Patient engagement framework

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Patient Engagement Framework

Created by the National eHealth Collaborative (NeHC), the Patient Engagement Framework is a model that guides healthcare organizations (HCOs) in the development and implementation of patient engagement strategies through eHealth tools. According to NeHC’s website, the Framework was developed over the course of nearly a year and was vetted by more than 150 experts in healthcare, technology and human behavior. It is designed to assist organizations of all sizes, and the adoption of the strategies found in the Framework will help these organizations meet the criteria of Meaningful Use.

The Framework consists of five stages:

1. Inform me: Demonstrates basic level of patient engagement with use of simple tools to make healthcare convenient and accessible. (Emerging Meaningful Use)

2. Engage me: More mature patient strategies; increased use of eHealth tools and resources. In this stage, patients have access to their EHR and can complete administrative tasks online. (Meaningful Use Stage 1)

3. Empower me: Advanced patient engagement activities through substantive use of health IT. Patients have access to secure messaging with providers, basic patient generated data is integrated into EHR systems, ratings systems are utilized, and the organization demonstrates an effort to enhance care coordination between providers. (Meaningful Use Stage 2)

4. Partner with me: Reflects providers who make the patient a partner in their care; includes condition-specific management tools, care summaries, on-going patient generated data; EHRs are connected to public health reporting agencies and coordination of care occurs seamlessly across providers. (Meaningful Use Stage 3)

5. Support my e-community: Fully leveraged and implemented eHealth tools that connect patients with their full care team. (Meaningful Use Stage 4+)

About the National eHealth Collaborative

NeHC is a public private partnership with the goal of creating a more patient- and family-centered healthcare system through the effective use of health IT. By partnering with organizations such as the Office of the National Coordinator for Health IT, part of the U.S. Department of Health and Human Services, NeHC’s primary focus is to encourage health information exchange, provide tools to support engagement with consumers, and leverage an education platform and health IT programs with broad stakeholder reach.

Barriers to Patient Engagement and Critiques of the Patient Engagement Framework

Much attention and emphasis is placed on patient engagement, but it is only one strategy for decreasing healthcare costs and improving quality. While there are many examples of its success, there are still several barriers that need to be overcome in order to carry out effective patient engagement strategies as outlined in the Patient Engagement Framework. One such example is low health literacy. Many patients do not understand their health conditions, how to deal with them and struggle to understand commonly used medical terminology. Another significant barrier is that of the technology itself. The Framework does not account for patient groups that might not have access to computers or those that might struggle with technology such as the elderly or low-income patients. Finally, there is an assumption made that patients will willingly engage in patient engagement activities and actively participate in their care. Factors such as cultural differences, religious beliefs and the overall psychology of patients need to be considered by providers in order for the strategies of the Framework to be successful.


Overall, the Patient Engagement Framework provides a clear roadmap for healthcare systems and providers to engage patients in their care. According to NeHC, the Framework can enable its users to more efficiently and effectively treat patients as partners rather than as customers. Many in the industry see this as a valuable tool for health systems that want to transform the way they deliver care.


Submitted by Peter Shields