Is patient engagement the key to positive health outcomes?

How can value demonstration play an important role in pharma market access

We have all heard a lot about the need to control our thoughts. That controlling our mind will control our outcomes. Input = output, garbage in, garbage out, etc. Effectively what we put in our mind creates the expectation of our output.

Let’s start by looking at expectancy, the Expectancy Value Theory states the following:

Expectancy Value Theory (Vroom 1964) postulates that motivation for a given behavior or action is determined by two factors: (i) expectancy, i.e., how probable it is that a wanted (instrumental) outcome is achieved through the behavior or action (ii) value, i.e., how much the individual values the desired outcome.

There are multiple studies, white papers, etc., that have demonstrated when patients are engaged in their healthcare, the outcomes improve. This happens both within a preventative healthy lifestyle strategy or while they are under treatment for a medical condition. The result is that these patients spend less time in the hospital, require fewer doctor visits, and recover from illnesses more quickly. More efficient use of healthcare resources also improves patient care outcomes for all the other patients in the system.

Question. Is this driven by the expectancy theory? Do we get better healthcare results because a patient does better or in part because the patient expects better results?

The Benefits of Improving Patient Engagement

Patient engagement includes efforts made by patients to improve their health and increased self-management of health conditions. When healthcare providers and systems focus on developing engaging patients, this encourages patients to invest their time in improving their health.

This engagement can be facilitated in a variety of ways and through a variety of touchpoints be it in-person, telephonic, or digital (i.e., watches, etc.). This process can help the patient know if what they are doing is helping the process. As an example, I know multiple people who count their steps every day. While counting steps can be good, anyone who has ever studied exercise knows that steps without increasing your heart rate will have minimal value.

The goal of engagement is straightforward – to have a positive impact on healthcare results. Focusing on a positive patient impact can drive health provider education and policies, enhance the quality of medical services, and improve healthcare system governance.

As one would expect, Patients engaged in their healthcare have more invested in the outcome. This happens irrespective of if the patient initiates the engagement of the engagement comes from an entity engaged in the delivery of healthcare services, Physicians, Pharmacies, Hospitals. Studies show that these patients feel empowered, have improved self-esteem, and are more independent.

The process however has to be flexible to meet the patient, in the way the patient wants to interact. As an example, D2 has worked on digital programs where greater than 80 percent of patients who are approached, get engaged with the process. This is irrespective of age and/or other mitigating factors.

Another benefit of a patient engagement strategy is to involve the patient in the decision-making processes. They can be an active participant in creating a customized care plan. The idea is to encourage the patient to take ownership of the responsibilities of daily healthcare management. Patients who are actively involved in their care become partners in the care plan efforts, working together with healthcare providers, and gain a feeling of having more control over the outcomes. Again, they expect better results.

Improving Patient Engagement

A successful strategy used by some social service systems is to employ community health workers to bridge the gap between a patient and a healthcare provider. These community health workers provide services that address needs not usually met by healthcare systems. Examples of these services include social support, health education, counseling, treatment assistance, and medication monitoring. These efforts can reduce the time spent by other healthcare professionals, allowing them to focus on their specialties more.

As an organization that has worked with across hundreds of organizations and a plethora of delivery models, D2 has seen where virtually all of these models can be significantly enhanced using digital engagement. Specifically, leveraging gaming technology enables patients to receive actionable information and use/respond to that information at their convenience.

If developed correctly we see response rates approaching 90 percent, this is across various disease states and across all age cohorts. The rate however is highly dependent on the development of the right program which can include:

  • How to ask questions in the right way.
  • Ensuring that the patient is comfortable that they are sharing information in a secure n fashion.
  • Enabling information back to a meaningful entity (Provider, Hospital. Specialty n Pharmacy etc.).

Using Technology as an Engagement Strategy

Using technology, such as web responsive gaming technology is a great vehicle to engage patients. These tools can remind patients of appointments, notify them of test results, provide lifestyle coaching, enhance medication compliance, educate patients on how to medication effectively (i.e., time of day, food effect, etc.). Further, this technology can effectively be used to:

  • Collect patient feedback to drive changes in care patterns that improve results.
  • Collect Patient-Reported Outcomes for data and clinical evaluation.
  • Collect data for Value-Based Contracting.


Patients who engage with their healthcare end up as healthier patients. Whether it be what engaged patients learn, what they do, or simply because they are more aware, an engaged patient invariable gets a better outcome. As such our next challenge is simple. How do we get more patients engaged? How do we help patients get more of what they expect – a better healthcare experience resulting in better outcomes.

Contact us at D2Rx if you are interested in knowing how D2 has effectively improved patient engagement for their clients.

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