Patient Engagement: Who are the Real Targets?

As I further considered the ideas generated by the breakfast panel I had the opportunity to participate in recently, Doctors and Patients: Bridging the Digital Divide, I was reminded of a stimulating comment made by Nikolai Kirienko, a patient advocate with Crohn’s disease. He stated that we need to use the current technology to reach patients who need it most.

But who are these patients, really?

Are they the well and well-to-do, middle to upper-class population who are internet-savvy, highly educated, and compliant with following the plans suggested by the healthcare provider?

Are they the patient struggling with chronic illnesses, the symptoms of which may tend to wax and wane on a daily basis, making their issues a daily struggle?

Are they the poverty-stricken residents of typically lower class neighborhoods in metropolitan areas, who may have more limited access to digital technology?

From my personal experience in a downtown metropolitan area, namely Washington, DC, I can tell you that most of the patients who are engaged in seeking out new information regarding their health conditions tend to be highly educated, middle to upper-class patients with excellent access to digital technology.

But I have to come back to the initial comment in question, which begs the question of who should we really be targeting?  Who can really take the most advantage to gain from the digital healthcare revolution?

I could take the Pollyanna-esque view that everyone should be able to take advantage of everything equally and we should all just get along and be happy.  However, real-world experience tells me that there may be a different answer this question.  There are also limited resources for healthcare outreach campaigns.  Therefore, it would seem appropriate to do more research into the area to really define who the best targets are for the maximum benefits. It certainly seems like a valuable question to answer and one that’s worth going after.  What do you think?

About the author

Dr. Michael West

Dr. Michael West

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at


  • Hi Carl. It’s an interesting list, but not much of a plan or description. It’s actually a list of ICD9/CPT codes. They’re going to have to do a better job than that to target population subgroups in my opinion.

  • I am working on a book on a similar topic: my goal is to get create a national dialogue from the everday patient/”Joe Plumber” perpective regarding the EMR/IT changes coming so people can understand both the importance of and HOW to take responsibility for their health car records.

  • David,

    It’s a very important topic from what I’m learning. The public is demanding more and more online engagement using a variety of access points. Best wishes for your book.

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