Patient Activation Strategies and Why Patient Engagement is Not Enough


You’ve probably heard quite a bit about patient engagement recently, but what really matters is patient activation. It’s vital for healthcare marketers to get patients to become active participants in their care in order to improve health outcomes.

What is Patient Engagement?

Patient engagement is a strategy promoted as helping achieve the "triple aim" of improved health outcomes, better patient care, and lower costs for patients and health care providers. It’s been defined as “a [broad] concept that combines patient activation with interventions designed to increase activation and promote positive patient behavior, such as obtaining preventive care or exercising regularly.”[1]

Patient Activation vs. Patient Engagement

Patient activation is a measure of an individual’s understanding, competence, and willingness to participate in care decisions and processes. As the root of the word “activation” implies, it is focused on getting the patient to take action. In contrast, patient engagement denotes a broader concept that includes activation; the interventions designed to increase activation; and patients’ resulting behavior,[2] but is focused on communication.

Many patients don’t know how to access, process, communicate, and understand basic health information and services. Patients often lack health literacy and don’t truly understand their medical conditions.[1] “An activated patient is more likely to engage in preventative behaviors such as immunizations and annual appointments, adhere to their medications, understand their health, and have the knowledge to understand and navigate the healthcare system.”[3]

Benefits of Patient Activation

Higher patient activation levels

Studies have shown that patients with higher activation levels have lower average costs than patients with lower activation levels. In fact, “an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, [found] that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation [levels].” 

A patient’s ability and willingness to manage their health is an important piece of information that can help health care providers improve outcomes and lower costs.[4] Higher activated individuals are also more likely to engage in positive health behaviors, tend to have better care experiences, and are more likely to have better health outcomes.[5]

Higher activation levels are also beneficial to healthcare providers. The more activated its patient base, the more a healthcare system can focus on delivering diagnostic services and preventative care rather than on emergency procedures to deal with unaddressed health issues.

Patient Activation Strategies

When creating your patient activation strategy, it’s vital to be able to use the information within your organization to proactively deliver highly relevant, 1:1 outreach as every patient will require a unique activation strategy. With the right approach, each patient’s unique data set can be leveraged to inform the delivery of their health care communications at the best time and using the best channel to reach them. You have a lot of data in your healthcare CRM and other systems; it’s what you do with it that matters.

Communicate Relevant, Influential Information in a Coordinated Way

In order to increase the likelihood that a patient will take action, communications must be relevant (the “next best action” for the individual patient), influential, and coordinated. All communications must be coordinated so that patients don’t receive conflicting messages, too many messages in a short period of time, or no messages at all. Your goal should be to make every communication count. To be influential, your communications must be relevant. For example, don’t send reminders to get a 2nd COVID shot to patients who haven’t received their 1st shot.

Consider Your Healthcare System’s Capacity

When determining who gets what communication when, it’s important to consider your healthcare system’s capacity. Staggered, prioritized communications for high value patient audiences over a period of time are far better than everyone receiving a communication at one time. Consider the typical conversion rate for a certain communication and the healthcare system’s capacity when determining how many patients you should communicate with during a period of time. You wouldn’t want to send out a communication to 10,000 patients to come in for a flu shot next week if your healthcare system only has 500 flu shot appointments available and you know that your flu shot communications typically have a 10% conversion rate.

Don’t Fear Automation

“Although automated tools can make it easier for providers to reach more patients quicker, a personal connection via patient portal message or personal phone call can also be key for motivating patients.” Automated technology is great for standard appointment reminders or drug refill notifications, but when it comes to addressing irregularities observed using remote patient monitoring technology, a personal message may be more appropriate.[2]

Automation can help marketers be more efficient and reach more patients in a more targeted and precise way. It can also help them spend more time on strategic efforts, programs, and campaigns that are not evergreen and less time on mundane administrative tasks. Automation can ultimately help marketers achieve a greater ROI.

Improve Personalization with AI

“Less activated patients may not easily adopt a new engagement technology or a more complex or demanding health behavior [change]. Simpler engagement strategies will resonate with low-activation patients and allow those patients to experience success, thus further encouraging and activating them.”[2]

Personalizing activation strategies at scale is achievable using AI-based CRM intelligence technology. CRM intelligence blends AI clinical models with AI behavioral models to ensure the best solution for driving patients to seek care. It automates the process of sending the most relevant and influential messages to each patient via their preferred communication channel, to optimize activation.

For example, one large regional health system generated so much data that it was a struggle to identify and track at-risk and non-compliant patients. By adding Actium’s CENTARI platform to their pre-existing adherence outreach program, previously overlooked patients were immediately identified and paired with a next best action. In concert with outreach by the call center team, CENTARI also armed providers with a breakdown of Predictive Value Positive Results (PVPs). This coordinated approach led to an immediate uptick in patient conversions. Over the course of its next fiscal year, the health system generated significant revenue lift, with bookings, wellness visits, and annual profits all rising dramatically.

Patient activation results
Measuring Results and KPIs

Healthcare marketing metrics need to go beyond clicks and opens to reflect how it affects the healthcare system and patients. From a business standpoint, a far more meaningful way to measure the success of your patient activation marketing efforts would be to keep track of:

  • Appointments booked
  • Revenue generated
  • Lives impacted
  • Referrals generated

These KPIs can show business value to the health system (appointments and revenue) while also demonstrating the positive impact on the health of patients.

Next Steps for Activating Patients

In order to help patients become active participants in their care so there is a greater probability of improving their health outcomes, healthcare marketers must focus on communicating relevant, influential information in a personal and coordinated way. Knowing when to communicate, how to communicate, and when to use automation to communicate with patients are important factors to keep in mind when creating your patient activation strategy.

To learn more about how health systems are looking to maximize patient activation and lifetime value with AI-powered CRM intelligence tools, download the white paper: Moving Beyond Traditional Healthcare CRM.

moving beyond traditional healthcare crm software


[1] Patient Engagement, HealthAffairs
[2] Patient Engagement Strategies for Improving Patient Activation, Patient Engagement HIT
[3] 5 Ways Telehealth Increases Patient Activation, Health Recovery Solutions
[4] Patients with lower activation associated with higher costs; delivery systems should know their patients' 'scores',
[5] Patient Activation, The College for Behavioral Health Leadership