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Beyond dated models of engagement to a person-centric perspective

True engagement and behavior change require continuously available, real-time, personalized and targeted nudging that is distinctive and meaningful to that person.

patient engagement

More often than not, discussions of engagement wrongly pivot and narrowly focus on “patient” medication and drug therapy adherence rather than on leveraging the person to get and stay healthier.

Medication adherence is not a primary driver for most of us. Instead,  it’s about doing what we like, how we like to do it and savoring that process. I can’t imagine most of us welcoming the day with “What a great day to avoid illness and disease so I better take my meds.”

How to get people sufficiently motivated to act in a manner that is meaningful to them, that matters or is important enough for them to act is the crux of engagement. That goes way beyond adherence, To make that work, we need to shift our focus beyond the passive and subservient concept of patient, sickness, and illness and go back to the person. Patients don’t change or take ownership or self-determine their futures and destinies. Persons do!

I contend that engaging and activating the person towards a healthier life and lifestyle will be never achieved as a patient. Oddly enough, we perceive patients as passive, wounded, sick, vulnerable, subservient and on unequal footing, yet we admonish them for being non-adherent, non-compliant, and not accountable.

If they are indeed passive why would we expect anything else? Only the person, not the patient can change if and only if, when and only when they find something that matters enough to them to stimulate, promote or sustain such change. The central pivot or regulating fulcrum is the degree of meaning and value to the person. That is the foundation for true and effective engagement, activation and positive change.

Person-centricity is a term that I have trademarked. It is an entirely new paradigm that frees the individual from assuming the patient role and dramatically changes the way individuals view themselves and how they interact with the world around them.

It is an ongoing continuous, dynamic process in which all constructs and actions revolve around the person and his/her decisions. It profoundly transforms how decisions are made and who has the authority and ability to make them. More broadly, a person makes changes to promote, improve, maintain and sustain their health and lives they lead as persons, not patients.

Such a paradigmatic shift views the individual as a “regulating fulcrum” managing information and requires a supportive infrastructure to help evaluate and filter the information in a way that is consistent with his/her values, priorities, preferences, beliefs and aspirations. The person-centric focus cuts to the core of who we are and our interactions with the world around us. The prescription for health centers on meaningful changes in behavior needs to be in concert with person-centric solutions.

The relationship between the notion of person-centricity and the transition from healthcare to a culture of health to help us add years to our lives and life to our years is symbiotic. It functions as both the missing link and the common thread that weaves together our needs, choices, and aspirations of people throughout our lives and health journey.

Next generation engagement must unpack the baggage of the patient and its association with pathophysiology and disease and move back to the person as the default and pivot for meaningful personalized decision-making aimed at enhancing our lives. That includes getting and staying healthy.

Health for the ancient Greeks was based on the mean between the extremes of self-indulgence and self-neglect. For Hippocrates, it was about “Rules of Life”, essentially, the way one lives one’s life. From this perspective our view of prevention must change as well. Prevention must move from merely preventing illness and disease to something linked to life and health. As such, prevention tactics would prevent interference from that which would undermine our ability to savor what matters to us and how we live our lives.

True engagement and behavior change require continuously available, real-time, personalized and targeted nudging that is distinctive and meaningful to that person. To deliver and scale that we need the help of a platform of ecosystems and advanced technologies, which together enable true synergies to leverage diverse ecosystems to promote and sustain health.

The right tools for the right person at the right time can help create a behavioral symphony of health and wellness and a culture of health. We can best promote and sustain change by realizing that even small changes collectively can make huge differences. We need to put the whole person, not just their skin, in the game.

By shifting our focus from the “patient” back to the person and supporting the person in embracing healthy behaviors/living and making prudent proactive choices, we adopt an approach that is more reflective of the way we change the trajectory of the lives. By engaging a mix of readiness, resilience, mindfulness, balance, hardiness, and endurance we can not only bend the sickness curve but also have a dramatic impact on the health of the person and well-being of our greater society.


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Dennis Robbins

Dennis Robbins is Strategic Engagement Advisor at WeLLnessCodes & Center for HealthTech/ Innovation, AHA.

Robbins (M.P.H. Harvard, Ph.D., Boston College) is a prominent innovator, thought leader, and health activist. His distinguished career spans multiple sectors of health, wellness, healthcare, industry, medical and surgical devices and technology, disruptive innovation, ethics, and policy. His initial work on patient-centric engagement and now person-centricity ™ has stimulated a major paradigmatic shift in how we think about health, healthcare, and next-generation engagement across diverse ecosystems.

Dr. Robbins was a National Fund for Medical Education Fellow, Visiting Scholar and Research Fellow at Harvard. He has advised Presidential and White house commissions, the military health system, start-ups, two US Supreme Court Cases and chaired the PCMH 2.O national think tank where he created the concept of person-centricity™, to help people become and stay healthier while adding years to their lives and life to their years. He blends elements of health information technologies, ethics, behavioral economics, exercise physiology, sleep, mindfulness, and healthy eating to bend the sickness curve. He serves on the boards or advisory boards of several companies and national organizations including the Global Innovation and Leadership Council of Frost and Sullivan and the American Heart Assn’s Technology and Innovation Advisory Board.

Dr. Robbins was a major force in the early Hospice Movement and worked closely across both aisles and CMS in helping to promote the Hospice Medicare benefit. His legacy of nine books and more than 400 articles is complimented by a plethora keynote presentations and panels. He has been recognized in the national media in such publications as Forbes, Medical Economics, Modern Healthcare, Hospital Ethics, and Managed Healthcare Executive who depicted him as among the top ten keenest thinkers in Managed Care.

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