Patient Engagement
Talk
Increase Compliance by Providing Actual Solutions (03:51)

How can we increase patient compliance? By providing actual solutions, according to Punam Keller, Associate Dean for Innovation and Growth at the Tuck School of Business at Dartmouth College. No barrier is too small when it comes to a patient’s difficulty with following instructions for better health. Take patients who need to weigh themselves — what if they can’t see the scale? Or, what if they’re supposed to track individual pounds, but they can’t tell if they’ve gained two or lost three because their scale only shows five pound intervals? For an individual in danger of a heart attack, for example, these difficulties become major barriers. “So many of the patients we spoke to said they couldn’t even tell if it was two or three pounds, and that is unfortunately all it takes,” Keller says.

So what can we do? Keller lays out three steps:

Step 1: Identify patient barriers.

Identify all the barriers that patients are facing, Keller says.

Step 2: Identify solutions to overcome those barriers.

“This is where your service providers can help, and that includes the physicians,” Keller says, describing how she’s working with a team to help patients in wheelchairs weigh themselves by using a tire pressure gauge.

Step 3: Create behavior change tools for service providers.

Keller conducted a study during which these kinds of examples, such as inability to weigh yourself, were shared with patients directly. Then, patients were asked if they could foresee any similar challenges, or wanted to address challenges they’ve already had. These were written down on cards, with “concerns” and “solutions” clearly labeled — “we didn’t say ‘barrier,’ we just said ‘concern’ because that’s much nicer,” Keller explains — and the cards were then given to the patient as they exited the hospital.

From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016. Watch Part 1, Part 2, and Part 4 of Keller’s talk.

More From Patient Engagement

Patient Inducements — High Graft or High Value?

Can health care be more like Uber and Lyft?

Using a “Nursing Bundle” to Achieve Consistent Patient Experiences Across a Multi-Hospital System

How Geisinger addressed inconsistent patient experience by creating a nursing bundle that helped make patients’ experiences more consistent.

Consumer Engagement: New Tools and Capabilities for Health System Marketing

Novant Health is using research and data analytics to identify and engage new consumers, develop more relevant products and services, and support its mission and brand promise.

Engaging Patients to Optimize Medication Adherence

Medication adherence is a significant public health challenge. As each patient is unique, it is critical for health care systems and providers to better characterize and meet individual patient needs at each stage along the way in order to improve medication adherence and ultimately improve patient well-being.

Shared Decision-Making for Good Clinical Care: Better, but Not Easier

Active patient involvement and patient autonomy can be burdensome to patients, especially when they are faced with serious illness. The primary goal of shared decision-making is not autonomy, but good care that fits patients’ lives.

The Patient as Consumer and the Measurement of Bedside Manner

Many physicians do not believe patient satisfaction is a legitimate pursuit. Yet they must meet consumers of health care where they are — on Internet ratings sites.

Health Care — A Final Frontier for Design

Design must move beyond narrow projects and encompass complex systems.

Halpern02_clip_still: A/B Testing Health Behavior Interventions

A/B Testing Health Behavior

Health care can’t implement changes overnight like Silicon Valley, but we can still learn from their version of treatment and control.

Social Interventions Can Lower Costs and Improve Outcomes

We can better serve our under-resourced patients by helping them access treatments and social interventions we already know to be effective.

Better Communication Makes Better Physicians

How Adrienne Boissy and Cleveland Clinic are focusing on physician communication — and getting results.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

My Favorite Slide: Surprising Mortality for…

Call to action: Survival statistics for a slice of middle-aged white people in the U.S.…

Patient Incentives

44 Articles

Patient Inducements — High Graft or…

Can health care be more like Uber and Lyft?

Protecting the Tired, the Poor, the…

After President Trump’s executive order banning refugees, the United States is no longer a bright…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now