Patient engagement/activation have long been a concern for the professional case manager. How can we get our patients/caregivers actively involved in their own care? Digital technology can be a key strategy in patient engagement and activation. One key concept is linked to the practice of “neuromarketing,” where technology is utilized to “capture the subject’s attention and keep it concentrated on monetizable activities” (Mouchabac et al, 2021). The concept behind this is that social interactions (attaining “likes” or earning “badges”) creates dopamine and keeps the individual engaged in the activity. Think of “going viral” or how many “likes” your social media posts get and the feeling associated with that.
The current boom of healthcare apps for symptom tracking allows patients to track their symptoms related to their individual diagnosis and can be a key to engaging patients in their own health management. These types of apps allow for in-the-moment assessment and a real-time evaluation of symptoms with earlier detection of exacerbation, complication or relapse. This is especially being seen in the mental health arena. The number of mental health management counseling apps is exploding!
Mouchabac et al (2021) postulates that these apps can provide a “digital dopamine” response that can be harnessed for positive use (more patient engagement, greater health confidence) versus the more negative experience of digital addiction. The technology has the potential for getting people “addicted” to being engaged, active participants in their own healthcare.
Caveats to consider with all forms of technology:
1. Health literacy, digital literacy
a. Assess your patients/clients/members at every interaction for their ability to use and engage in the use of the apps, portals or other technology.
b. Remember that acute health issues or escalating chronic conditions can lead to a person being able to manage technology at one visit and not being able to do so in the next visit.
2. Technology overload
a. A dear friend of mine reported that while under care for her cancer diagnosis, she had to manage four patient portals from all of her healthcare providers and facilitate the communication between these herself. Too much during a period of wellness, I can only imagine what this put her through, trying to manage during a period of stress and illness.
Digital technology has great potential as a tool in healthcare but should not be used as a substitute for care interventions. The professional case manager is vital in the process of educating and engaging patients in the use of technology (see the new Health Information Standard in the CMSA Standards of Practice, 2022) but also in assessing whether a patient/caregiver can use the technology as intended.
, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM, is the associate chief clinical operations officer, care continuum for University of Illinois Health System and the current president of the Case Management Society of America National Board of Directors. She has held positions in acute care as director of case management at several acute care facilities and managed care entities in Illinois, overseeing utilization review, case management and social services for over 14 years; piloting quality improvement initiatives focused on readmission reduction, care coordination through better communication and population health management.
Her current passion is in the area of improving health literacy. She is the recipient of the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020) for her work in this area. Dr. Morley also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, A Practical Guide to Acute Care Case Management, published by Blue Bayou Press, was released in February 2022.
Dr. Morley has over 20 years of nursing experience. Her clinical specialties include med/surg, oncology and pediatric nursing. She received her ADN at South Suburban College in South Holland, Illinois, BSN at Jacksonville University in Jacksonville, Florida, MSN from Norwich University in Northfield, Vermont and her DNP at Chamberlain College of Nursing.
REFERENCE
Mouchabac, S., Maatoung, R., Conejero, I., Adriend, V., Bonnot, O., Millet, B., Ferreri, F., and Bourla, A. (2021). In search of digital dopamine: how apps can motivate depressed patients, a review and conceptual analysis. Brain Sciences. 2021, 11, 1454. https://doi.org/10.3390/brainsci1111145
