Enhancing patient engagement in healthcare – a paradigm shift for improved outcomes

  • Patient engagement allows patients’ beliefs and preferences to be included into the treatment plans, resulting in more customized and responsive treatments.
  • By encouraging active participation, patient engagement can result in better adherence to treatment plans, better outcome, and fewer adverse events.
  • Active patient engagement can help to enhance patient-provider relationships, foster trust, and increase patient satisfaction.
  • Engagement among patients has the potential to lower healthcare costs by reducing hospital re-admissions, reducing adverse events, and optimizing resource utilization.
  • Patient participation helps to ensure the long-term viability of global health systems by encouraging informed treatment decisions and effective resource utilization.

In today’s rapidly evolving healthcare scenario, patient engagement is critical. Active patient engagement improves treatment quality, especially in case of chronic diseases. Recognising the impact, it has on health behaviours and outcomes, healthcare fraternity is looking for newer ways to engage patients.1  

What is patient engagement?

Patient engagement refers to the active participation and collaboration between healthcare providers and patients, aiming to ensure that patients are well-informed about their treatment, recovery, medication choices, and other important aspects of their medical care.2,3 It is increasingly recognized as an integral part of health care and a critical component of safe, people-centered services. Engaged patients, who understand the patient engagement definition, are better equipped to make informed decisions about their care options. By aligning resources with patients’ priorities, healthcare systems can enhance resource utilization and contribute to the long-term sustainability of health systems worldwide.1

The impact of patient engagement in healthcare

Enhancing healthcare outcomes: Active patient engagement in healthcare is critical for improving treatment adherence, disease management, and overall well-being. Measurement of patient-reported outcomes and focus on strategies such as personalised communication and visual aids help providers improve healthcare value. This approach enhances not only clinical care but also the patient experience, satisfaction, and overall outcomes. Providing comprehensive patient data not only empowers patients by identifying areas for engagement improvement but also enables healthcare professionals to implement evidence-based policies.1,3

Patient satisfaction and trust: Healthcare workers can develop trust and strengthen patient-provider relationships by actively incorporating patients in decision-making and care planning. Engaged patients often express higher levels of satisfaction and a sense of ownership in their healthcare journey. Patient engagement encourages a patient-centered approach in which patients’ preferences and interests are recognized and respected. This cooperative partnership fosters trust increases communication and boosts patient satisfaction. 2,3

Cost-effectiveness: Patient participation has the potential to lower healthcare costs by reducing hospital re-admissions, decreasing adverse events, and optimizing resource utilization. Engaged patients are more likely to seek preventative treatment, actively manage their health, and recognize potential difficulties early on. This preventive strategy may result in fewer difficulties, hospitalizations, and emergency department visits. Unnecessary healthcare use can be avoided by encouraging self-management and empowering people to take an active role in their healthcare, resulting in cost savings for both patients and healthcare systems.3,4

Factors affecting patient engagement

Patient-related: Patients’ engagement is driven by their knowledge, beliefs, emotions, and demographics. A sense of vulnerability can lead to proactive safety measures. With 75% of Americans considering healthcare moderately safe, and many worried about errors, active patient participation is crucial to reduce errors. Age, sex, education, and potentially ethnicity influence engagement levels – younger, female, and highly educated patients typically look for more active roles. Health literacy and coping styles also affect engagement and safety behaviors. Understanding these influences can improve patient engagement strategies.5

Disease-related: Patients with less severe conditions are more involved in their healthcare, while the relationship between disease severity and involvement is inconsistent. Factors like symptoms, treatment plans, and health outcomes mediate patient engagement. Chronically ill patients benefit from active participation, while terminally ill patients may have different preferences due to limitations. Prior experiences with illness or safety incidents also influence involvement.1,6

Health care professional (HCP)-related: A study found that 58% of US physicians believed patients were partially responsible for medical errors, suggesting their role in reducing vulnerability. Health professionals’ beliefs greatly influence patient involvement, but the extent of support for patient participation in safety is still unclear. Positive interactions from healthcare professionals increase patient participation, while dismissiveness decreases it. Patients may feel more comfortable questioning nurses than doctors about safety practices. Health professionals’ beliefs and behavior play a crucial role in encouraging patient involvement in safety practices.6

Health care setting (HCS)-related: The healthcare setting impacts patient involvement, with communication difficulties in hospitals compared to primary centers. Hospitalized and emergency patients have limited opportunities for engagement due to uncertainty about their condition. In contrast, ambulatory care patients are more knowledgeable and able to actively participate in their treatment.6

Task-related: The nature of the required patient’s behavior can impact doctor-patient interactions. Patients may find it easier to manage their medical history than to raise concerns about the delivery of their healthcare, such as hand hygiene. These confrontational behaviors can be perceived as offensive by both patients and doctors. Patients tend to be more involved in non-medical aspects of their care that do not require medical expertise, as they may find them less confrontational to discuss with their doctors. 1,6

Strategies for promoting patient engagement7

Effective patient engagement hinges on clear, empathic communication, tailored to patient needs and cultural language norms. Encourage active patient participation in health discussions and ensure they understand their medical issues and treatment options. Shared decision-making is key, enabling patients to make informed decisions by understanding their health status, treatment options, and potential risks. This bolsters patient autonomy, trust, and treatment adherence. Assess health literacy and deliver understandable, targeted patient education about their conditions and care plans.7 Using simple language, visual aids, and interactive tools improves comprehension. Aim not just to impart knowledge but also boost self-efficacy and active health management. Leverage technology, such as patient portals, mobile applications, and remote monitoring tools, to enhance communication, accessibility, and self-management. These tools bring convenience and real-time support to patient care. Patient portals offer secure communication with healthcare professionals and access to health records. Mobile apps deliver education resources, reminders, and lifestyle tracking features. Remote monitoring facilitates health data tracking, timely interventions, and progress assessment. Such technology empowers patients to engage in their care and connect with healthcare providers easily.3

Read more about enhancing engagement and improving effectiveness trough patient support program, in our article on The impact of Patient Support Programs on adherence: enhancing engagement and improving effectiveness

Overcoming challenges and embracing the future

Addressing barriers to patient engagement: Addressing patient engagement barriers such as health inequities, cultural differences, and limited health literacy is critical to improving healthcare outcomes. To overcome these obstacles, health equality measures, culturally appropriate communication, health literacy program and user-friendly technological solutions must be implemented. Patient involvement can also be hampered by operational concerns such as cultural change, ill-defined guidelines, a lack of evidence-based monitoring tools, patient and healthcare staff views, and a lack of awareness. To develop an environment that supports patient engagement, healthcare organizations must address these concerns proactively with clear standards, evidence-based practices, and training. 8

The future of patient engagement:

The evolving healthcare landscape offers new patient interaction opportunities through personalized medicine, telehealth, wearable tech, and virtual care, boosting patient involvement and decision-making. These trends, aligned with value-based strategies, enhance outcomes and long-term success. A clear vision, effective technology, and experienced healthcare providers are vital for achieving patient engagement goals. This approach transforms healthcare delivery, aligns with industry trends, and promotes positive changes, fostering increased patient involvement and long-term success. 9,10

Read more about how Mobile apps can increase adherence in our article on Mobile apps for enhancing adherence to chronic diseases


Shifting focus to enhanced patient engagement in healthcare is key for better outcomes, quality of care, and cost-effectiveness. It fosters a patient-centric approach, using effective communication, shared decision-making, and technology, though cultural and technical barriers need addressing.9 Future developments in personalized care, telehealth, and wearable tech will augment engagement. Healthcare organizations need a clear plan and experienced service providers to achieve patient management goals. Embracing patient engagement will revolutionize healthcare delivery, empower patients, and align with industry trends, paving the way for improved health outcomes and lasting success.10

“Patients are the most underused resource in healthcare. We need to shake up the traditional hierarchy, give them better information, and let them decide about their own care” – Sir Muir Gray


1. World Health Organization. Patient engagement. 2016. Accessed June 2023 from https://apps.who.int/iris/bitstream/handle/10665/252269/9789241511629-eng.pdf

2. Barello S, Graffigna G, Vegni E. Patient engagement as an emerging challenge for healthcare services: mapping the literature. Nursing research and practice. 2012; Oct 31: 2012.

3. Krist, A. H., Tong, S. T., Aycock, R. A., and Longo, D. R.  Engaging patients in decision-making and behavior change to promote prevention. Information Services & Use. 2017; 37(2): 105-122.

 4. Bombard, Y., et al. Engaging patients to improve quality of care: a systematic review. Implementation Science. 2018; 13:1-22

5. Graffigna G, and Serena B. Spotlight on the Patient Health Engagement model (PHE model): a psychosocial theory to understand people’s meaningful engagement in their own health care. Patient preference and adherence. 2018: 1261-1271.

6. Davis, R. E., Jacklin, R., Sevdalis, N., and Vincent, C. A. Patient involvement in patient safety: what factors influence patient participation and engagement?. Health expectations. 2007;10(3): 259-267.

7. Coulter, A., and Ellins, J. Effectiveness of strategies for informing, educating, and involving patients. Bmj. 2007; 335(7609): 24-27.

8. Chegini, Z., Janati, A., Babaie, J., and Pouraghaei, M. (2020). Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nursing open. 2020; 7(1): 457-465.

9. Topol, E. J. High-performance medicine: the convergence of human and artificial intelligence. Nature medicine. 2019; 25(1): 44-56.

10. Haase, J., Farris, K. B., and Dorsch, M. P. Mobile applications to improve medication adherence. Telemedicine and e-Health. 2017; 23(2): 75-79.