In our previous article, we discussed the importance of adherence and some potential strategies patients, providers, and other stakeholders can use to increase treatment follow-through. Here, we’ll take a closer look at post-visit engagement, a critical adherence strategy providers can use to build a trusting, empathetic relationship with patients, quickly flag adherence issues, and combat patient forgetfulness.
Follow-up engagement doesn’t have to be time consuming—it just has to be smart. By combining the tried-and-true principles of engagement with human-centered design, the healthcare industry has an opportunity to develop new approaches to follow-up care.
Let’s look at some of the elements of a successful patient engagement strategy, how they can be used to improve post-visit care and adherence, and how one healthcare company has already put them into practice.
Marketers are engagement experts, and the healthcare industry can learn a lot from them.
Marketing is all about guiding people toward a specific goal with strategic messaging and engagement. For marketers, the goal is usually some sort of purchase. For healthcare providers, the goal is adherence.
According to Marketo, a successful engagement strategy encompasses these five principles:
We’d like to add a sixth principle: It makes life easier for everyone involved.
Below, we’ll take a look at each concept from a healthcare lens.
Studies show that adherence improves when people feel like they have a positive, trusting, and empathetic relationship with their provider. Follow-up messages should convey the same warmth people expect during their appointments in order to build the kind of rapport that improves adherence..
To accomplish that, messages need to feel personal—like someone took the time to craft it with the receiver in mind. Research suggests personalized emails are six times more likely to be opened compared to generic emails, and 84% of those surveyed expected companies to send personalized emails.
At minimum, emails and texts should include the patient’s name. It’s fine to send emails that direct patients to a secure portal for additional information, but the notification email should specify the patient’s name and the type of message waiting for them in the portal (e.g., test results, a direct message from the provider, or an important reminder).
Phone calls are even more personal than emails, especially when a real person makes the call versus a robot.
Here’s another idea: to find out how someone is feeling after starting their treatment plan, send a survey with questions tailored to their condition or symptoms. Don’t rely solely on generic satisfaction surveys.
Patient engagement isn’t about messaging people every few weeks just to tick a box. This can feel spammy and invasive, and it could actually damage the provider-patient relationship.
Instead, providers need to know who to follow-up with and when to do it. Patient data and behavior is key.
Patient data is available from a variety of sources, including:
Let’s take a look at what you could do with that data (with the patient’s consent):
Healthcare groups should consider all of the data at their disposal and consider how it could be used to trigger follow-up engagement.
It’s important to reach “the right audience at the right time” to maximize the effectiveness of an engagement campaign. In healthcare, messages need to be timed right to ensure maximum benefit to the patient. Researchers have found that patients sometimes feel they have to fight for their providers’ attention, and they feel heightened levels of uncertainty when important messages are delayed.
With that in mind, it’s important to make each message as timely as possible. But timely doesn’t necessarily mean instant.
Let’s say you want to check in and see how someone’s handling their new treatment plan. If you connect with them too early, they may not have an opinion yet. If you connect with them too late, you’ve lost an opportunity to help. And if you follow up too often, your messages may seem irritating or overwhelming.
There’s no standard follow-up schedule that will meet the needs of every patient, so consider each situation case-by-case. For example, if you prescribe a medication that becomes more powerful over time, consider following up after the patient should’ve experienced a therapeutic benefit. On the other hand, someone in a more fragile or vulnerable state may benefit from a follow-up call in 24–48 hours.
Likewise, there’s no set frequency that works for everyone. Too many messages can overwhelm people and cause them to start ignoring the communication altogether. It’s best to find a balance. Doing it right builds trust.
That said, think about whether some of your patients would benefit from daily automated reminders to take their medication. When you want to remind people about an upcoming appointment, give them at least a week’s notice so they can shift their schedule as needed. A text or automated phone call could be all it takes to improve adherence.
This principle is all about making sure your messages are actually received. You’ll waste time and resources emailing someone who doesn’t have reliable internet access, for example.
Healthcare providers should already be following this principle because HIPPA laws give patients the right to receive communications only through their preferred channels. But you can also think about this engagement strategy in literal terms.
Is there an opportunity to connect with people in the community at pop-up events or mobile clinics? How many follow-up visits could actually be video appointments or phone calls? This can help people adhere to their appointments despite transportation challenges.
Patients should clearly understand why you’re reaching out. Otherwise, engagement messages can feel spammy.
What do you hope to accomplish with your messages? If possible, break down large goals into smaller, more achievable actions. For example, if you want someone to take their medication as prescribed, first they need to get it from the pharmacy. If you want someone to regularly track their blood pressure, first they need to understand how to use the device.
The entire message should be crafted around the goal, and it should include a “call to action” that describes exactly what you want them to do next. If you expect someone to call you back, say so. If they need to click a link for more information, include that command in the text.
It also helps to tell your patients ahead of time that you’ll contact them after the appointment to see how they’re doing. That way, they can expect your outreach and be prepared to give feedback.
We know healthcare professionals’ time is already stretched thin. You don’t have to carve out time to personally call every patient in order to engage with them.
Automation is key. A good patient-centered engagement tool identifies who needs a follow-up, when and why it should happen, what the message should say, and how it should be sent, and then tracks responses.
The best engagement strategies also make life easier for patients. People rarely enjoy jumping through hoops, even for a noble cause like health adherence. Let people press a button to say they’re feeling better or plan to keep an appointment. Don’t ask for too much of their time too often.
Now that we’ve covered the guiding principles of engagement, let’s look at how the healthcare industry could adapt other industries’ popular engagement strategies to improve patient adherence.
Improving patient education has been shown to increase adherence, and written materials may be more effective than verbal instructions because patients can reference them as needed. Otherwise, forgetfulness creates a secondary barrier to adherence.
Sending a series of automatic emails after a new diagnosis or prescription could help bridge the gap. Other industries call it onboarding, and it helps customers have a good experience with a product or service.
Sometimes one onboarding email is all that’s necessary. Other times, multiple emails are sent over the course of a few days, and each one tackles a new topic or pain point.
Here’s how it could look when someone is prescribed medication for high blood pressure. Once the healthcare provider inputs the new medication data into the computer system, the patient is automatically flagged to receive a series of onboarding emails that will teach them about high blood pressure, how their medication works, common side effects of the medication, how to use a blood pressure cuff to track efficacy, and when to call their provider.
Gamification is the art of using game design elements to increase motivation around everyday tasks. One study found that earning badges, climbing a leader board, and tracking performance on a graph made people feel more competent and helped them find more meaning in the required tasks.
Customer experience designers use gamification and rewards all the time. If you’ve ever used a coffee shop punch card to get a free drink or earned travel rewards points on a credit card, you’re familiar with the concept.
Some health-related examples include closing the fitness rings on your Apple Watch by staying active, not losing your investment on WayBetter by completing challenges, or leveling up a new plant on Plant Nanny by logging hydration. Studies have also shown that incentives can even help people quit smoking.
There are pros and cons to this strategy. Gamified platforms can be expensive to design, so they tend to be well-suited for larger healthcare systems. And they need to be thoughtfully designed—the easier it is for people to participate, the better. Otherwise, convincing people to use the system becomes yet another adherence issue. Prizes must also be carefully planned out in order to comply with legal restrictions.
When you add things to your online shopping cart but never check out, you’ve “abandoned the cart.” Brands will try to re-engage with you to push you over the finish line. Often, this looks like a follow-up email reminding you to check out.
In healthcare, “abandoned carts” happen when people never pick up their prescriptions, don’t use home health monitoring equipment, or don’t go to their appointments, to name a few scenarios. They’ve made some effort but are having trouble completing the task at hand.
These patients may need a quick check-in to steer them back on track. Use patient behavior data to identify who to contact. For example, when pharmacy records show the prescription was never picked up, someone can reach out to the patient to learn more.
Sometimes companies offer starter kits, samples, or free trials to let customers evaluate the quality of the product or service without making a substantial purchase. The idea can be adapted to improve healthcare adherence.
In fact, it’s already put into practice in most dentist offices. When you get a goodie bag containing a toothbrush, toothpaste, and floss after your appointment, you have one less excuse not to take care of your teeth. The tools you need are right there.
Free condoms are another example, and evidence suggests that STI rates decrease when condoms are free and easy to access. In other words, people adhere to safe sex practices when the supplies they need are readily available.
What are you constantly suggesting your patients buy? Would it be feasible to offer it for free instead? Pill organizers are a good example. Or, consider working with insurance companies to order supplies on behalf of your patients. You may also try to negotiate free or discounted accounts for any paid apps or services that would benefit your patients.
Try to be as service-oriented and convenient as possible so there’s little reason for patients to say no.
In 2018, Children’s Wisconsin sent a digital engagement survey to 12 volunteer families. By 2025, this “e-advisory group” had blossomed to over 600 English- and Spanish-speaking families who give detailed feedback on a variety of topics, such as the quality of the valet service and cafeteria, misconceptions about installing and using car seats, and how to improve hospital communications.
Lori Albers, a Family Engagement Specialist at Children’s Wisconsin, has coordinated the e-advisory group since day one. She says the initial group of a dozen families “helped develop how we would ask questions, why we would ask certain questions, and what topics were really relevant.”
Because feedback is collected online, the e-advisory group remains accessible to many families. It fulfills two critical principles of engagement: meet people where they are and make life easier for everyone.
“The impetus was how do we engage with families that might not be able to come to the hospital and provide us with feedback?” says Albers. “A lot of our families don’t have access to transportation or childcare, so coming into the building was already a challenge.”
Having an online engagement platform at their disposal turned out to be a huge advantage during the COVID-19 pandemic. The group helped the hospital develop effective communications about masking and protective environments.
“The e-advisory group gave us an opportunity to do that in a very quick fashion, whereas our [in-person] focus groups had a set cadence and putting one together would sometimes take like two or three months,” says Albers.
Children’s Wisconsin has also been able to leverage the e-advisory group to learn more about how health literacy impacts adherence. The hospital’s data suggests that health literacy is a problem for about 90% of families. Albers attributes this high rate to stress and anxiety, which gets in the way of a person’s ability to read and understand information. “It all changes once you’re in that hospital setting.”
That’s why the team takes great care in developing resources that are easy to understand. And the e-advisory group vets those materials before they’re published. This is human-centered design in action. The e-advisory group helps Children’s Wisconsin figure out the core needs of their families and helps them address those needs in an empathetic way.
“In one of our sessions, we looked at how we communicate with families about the correct dosage of medication. For so many of our kids, medication is based on weight, so parents need to know what their child’s weight is to be able to give the right dosage.”
Albers says the hospital created dosage charts in an effort to improve dosage accuracy, but the e-advisory group pointed out certain elements of the charts that were confusing.
“We had to make it much more clear whether we were dealing with pounds or kilograms, and by and large everybody wanted weight in pounds, but certain diagnoses really needed them in kilograms,” she explains. “So many families didn’t realize there was a difference between pounds and kilograms until we educated them. So we had to make that very clear on the chart.”
In another session, Albers says the group looked at different drawings and photos showing how to correctly use a car seat. Families were tasked with choosing the most effective visuals.
“I thought it was really eye opening. Did they want something that was more cartoonish, or did they want to see a photo?” Detailed photos were a big hit.
“When they could see a photo, they could see how big the child was and how their legs were placed, or how tall they were in a booster seat. They’d tell us they didn’t know they had to cross this or lock that until looking at the photo.” With these meaningful reference points, parents had an easier time understanding how to use a car seat safely.
Albers says managing the e-advisory council is a relatively low lift. She used to be the only person working on it, but now works with a team. Healthcare systems with limited resources may find that an e-advisory council is a good way to increase patient satisfaction and adherence without investing in significant resources.
Plus, the group could also give feedback on your other engagement strategies. What’s the right balance for sending reminders and follow-up messages? What would help people feel like their communications are more personalized and helpful? Instead of shooting in the dark, talking directly to your patients can shed some light on what your audience needs.
So far, we’ve talked about engagement strategies that healthcare groups can integrate into their existing systems. But what if healthcare leaders took a different approach and redesigned the system from a human-centered perspective? Omada Health did just that.
Omada Health is a telehealth platform where patients, health coaches, and specialists can message back and forth. It’s designed to improve health and adherence rather than replace the patient’s primary care physician.
The platform has several features that make engagement easy for everyone, including:
Omada Health embodies human centered-design by:
Understanding the problem: Poor adherence and health outcomes due to limited engagement.
A study sponsored by Omada Health found that people saved at least $892 in medical expenses by using their platform. They also found a link between higher engagement, better health outcomes, and greater cost savings.
Even if your healthcare group doesn’t have access to sophisticated digital health solutions for improving patient engagement like Omada Health, other engagement strategies could help your patients see better health outcomes and greater cost savings too.
If you do want to harness the power of human-centered design strategies to improve patient engagement, connect with Oliven Labs for a spec call. With more than 20 years of experience designing patient-first solutions for the healthcare industry, we improve lives and create lasting impact.
Want to join us as a thought partner for our next article series?
