engagement is through electronic health records (EHRs) and patient portals, which are beginning to be adopted nationwide as novel ways for providers to partner with patients by providing information and support for care management.

The papers in this chapter review lessons learned from efforts to support the active engagement of patients in their healthcare decisions and health management and identify priorities and strategies for progress. In the first paper, George D. Lundberg of Cancer Commons provides an overview of the Internet revolution, which has democratized information. He reviews opportunities to improve the information available to or accessed by patients, as well as to use the Internet as a platform to engage patients in real-time, rapid learning communities.

In the second paper, Paul C. Tang of the Palo Alto Medical Foundation demonstrates the critical importance of engaging patients in their own care to close gaps in health outcomes and system performance. He reviews how information technology applications such as patient dashboards has helped make patients part of the health team, fostered patient and provider collaboration in tracking progress toward health goals, and provided tools to transform data into information from which patients can learn.

Dorianne C. Miller, formerly of the University of Chicago Medical Center, draws attention to initiatives that are helping to extend health care to settings outside of the clinical encounter. Shifts in patient population demographics and in the focus and capacity of health systems are driving the creation of applications to ensure that patients receive care (e.g., patient health records and portals, e-visits) and support beyond the traditional care environment. In addition to highlighting opportunities, she discusses barriers to expanded use of such technologies, such as social acceptability, lack of Internet access, and clinician reimbursement.


George D. Lundberg, M.D.
Cancer Commons

Change is everywhere and affects everyone. People handle change in three different ways:

  • Fear it; fight it; not recognize that change is inevitable; lose.
  • Fail to recognize the need for and reality of change and be swept away by it.
  • Seek it; recognize it; harness it; guide it; and eventually win with it.

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