Technology, access, and patient-provider relationships are vital for successful care continuum, experts say


Maddie McCarthy


Leaders in the healthcare community discussed ways to engage patients and develop a stronger care continuum at the 2023 Tennessee State of Reform Health Policy Conference last month.

Patients often need prompting and support in order to successfully engage themselves in the care continuum.

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Scott Bowers, chief executive officer at Spiras Health, said patients need to see clear messaging from their providers again so they’re more likely to follow up and find the right care.

“A multi-modal, multi-channel approach tends to be one way that we can get folks to be stickier on their engagement and their self-management,” Bowers said. “… It’s this idea of being able to meet the patient where they are.”

He also discussed the idea of motivational interviewing, where providers ask their patients about the goals they have for their health. This allows the patient to be more engaged and take an active role in making sure their health improves.

Rajesh Sharma, vice president and general manager of systems integration, data analytics, and interoperability at Gainwell Technologies, said member engagement in the continuum means patients staying on top of their own health.

“The biggest hurdle in member engagement that I have seen is lack of information in members’ hands.” 

— Sharma

He said the industry has made improvements in this area. From the Medicare perspective, the Centers for Medicare and Medicaid Services (CMS) put rules in place requiring payers and providers to consolidate member data so the patients can see all their health information in the same place.

“Around 2021, CMS came out with a patient access interoperability rule,” Sharma said. “What that mandates is that state systems should convert basic data, for example, member data, eligibility data, and provider data, into a file format and then expose that data out to the members using some kind of [mobile avenue] so that information is delivered to them in their hands.”

The Division of TennCare also implemented a provider lookup portal, which Sharma said increased member engagement.

Karen Thompson, assistant vice president of community engagement at HCA Healthcare, said the issue lies with both the provider and patients’ access to information, and with patients’ health literacy.

She gave the example of a chronically ill patient who has to see multiple providers.

“When you’re at your most vulnerable, our healthcare system expects you to be able to navigate between the different portals. Your payer has a portal, then your provider office has a portal and then if you have a specialist, they have a portal.”

— Thompson

In this situation, Thompson said complications can arise because there are so many disjointed platforms with the patients’ information. 

For example, a patient might get lab work done, and because labs have yet another portal, it’s possible the patient sees the results before the provider does, she said. Therefore, they may search the results of their lab on the internet before their doctor can tell them what it means within the context of their whole health.

“I think some of those hurdles are that we want to give more access, but it has to be in context,” Thompson said.

Having so much information available technologically presents its own set of issues. For one, Bowers said providers and payers need to be aware of generational gaps in peoples’ understanding of technology.

Sharma said information consent management is critical. Providers and payers need to be asking their members and patients how they want to receive communication. He also emphasized the importance of educating patients on the technological platforms used to deliver healthcare and health information.

“Technology is definitely helping, but I am sure we can do more,” Sharma said.

The panelists also discussed how provider interactions are vital to encourage patient care continuum.

“If there’s a true relationship, [patients] are much more likely to not change anything and to lean in, as opposed to if they’re not feeling that trust and that relationship, and they’re not engaging at that level—[then] they’re much more likely to look for another option.”

— Bowers

Thompson emphasized the need for every touchpoint within the healthcare system to be patient focused. Even if a patient has a good experience with a provider, they may get to the bill collectors and have a completely different outlook on the experience because of the communication they received from them.

“We need to train people in the front end and in the back end to think about that experience they’re giving,” Thompson said.

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