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What is Patient Engagement?  Depends Who You Ask

By Dr. Betty Rabinowitz, MD FACP

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Even prior to the COVID-19 pandemic, patient engagement had become a central theme in the U.S. healthcare conversation. This was no coincidence as several forces had all impacted this trend.  Among these forces was the widespread implementation of patient-centered medical homes which at their core, focus on patient engagement as part of high-quality, cost-efficient care. 

Other factors are the advent of high deductible insurance plans that introduced patients as central “payers” in the healthcare system and the strong incentive of advanced payment models to secure stable, loyal, engaged, and attributed patient panels. The COVID-19 pandemic further accelerated this trend by highlighting practice’s significant vulnerability to patient volume decreases and the importance of patient loyalty and trust, as practices shifted to virtual care and the new realities of very different in-person care. 

Patient engagement is a broad term that has multiple connotations. Speak with a care team member, a nurse, care manager or physician about patient engagement and they will likely be referring to a broader concept that combines patient activation with interventions designed to promote positive patient behavior, such as obtaining preventive care or adhering to a medication regimen. Patient activation requires patients to have the skills, ability, and willingness to manage their own health and healthcare experience. 

On the other hand, speak to a healthcare business leader and patient engagement has much more to do with removing barriers to patient access and creating a practice environment with workflows and technology that fosters patient satisfaction and loyalty thus securing a given healthcare organization’s market share. 

Regardless which definition you embrace, Health Information Technology (HIT) plays a major role supporting and fostering multiple facets of patient engagement. Patient access and satisfaction are enhanced by providing contemporary full feature, integrated, patient engagement platforms (a long cry from early patient portals) which facilitate patient access and engagement by creating an enhanced, seamless, experience with all aspects of a patient’s interactions with the practice. Self-scheduling tools, document and form handling, payment, messaging and multi-modal communication are just a few examples of such supported interactions.    

When it comes to supporting the clinical aspects of patient engagement, HIT is playing an increasingly central role by supporting the activities of care management and chronic disease management. At its core, care management has a care model that espouses patient engagement and activation. For example, the ability to determine a patient’s level of health literacy is a crucial capability of contemporary care management tools. Health literacy impacts patient’s ability to seek, understand and utilize health information and to participate in decisions about their health. In spite of the central role that patient health literacy plays in patient engagement, all too often care teams proceed with providing patients complex care instructions without an assessment of their ability to engage with this information.

When one delves a little deeper into these definitions, it becomes clear that the administrative and clinical definitions of patient engagement are much less separate than they appear. In fact, they likely represent different aspects and reflections of a similar approach that places the patient squarely in the center of both the practice and the business of medicine. 


Dr. Betty Rabinowitz, MD FACP

Chief Medical Officer

Dr. Betty Rabinowitz was appointed as our chief medical officer on April 19, 2018. She brings to this position more than 25 years of extensive clinical experience and expansive knowledge of population health and value-based practice transformation. In her role, Betty is tasked with helping NextGen Healthcare promote and improve our solutions in support of our clients’ provider performance, clinical outcomes, patient satisfaction, and financial efficiency…

Dr. Betty Rabinowitz was appointed as our chief medical officer on April 19, 2018. She brings to this position more than 25 years of extensive clinical experience and expansive knowledge of population health and value-based practice transformation. In her role, Betty is tasked with helping NextGen Healthcare promote and improve our solutions in support of our clients’ provider performance, clinical outcomes, patient satisfaction, and financial efficiency.

Betty joined the NextGen Healthcare family in August 2017 as one of the founders and the former chief executive officer of EagleDream Health, the cloud-based analytics and population health management solutions we now know as NextGen® Population Health, which drives meaningful insights across clinical, financial, and administrative data to optimize ambulatory practice performance.

Born in Johannesburg, South Africa, Dr. Rabinowitz graduated from Ben-Gurion University Medical School in Israel, where she also completed a residency in Internal Medicine. She came to the United States in 1990 for a fellowship in Medicine and Psychiatry at the University of Rochester School of Medicine, where she became a professor of clinical medicine. In addition, Dr. Rabinowitz served as the medical director of the University of Rochester’s Center for Primary Care, overseeing clinical operations and population health management for the university’s large employed primary care network. In 2020, she was named on the list of the Top 25 Woman in Healthcare Software by the Healthcare Technology Report.

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