Expert’s Corner with NexJ Systems Inc.: The Role of the Public Health System in the Age of the Engaged Patient

In anticipation of The 14th Annual Healthcare Summit, Reboot is excited to present “Expert’s Corner”, a series of blog posts featuring a number of outstanding companies and industry leaders that are participating in #HealthSummit14, happening later this month in Kelowna, BC. Read on for a glimpse of what NexJ Systems Inc. has planned for shaping the future of healthcare in Canada…

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Much like the well-known African proverb: “it takes a village to raise a child”, we could say: “it takes a community to support an engaged patient”.

The public health system’s role is to promote health, prevent disease, and prolong and improve the quality of life for its citizens. It strives to do this in an equitable way for all citizens in order to provide service to the community as a whole.

How does this fit in the Age of the Engaged Patient? An engaged patient, particularly one that is highly activated in their own health and wellness, might desire or demand support and services that are not generally available to the population at large. Does the public health system have a duty to inform and educate its citizens about the options for their health and wellness if they are not available from the public system? Must all patients be treated equal when some patients are more activated than others? They aren’t today. For instance, a transplant candidate will be served faster if he/she achieves the lifestyle and biometric requirements aligned with the best outcomes for the transplant. Why should it be different for patients needing other forms of care?

Patient engagement represents a passive approach to healthcare where patients might be given their health information but not necessarily the means in which to become an active participant in their own care. Conversely patient activation is about empowering patients with the knowledge, skills, confidence, and tools to proactively preventing disease and/or actively managing it themselves. An activated patient has developed the health literacy skills needed to be able to absorb the necessary information for self-care – and is acting upon that knowledge. It often entails developing new habits and daily behaviours, and it usually requires the ongoing support of family and a roster of caregivers and advocates – the patient’s Circle of Care.

Sadly, the public health systems in Canada are more often than not taking a passive approach to engaging patients. It is not enough to simply give people their health information in order to ‘engage’ them as active participants in their health and wellness. Unfortunately, few people in Canada can be described as health literate or activated in their own health and wellness. Between 60 and 88 per cent of Canadians do not have the necessary health literacy skills to manage their health adequately.

As a result, roughly three out of five people over the age of 20 live with a preventable chronic disease. When they get sick and see a doctor (clearly ‘engaged’), they accurately retain only about 10 per cent of what the doctor has said. They go home unsure of what they should do to help themselves and why they should do it. They don’t follow their treatment plans and their health progressively worsens.

We can no longer afford to have the public health system only treat patients who are ill. Instead, we need a public health system focused on helping us stay healthy, by supporting efforts that raise the level of activation in Canada so people in good health remain that way – and our sick patients are better primed to be participants in their health and wellness. Governments must fund the public health system to improve the capacity and motivation of all Canadians – before and after they get sick – as partners in their care. Canadians need to understand their role in keeping themselves – and our communities – well.

We have the technologies available now to improve a citizen’s and a patient’s ability to understand their challenges – and to support them as they become more activated in their own health, wellness, and care.

One example is NexJ Connected Wellness, a patient activation platform offered by NexJ Systems that is used to deliver patient education, improve care collaboration, and motivate patients to achieve their health and wellness goals. Starting at the point-of-care, NexJ’s patient education app called Liberate, gives healthcare professionals (HCPs) a powerful tool to improve the amount of information that patients absorb and comprehend by making teaching easier and more effective for HCPs. It uses plain language and infographics to make learning easy and to deliver the key messages patients need to retain. The patient goes home knowing:

• What they’ve got or are at risk of getting;
• What they need to do about it;
• Why they need to do it

In effect, by being more effective educators, HCPs are improving their patients’ health literacy. This, in turn, gets patients involved and improves their understanding of their condition and treatment care plans. It also enables them to do what’s necessary to better utilize the limited health system resources the public health system has to offer them.

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Once patients leave the HCP’s office or hospital and return to real life, they can use Connected Wellness to review the conversation they had with their HCP in detail, improving information retention.  Patients can also collaborate with their care team, view their care plan and share it with their loved ones.  They can also gain from the support of a health coach, and learn about the effect of their behavior by using digital tracking tools.

For example, NexJ’s solution for health coaching patients use their mobile device and the web to connect to their health coach who provides on-going feedback and positive encouragement to eat healthy, exercise, and take their medications. The coach’s support helps patients gain a better understanding of the relationship between their behaviours, how they feel, and their wellness, driving the motivation for sustainable behaviour change….and taking the burden off the public health system.

Empowering patients, and their Circle of Care, to actively participate in the patient’s health and wellness is proven to have a positive effect on outcomes. For example, in a recently published research trial at Black Creek Community Health Centre, NexJ’s solution for personal health coaching has been shown to reduce HbA1c levels in type 2 diabetic clients.  And in a recent pilot study at Beth Israel Deaconess Medical Center, it was shown that just by delivering patient-friendly care plans to patients, patient satisfaction improved from 36 per cent to 96 per cent and patient follow-up calls to physicians reduced by more than 80 per cent.

The public health system could be supporting patients in a similar manner. NexJ’s Circle of Care concept could be extended to be a Community of Care. For instance, with improved government funding, health coaches could be provided by the public health system to empower patients with the knowledge, skills, confidence and tools to actively participate in managing their health conditions. Much like the well-known African proverb: “it takes a village to raise a child”, we could say: “it takes a community to support an engaged patient”.