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Patient Engagement During the COVID-19 Pandemic
By Anil Patil

Patient engagement was never as critical for chronically ill individuals—especially high-risk and high-utilizer patients—as it is during the COVID-19 outbreak. The entire health care world has shifted its focus from patient care to COVID-19 care, which has negatively impacted the health of those who are the most vulnerable.

Because the health care system is overwhelmed, the pandemic has also affected medication adherence and behavioral health for those with chronic and life-threatening medical conditions. What’s needed is a health care system with a more integrated patient engagement approach to close the gaps in care delivery and improve care responsiveness among vulnerable populations.

The pandemic has adversely impacted health care delivery and provision. Missed appointments and lack of adherence to medication have risen exponentially. Children are missing their regular pediatric visits and vaccinations; according to the Centers for Disease Control and Prevention, vaccination rates have fallen almost by 50% during the pandemic. This gives an indication of how serious the issue is and calls for immediate attention to keep our future generation healthy. Furthermore, hospitals have witnessed a noticeable drop in the number of patients seeking non-COVID-19 care due to a widespread fear of the virus.

The risk of contracting the virus has instilled fear, particularly in those with chronic conditions, because they are at higher risk. Another contributing factor is a sense of selflessness for limited health care resources. Most people prefer staying at home to free these valuable resources for COVID-19 patients because “they need it most.”

Social distancing measures are leading to chronically sick individuals missing crucial doctor’s appointments, health scans, follow-ups, and medication refills. Many patients have gone on survival mode, and going for doctor’s appointments and prescription fills have become luxuries. As a result, chronic conditions will manifest with increasing complications that will be hard and expensive to treat. Skipping appointments and medication leads to deterioration of health, making individuals miss the signals of significant health problems.

During the pandemic, many early strokes and heart attacks will go unnoticed, increasing the risk of fatal ones in the future. Consequently, the cost of health care will increase.

A Game Plan
Tailored patient engagement approaches, alongside the use of available technologies such as predictive analytics and telehealth, can mitigate these health care risks. The relationship between patients and health care entities has become extremely critical during these times. The new era of social distancing has accentuated the need for health care providers to engage patients, mainly through technology.

This engagement can build a strong bridge between health consumers and providers by encouraging active participation in the management of chronic and critical diseases. Through constant communication with health care providers, patients will feel empowered to take charge of their health. It can also help in collecting data to predict potential health events that can lead to hospitalizations. Engagement with patients who are already exposed to the virus or at risk can help reduce anxiety and the aggravation of symptoms.

Technology is at the heart of patient engagement. Health care providers can reach out to proactively and support their efforts to maintain health in these trying times. They can engage in virtual consultations and follow-ups through texting, phone and video calls, e-mails, social media, Skype, or Zoom. Through video teleconferencing, physicians can instruct patients on what to do, monitor their physical conditions, and recommend treatment. Notably, teleconferencing cannot replace face-to-face appointments, but it will help keep patients engaged and allow doctors to evaluate the overall well-being of their patients and advise them accordingly.

Technology provides avenues to monitor vital signs. With COVID, keeping an eye on one’s temperature and vitals has become paramount. This practice is particularly critical among high-risk patients who have had recent exposure to the COVID-19 virus. Telehealth can provide virtual instructions on how to monitor vital signs without seeing doctors. Through digital platforms, health care providers can ensure patients receive the right medical devices, learn how to use them, and chart the results correctly. They can then observe the trends virtually to identify potential risk indicators and direct the patient on appropriate measures to take. Doctors can also track the outcomes of recommended approaches to determine which are working.

Isolation and social distancing have made gatherings close to impossible and very risky; consequently, mental health has been significantly affected. As a result, many people, particularly those classified as high risk, are holed up in their homes with minimal interaction with others, resulting in widespread cases of depression and anxiety. With interactive video conferencing, mental health providers can help reduce the psychological effects of loneliness and improve behavioral health. Doctors can also check up on their patients to reassure them and dispel unnecessary anxieties about their health.

Other Benefits
Telehealth can encourage patients to participate actively in managing their chronic conditions and adhere to treatment. It empowers them with the knowledge and skills required to take charge of their well-being. For these patients, monitoring vital signs such as blood sugar for diabetes or blood pressure for hypertension is a critical aspect of their life. A lack of engagement with health care providers makes this requirement almost impossible, increasing the risk of exaggerating the medical conditions.

During the pandemic, tracking well-being is more critical than ever. Studies have shown that conditions such as obesity, diabetes, hyperlipidemia, and hypertension are risk factors for adverse outcomes associated with the COVID-19 virus. Telehealth can enable patients to keep track of and manage these conditions without risking their lives by going to clinics. Depending on the circumstances, they may be able to use simple portable medical devices, including glucometers and blood pressure machines, from the comfort of their homes.

Currently, some mobile applications and websites allow individuals to track changes in their vital signs. Some have resources to help interpret the results and recommend treatment. Other than guaranteeing safety, home monitoring saves time, eliminates transportation costs, and reduces health care expenditures while mitigating the risk associated with missing in-person doctor’s visits.

Patient engagement through telehealth also ensures adherence to treatment. One of the most urgent problems during the pandemic is refilling prescriptions. Many Americans who rely on medication to manage their conditions have run out of their doses. With telehealth, physicians can perform virtual consultations to encourage patients to keep taking their drugs and provide alternative ways to refill prescriptions. They can package and deliver medications through couriers or the mail at regular intervals to ensure adherence.

Patient engagement approaches can support the health care journey of the elderly, chronically ill, and critically ill patients. It can empower patients with the required knowledge and skills, eg, using technology to take responsibility for their health. By building a bridge between doctors and patients, it can keep them healthy by closing care gaps and encouraging healthful behaviors. Consequently, emergency cases and hospitalizations will reduce, resulting in lower health care costs.

— Anil Patil is a physician and health care technology professional and has been leading clinical IT tools development for health care industries in the United States, Canada, and India. Patil has been involved in bridging the gap between diverse health care professionals and development and design teams to define, build, and maintain intuitive clinical IT solutions critical to patient care, growth, engagement, and customer retention. Patil can be reached at patilanild@gmail.com.