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
DLewis01_pullquote Opening Up to Patient Innovations Like Automated Insulin Delivery

Opening Up to Patient Innovation

Next-gen innovations — by new stakeholders — will need a next-gen regulatory system, and clinicians willing to adapt.

Karen DeSalvo - public health population health social determinants of health expert social services infrastructure

Moving from a Sickness Model of Health Care to One of Well-Being — Part 2

A public health expert discusses the scientific, technological, and financial foundations needed to modernize the social services infrastructure and address social determinants of health.

PROs Associated with Better Top-Box Satisfaction Scores at UPMC

Better Physician Ratings from Discussing PROs with Patients

A UPMC study demonstrates the value of PROs, but finds that physicians need to discuss that information with patients during visits.

Karen DeSalvo - public health population health social determinants of health expert social services infrastructure

Moving from a Sickness Model of Health Care to One of Well-Being — Part 1

The expense of the U.S. health care system is so misaligned from what we need as a country — a healthier population. A public health expert discusses how we can move toward a model that addresses social determinants of health and promotes well-being while still growing our economy.

Different Means of Initiating and Sustaining Behavior Change

Survey Snapshot: Social Support, Whether In-Person or Virtual, Is the Key to Sustained Behavior Change

NEJM Catalyst Insights Council members seek ways to create relationships with patients — but the hurdles are high.

Different Means of Initiating and Sustaining Behavior Change

Patient Engagement Survey: What Creates Behavior Change May Not Sustain It

An NEJM Catalyst Insights Council survey finds that human interaction and social support are vital for patient behavior change and employee wellness programs.

How the EpxSubstanceUse Substance Use Disorder Mobile Health Texting Program Works - Preferred Family Healthcare Epharmix Technology Assisted Care Coordination Project Opioid Abuse

Messaging System Helps Caregivers Keep Tabs on Growing Number of Patients with Substance Use Disorder

One behavioral health provider pilots cost-effective outreach to patients with SUD that checks up on their recovery, triages needs, and facilitates communication.

Gary Kaplan Head Shot

Improving Patient Involvement in Care

The CEO of Virginia Mason on facilitating and enhancing patient participation in care.

Chou01_pullquote_Time to Start Using Evidence-Based Approaches to Patient-Provider Communication

Time to Start Using Evidence-Based Approaches to Patient Engagement

Clinicians must acknowledge that there is a dramatic difference between learning a concept about patient-provider communication and learning the actual skills for effective execution.

Nash01_pullquote - A Requiem for Value-Based Care Population Health.

A Requiem for Population Health?

Despite some fits and starts for value-based care, there is abundant evidence that the concept will continue to survive and thrive.

Connect

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

Learn More »

Topics

Patient Incentives

62 Articles

Behavior Change Basics: Simplicity to Self-Compassion

Four principles and practices to keep in mind when trying to help patients lose weight,…

Opening Up to Patient Innovation

Next-gen innovations — by new stakeholders — will need a next-gen regulatory system, and clinicians…

Patient-Centered Care

218 Articles

Survey Snapshot: Seeing Progress in Transparency,…

NEJM Catalyst Insights Council members agree that despite the challenges and caveats, transparency efforts are…

Insights Council

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

Apply Now