Health Dialog Connections

Dynamic Healthcare Services: How to Motivate and Engage Patients with SMART Content

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Transparency in healthcare has been an increasingly hot topic over the last several years. The ever growing computer savvy population of healthcare consumers means todays patients are more involved with their health than ever. The concept of shared decision making (SDM) has made great strides in becoming mainstream since it was conceptualized in the early 2000’s.  Recognizing the importance of a collaborative approach, SDM has become integral at the policy level in various provisions in the Affordable Care Act as well as requirements for certain procedures covered by The Centers for Medicare & Medicaid Services.  However, despite this growing idea of patients as consumers we still have a long way to go to engage people in their health and health decisions.  Engagement of patient-consumers comes down to motivation.  In order to be motivated towards change one needs to feel they have:

  • a vested interest,
  • the knowledge and skills to achieve it,
  • the effort to make the change must outweigh the effort to not make any changes at all.

Mathematical Probabilities and Change Motivation

Newton’s first law of motion not only expresses the nature of physical science, but can be adapted to support a “motivation” analogy. It is inertia that plays a great role in how motivated someone can be towards change:  “Every object persists in its state of rest or uniform motion in a straight line unless it is compelled to change that state by forces impressed on it.” Translation: does it take more effort to get moving, eat better, or take medicine than it does to keep the status quo?

Let’s break this down: External forces are what often times motivate people towards change, for example a heart attack may be the impetus to drive a person to quit smoking, or a diagnosis of diabetes may be the catalyst towards eating healthier. The challenge for healthcare providers is recognizing how to leverage what we know about our patients’ current health and likely disease progression and help them become fully engaged in their own healthcare, which could change their paths of illness. We need to learn what motivates them towards change and be their “external force” with a well-timed nudge.

Moving in the Right Direction

Once the ball of change is rolling the next step is appropriately measuring the effectiveness of the patient motivation. In order to measure effectiveness of patient engagement it has been posited that we need to build a better measurement tool. Shared decision making has been identified as a strong support for people who are motivated to make certain health decisions. These tools help consumers make decisions on treatments or surgery that is best for them by folding in medical evidence with their own personal values, preferences, and supports. But what about support for lifestyle changes, medication adherence, or other health changes for which there are a wide range of available resources? That is where we need to get SMART about what tools we provide.

A SMART Approach

In addition to SDM tools and processes, there is the idea of a SMART goal. SMART goals help to enable the user to identify short and long term steps towards the overall health objective. Instead of a goal of “My patient needs to lose weight to lower their diabetes risk” a SMART goal would lay the specific foundation of how your patients would target individual steps towards their ultimate goals of weight loss. SMART goals help patients choose the right tools for them and help us serve up what is most relevant and more likely to lead to sustained behavior change.

  • Specific-Simple, clear and concise statement that includes the “Who, What, and How”
  • Measurable- Clear metrics for success, includes the criteria for whether a goal has been reached
  • Achievable- The goal should be ambitious but attainable, as well as something your patient is willing to do.
  • Relevant- The objective should apply to the overall goal of improved health, or to a specific treatment goal.
  • Timely- Goals should be grounded within a time frame with a clear end date. This allows for evaluation and restructuring of a goal that may not be holding the patients motivation.

Reevaluation of your patients’ progress is critical. Waiting too long to evaluate how well (or not well) things are going can derail the momentum towards patient health. Newton’s 3rd law of motion: “For every action there is an equal and opposite reaction”. In other words, hitting a brick wall of forward progress towards their goal could cause your patients to backslide to where they started or even farther back.

Steps you can take as a provider:

Coming soon: A closer look at SMART goals and how they lead to lasting behavior change.

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