found that patients who are more directly involved in their health have less pain and faster recovery, are more adherent to doctors' treatment plans, and are less likely to choose elective surgeries.
In the latest report, entitled "Improving Quality and Reducing Costs in Health Care: Engaging Consumers Using Electronic Tools," the BPC looked at two categories of electronic tools, those that promote education and self-care, and those that enhance patient-physician communication. The first category includes online and app-based educational materials, trackers and health management apps, online support communities, and personal health records. The center noted that for many patient it's currently not easy to download data to a personal health record from a doctor's electronic health record system. In many cases, patients must instead input their health data manually, which is time consuming and introduces a lot of room for error into the system.
Among the tools in the second category -- those that help patients interact with the health care system -- the report listed patient access to EHRs, secure email, remote monitoring, and online tools for scheduling appointments and renewing prescriptions. The report says some physicians are slow on adopting these tools because patient interaction outside of office visits isn't covered under fee-for-service payment models, leaving providers uncompensated for electronic interactions. However, privacy concerns continue to be one of the largest barriers to adoption on both the physician and patient sides, according to the report.
At the end of the report, the center outlined some suggestions to the government for overcoming the barriers to adoption. Increasing awareness of electronic tools among both consumers and providers was one suggestion. The report also emphasized the need to develop and disseminate standards and best practices for adoption, especially in small clinics where the cost could be prohibitive.
"The federal government and the private sector should accelerate the development of principles, standards, policies, and strategies that guide the development, selection, dissemination, implementation, and use of electronic tools that promote engagement of patients and their families by providers," the report reads. "Approaches should be tailored toward intended populations—particularly those that are historically underserved."
Finally, the authors suggest increasing federal and private sector incentives for adopting electronic health tools, including continued support of mobile health by the Center for Medicare and Medicaid Innovation, public and private reimbursement for telemedicine services, and employer and private payer incentives for using electronic tools to manage wellness or chronic disease. A bill recently proposed by Congressman Mike Honda in the House also calls for a loan program to help smaller practices adopt patient-engagement technologies, not including EHRs.
