Patient engagement describes how patients, caregivers when appropriate, and care teams participate in communication and decisions about health and care. It is not a patient’s willingness to follow instructions, nor is it the same as signing up for a portal. Meaningful engagement makes room for a person’s goals, preferences, circumstances, and questions while supporting informed choices.
AHRQ describes shared decision-making as a collaborative process that combines evidence, clinicians’ knowledge and experience, and the patient’s values, goals, preferences, and circumstances. The exact approach depends on the decision, clinical context, and the patient’s wishes.
What engagement can look like
- Clear, two-way communication: Invite questions, explain options in understandable language, and check what matters to the patient.
- Shared decisions: Discuss reasonable options, benefits, risks, and uncertainty when a decision is preference-sensitive.
- Preparation and follow-through: Help patients understand next steps, who to contact, and how to access instructions or results.
- Caregiver participation when appropriate: Include a patient-designated support person while respecting consent, privacy, and applicable rules.
- Patient access to information: Offer records and communication tools that patients can use, with help when needed.
- Feedback on services: Ask patients about barriers, communication, and experience, then explain how the organization will use what it learns.
How care teams can support engagement
- Ask what the patient needs from the visit. Start with the patient’s concerns and priorities rather than assuming which issue matters most.
- Use understandable information. Avoid unnecessary jargon, provide translated or accessible formats when needed, and use teach-back as a way to check whether the explanation was clear—not to test the patient.
- Make next steps explicit. Summarize who is doing what, expected timing, how to get help, and what should prompt a call or urgent evaluation.
- Offer appropriate communication choices. Portals, phone, in-person discussion, printed summaries, and other channels may be useful for different people and situations. Provide a non-digital path where practical.
- Make technology inclusive. Explain how to enroll and use portal features, support accessibility and language needs, and provide proxy access only through proper authorization and safeguards.
- Build it into the workflow. Assign staff ownership for messages, referrals, results, and patient questions; define response expectations and escalate clinical concerns appropriately.
Where patient portals can help—and where they cannot
A portal may support appointment requests, records access, secure messaging, prescription requests, or visit summaries, depending on the system and configuration. The technology helps only if patients can access it, understand it, and know when to use another channel. A portal should not be treated as an emergency service, and teams need clear coverage and response workflows for messages.
Do not assume that portal enrollment alone means a patient is informed or involved. Some patients may prefer another channel, face accessibility or connectivity barriers, or need help understanding information. HealthIT.gov’s Patient Engagement Playbook recommends making enrollment easier, selecting features that meet patient needs, ensuring information is accessible and understandable, and considering caregiver access appropriately.
