“If patient engagement were a drug, it would be the blockbuster drug of the century and malpractice not to use it.”
Leonard Kish

Multiple studies have shown that patient engagement leads to better treatment outcomes, and it has been identified as a critical component for a successful treatment plan (1). For example, a study conducted with Minnesota-based primary care clinics shows that patients with low engagement levels cost up to 21% more than patients that were classified as “engaged” (2).

Patient engagement can also drive patient satisfaction, which is instrumental in increasing patient retention and in staying competitive in a market that shows more and more characteristics of a consumer-centric industry.

But what exactly is patient engagement?

“Patient Engagement” can be defined as activities by the patient facilitated by resources provided to them, aiming to promote behaviors and decisions that improve health outcomes. (3)

Engaged patients are actively trying to improve treatment outcomes by seeking information and engaging in healthy behaviors. (4)

“Patient engagement is one strategy to achieve the “triple aim” of improved health outcomes, better patient care, and lower costs.” (5)

What can healthcare providers do to improve patient engagement?

According to various studies, some key elements can be used to increase patient engagement for better treatment outcomes. These include:

# 1 Patient Education

According to Deborah, T. Gold, Ph.D., and Besty McClung, MD, RN, there is a correlation between patient education and treatment compliance. Low levels of patient education can have adverse effects on clinical outcomes and lead to increased healthcare costs. Well educated patients, on the other hand, show higher levels of engagement and program adherence.

A study conducted by Schaffer and Tian compliance increased up to 19% after six months of treatment when patients were provided with educational material as opposed to a 22% decline in compliance without education. (6)

Apart from better compliance, well-educated patients seem to be more engaged in their health care and have better treatment outcomes, which leads to higher patient satisfaction.

Adequate patient education is especially important when the patient is required to do home care, such as home exercise programs. The more knowledge the patient obtains regarding the conditions and the associated treatments, the more confident he / or she will be to adhere to the necessary components of their home care. (7)

However, according to a study, by McGuire MC, patients forget 40 – 80% of the information given when they walk out of your door. Besides that, almost half of the information was not remembered correctly. (8)

Therefore, it is critical to provide patients with resources that help them to review the information needed to successfully perform their home care.

For more information regarding this topic, you can also read our Patient Education blog post.

# 2 Patient-reported outcomes / Self-Monitoring.

“Frequent monitoring and feedback may be the most effective strategies for improving medication adherence.” (8)

According to a study by the University of Kentucky, self-monitoring can improve exercise adherence and results of exercise program significantly and seems to be more effective than monitoring by others. (9) Another study by the Cleveland Clinic (10) showed that allowing patients to record data specific to their care programs can help to improve patient engagement significantly.

One reason for this might be the active involvement that self-monitoring requires versus being monitored by others. The patient must add their data regularly and frequently and is “confronted” with his/her behaviors whenever he/she does this.

Also, self-monitoring can be done more frequently and consistently, which can improve the benefits of healthcare interventions and might help to create long-lasting behavior change.

The implementation of self-monitoring can be supported by the utilization of digital tools. The fact that the market for fitness trackers is booming helps self-monitoring in the medical context: many patients are used to tracking and self-monitoring as consumers and are open to doing this as part of a treatment plan as well.

According to a survey conducted by CDW Healthcare in 2018, 70 percent of the participants of the poll said they have become more engaged with their care in the past two years due to the usage of a digital tool. In 2016 only 56 percent reported being engaged with their care. (11)

#3 Feedback

According to Leonard Kish, an expert on patient engagement, a critical success factor is two-way communication.  Also included is an exchange of information. It’s a two-way street:

“One person cannot be engaged; there has to be sharing between two parties. Finally, engagement is dependent on a patient being on a journey toward their own goals.” (12)

That’s why patient feedback is one of the main drivers of patient engagement. Apart from that, it can help providers in many other ways:

  • Feedback provides insights on the patient’s progress and indicates if the exercise program should be updated. Regular data exchange can help to optimize treatment plans over time.
  • It creates a touch point between patient and health care provider and can thus help to build a stronger relationship and increase patient retention.
  • The patient must track their sets and reps to provide feedback. Self-monitoring (see above) is a proven behavior change technique that can help to improve compliance.
  • It can keep the patient engaged in doing their exercises and in reporting their progress
  • It can help to reinforce encouragement by reminding the patient

How can WebExercises help you to take your Patient Engagement to the next Level?

WebExercises has been developed with the intent to provide patients with the resources they require to complement their in-office treatment through home exercise programs.

Our exercise videos and education resources allow patients to understand how to perform their home exercise programs.

In 2016, we added the WebExercises Patient Portal to further increase engagement and compliance. It allows the patient to log their sets and reps and provide feedback on pain and perceived exertion, which will be displayed on the provider Rx management page instantaneously. End of this month we will release an improved version based on the feedback from our WebExercises Provider Community and our experiences and data collected since 2016.

To increase transparency on the provider side, we also developed a provider dashboard that will allow you to track the Ex Rx send to patients and the patients’ engagement level. The dashboard will be live in your provider portal end of June 2019.

We also developed a library of patient engagement and education handouts and videos that can be found in the resources section of your provider portal and that you can use to further engage or educate patients that are currently in your care or to re-engage previous patients.


(1) Patient Engagement, World Health Organization 2016

(2) Leonard Kish: “Patient Engagement is a Strategy, not a Tool,” 2014

(3), (5)James J: Patient Engagement, Health Affairs / Robert Wood Johnson Foundation, 2013

(4) National Learning Consortium Fact Sheet, August 2012.

(6), (7) Deborah T. Gold, Ph.D. and Betsy McClung, MN, RN: Approaches to Patient Education: Emphasizing the Long-Term Value of Compliance and Persistence, The American Journal of Medicine, 2006

(8) McGuire LC. Remembering what the doctor said: organization and older adults’ memory for medical information, 1996

(8) Daniella Koren: “The Impact of Knowledge: Patient Education Improves Compliance and Outcomes,” The Wellness Network, 2016

(9) Dan Kirschbaum, Ph.D.: Behavior Therapy, 2017

(10) Carman KL, Dardess P, Maurer M, Sofaer S, Adams K, Bechtel C, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff. , 2013

(11) Jeff Rowe: HealthcareITnews.com 2013

(12) Leonard Kish: “Patient Engagement is a Strategy, not a Tool,” 2014

The WebExercises Story: Created by Clinicians for Clinicians

We understand the challenges that clinicians face on a daily basis: lack of patient engagement, high drop-out rates, time-crunched clinicians. We developed a solution for you and your patients that provides you with great clinical education, efficient and evidence-based exercise programming, and an engaging patient experience . To find out more how WebExercises can improve your practice call us 866-411-4825 or visit webexercises.com.

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