Readmissions and consumer engagement

The term "consumer engagement" is bandied about a lot these days. Often the term doesn't mean all that much --just a consumer logging onto a wellness website or reading a handout they picked up at the office. It's pretty hard to get a healthy person involved in their health, and there are plenty of clinicians who are still happy to have unengaged patients who don't ask questions and don't challenge authority. They might talk about consumer engagement but they don't really mean it.The Wall Street Journal  has an excellent article today (Need Surgery? You Might Have to Get Healthier First) that documents how hospitals and physicians are responding to new incentives --including penalties for readmissions and incentives for cost control and quality-- to engage with surgical patients about their health and decisions.Providers are putting into practice the evidence that smoking, nutrition, blood suger and medications are important drivers of surgical outcomes. They are trying hard to get patients to stop smoking, get their blood pressure under control and so on in order to get better results. And they're moving away from so-called "defensive medicine" --and are thinking twice before ordering routine tests for people who likely don't need them. From the article:

Rather than take a "one-size-fits-all approach," Dr. [Karen] Mauck [of Mayo Clinic] says, "in the 30 days before surgery, we should be looking at each patient, assessing their individual risks and making recommendations to get them through the period 30 days after surgery with the fewest complications."

I'm impressed and pleasantly surprised to see organizations responding to the 30 day readmission rule in such an enlightened manner. There's a genuine need to engage the patient to optimize outcomes and I'm glad to see providers picking up the ball.