Engaged and activated patients have better outcomes, better satisfaction and lower costs. However, there is wide variation about what it means for patients to be engaged and activated. Health systems vary widely in how they define and in the activities they do to engage the patient.  This ambiguity risks failing to fully engaging patients. Dr. Peter Pronovost, one of Doctella’s Co-founders with his team at the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality sought to describe the three behaviors that define patient engagement from the health system perspective. First the health system seeks to more actively involve patients in all aspects of their care, ensuring that they understand and participate in their healthcare-related decisions. Second, they ensure they meet patient’s needs; needs for information, for relief of suffering, for communication, for comfort, for education. Third, they ensure patients are able to self care and know their follow up when they leave.

Much of this work involves providing patients information about their diseases, their treatments, and their medications. Currently, most of this information is generic, and usually provided to patients as static printed or electronic content. However, patients, their physicians, and other members of the care team now increasingly want personalized information.   Patients want information and content customized for them, to reflect their values and goals, their unique disease biology, and their risks. Physicians also want personalized care plans to reflect what they want for their patients. Physicians do not want generic information from just content provider.  They want to specify exactly what their patients can expect and what they should do to get well. These types of personalized plans are not possible with paper or electronic health records (EHR). It is simply not feasible to customize paper or EHR plans by physicians and by patients.

Open platforms can change this.  Platforms have a unique attribute;  they create a marketplace to connect producers of content with consumers of content through an electronic marketplace that is easily customizable.  Apple accomplishes this with the App store , which is a platform as is the Google Play store for Android.

Doctella, the Smartlist (smart checklist) company, is providing a platform to help propel patient engagement to its full potential. Our platform connects physicians and other clinicians (producers) with patients and their loved ones (consumers) in a marketplace to exchange information on how to help patients stay healthy or heal faster.   Moreover, our technology makes it easy to customize these lists.  Improvement science informs us that a key to getting a checklist used is to encourage local users to customize the list; usually only 5% of the content ends up being customized. But even that small amount of customization results in a much increased adoption.


Video: Comments from Dr. Peter Pronovost, Co-Founder Doctella.com

Our Smartlist technology makes customization easy.  In these Smartlists we have created items that help patients easily describe their preferences, goals, behaviours, beliefs and belonging. Smartlists enables providers like never before to prompt patients and get realtime feedback with customized shared decision making guides, educational multimedia content, timely reminders, action acknowledgements, outcome measures and experience surveys. What this means is that physicians can create a Smartlist, can customize a Smartlist item, can learn from others, can borrow lists from others and modify them for their own use.    For example, a surgeon can create a smartlist that describes the options for care, the tasks the individual patient needs to do to have the safest surgery possible, when they should stop taking aspirin, when they should stop eating. Patients receive a text that installs the Smartlist items on their smart phone calendar. Patients receive reminders about these tasks and physicians can monitor whether and when patients performed these items.   Patients can see what other surgeons recommend and how their surgeon’s Smartlists compare with others.  All of this increases the chance that a patient will have an optimal outcome, improves the physician’s efficiency and reduces the probability that patients will either not show up for surgery or show up ill prepared, ultimately resulting in improved patients outcomes and lowering healthcare costs.   All of these create a learning market to link producers and consumers.

Our Smartlists also encourage patients to customize their Smartlists, reflecting their goals and values, their frustrations and fears, their questions and concerns, their goals and hopes.  The platform also provides an efficient means for patients to share this information with their physician and care team so they are truly engaged in a personal way. For example, patients may say they are very worried about pain, or getting back to work as soon as possible.

The Doctella platform also allows for monitoring. Through our analytics, powered by the same tools used by Google, we can monitor and feedback information about variation in Smartlists, use of Smartlists, and link of Smartlist behaviors with patient outcomes. It does not have to stop there. With its open platform architecture, Doctella allows individuals and groups to create their own novel uses based on new ways to engage. From pathway based followups to tracking activity stats, the platform can help democratize the sharing of knowledge and information between the consumers and producers in unprecedented ways.

With this ability for physicians and patients to create Smartlists or customize existing ones, we can realize the dream of personalized patient engagement for all.  With this platform we can scale personalized engagement to partner with patients, and their loved ones to end preventable harm, continuously improve patient outcomes and experience and eliminate waste.


Figure Source: Model Adapted from Harvard Business Review, April 2016

Doctella.com by Patient Doctor Technologies, Inc., the Smartlist company, based in Silicon Valley provides a comprehensive patient-centered outcomes management platform to improve the culture, communication, and engagement between patients, families, and providers. Doctella was founded by Amer Haider, Dr. Peter Pronovost, and Dr. Adil Haider. The app was developed by leading researchers from Johns Hopkins and other leading institutions. Staywell Krames in an investor in Patient Doctor Technologies, Inc. Start your journey to better, safer care at http://www.doctella.com.

Doctella by Patient Doctor Technologies, Inc.

440 N. Wolfe Rd, Sunnyvale, Calif. 94085. Web:  http://www.doctella.com. Email: info@doctella.com