The Evidence Base for Consumer Engagement ROI

“Consumer engagement” is a complex concept, encompassing consumers’ willingness and ability to engage in their own care, as well as to contribute in various ways to help make health care more responsive to patient needs.[1] One widelyaccepted definition of consumer engagement is “patients and health care providers working together to promote and support active patient and public involvement in health and healthcare and to strengthen their influence on healthcare decisions, at both the individual and collective levels.”[2]

Consumers have a unique and valuable perspective on the health care system. A growing focus of consumer engagement is recognizing the role of consumers as equal partners in their care. The Institute of Medicine has identified consumer engagement as an essential component in improving health care quality.[3] Growing evidence suggests consumers who are more engaged in their own care have better health outcomes and incur lower overall costs.[4] However, in the complex modern health care environment, consumers, especially those with chronic conditions, may struggle to understand and manage all the aspects of their care. This holds especially true if a consumer’s care involves multiple providers and multiple treatments. Health literacy is a notable barrier to consumer engagement. At the same time, many providers, facing limited time and increased expectations, struggle to provide their patients adequate information and guidance.

Models of consumer engagement range from direct care, to organizational design, to policy making. Under the direct care model, consumersreceive information about a condition and answer questions about their preferences for treatment. Within organizational design and governance, health care organizations seek consumer input to ensure care is as responsive as possible to consumers’ needs. Finally, consumers engaged in policy-making are involved in the decisions communities make about policies, laws, and regulations in public health and health care.

Although consumer engagement has garnered increased interest in recent years, wider acceptance and implementation of consumer engagement strategies and interventions is hampered by a lack of evidence of its cost-effectiveness.[5] Research in other fields illustrates the value of engaging customers in product design, quality improvement, and governance. In the health care arena, strategies for enhancing patient self-management and creating patient-provider partnerships have been shown to improve outcomes for people with arthritis, asthma, heart disease, lung disease, stroke, diabetes, hypertension, and breast cancer.[6],[7]

Apart from costs savings, engaging consumers offers other benefits, such as improved patient experience survey scores and greater staff satisfaction. Medical practices or communities that have embraced patient engagement often speak of the impact in terms of a “culture change.” While the effects of culture change can be far-reaching, they also prove particularly difficult to quantify. Because engaging with consumers can be timeconsuming and resourceintensive, the ability to articulate the specific benefits of consumer engagement is important to advancing the field and increasing patient-centered care model uptake.

[1]Carman, Kristin L., Pam Dardess, Maureen Maurer, Shoshanna Sofaer, Karen Adams, Christine Bechtel, and Jennifer Sweeney.(2013) "Patient and Family Engagement: A Framework for Understanding the Elements and Developing Interventions and Policies." Health Affairs 32(2):223-31.

[2]Coulter, A. (2011) Engaging Patients in Healthcare. New York: McGraw-Hill Education, p. 10.

[3]Institute of Medicine.(2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press.

[4] "Health Policy Brief: Patient Engagement," Health Affairs, February 14, 2013.

[5]Roseman, D., J. Osborne-Stafsnes, C. H. Amy, S. Boslaugh, and K. Slate-Miller.(2013) “Early Lessons from Four 'Aligning Forces for Quality' Communities Bolster the Case for Patient-Centered Care. Health Affairs (Millwood) 32(2):232–241.

[6]Consumer Focus Collaboration.(2001). The Evidence Supporting Consumer Participation in Health. Canberra, New South Wales: Commonwealth Department of Health and Aged Care.

[7] Hibbard, J. H. (2003). “Engaging Health Care Consumers to Improve the Quality of Care.”Med Care 41(1):I61–70.