Patient engagement is not simply a portal login, reminder response, or app download. It means patients have meaningful opportunities to understand their care, share what matters to them, access appropriate information, and participate in decisions to the extent they want. The future will include more digital options, but the central challenge remains designing care around people’s needs, preferences, and circumstances.
Digital access is expanding—but it is not the whole story
Patient portals and apps can make selected tasks more convenient, such as viewing available health information, communicating with a care team, or managing an appointment. ASTP/ONC reports broad adoption of several hospital digital engagement capabilities, including access to records and secure messaging. The presence of a feature, however, does not tell us whether patients can use it, find it understandable, or prefer it over another channel.
Organizations should offer digital tools as part of a broader access strategy. Consider device and broadband access, disability accommodations, language, digital skills, privacy, and whether a patient has a safe and private way to receive notifications. Keep phone, in-person, or other appropriate alternatives for people who cannot or do not want to use a digital option.
Shared decisions and patient-reported outcomes
Shared decision-making brings clinical evidence and professional expertise together with a patient’s goals, preferences, and circumstances. Digital decision aids or educational materials may support preparation, but they do not replace a conversation or ensure that a patient feels heard. Engagement should be based on patient choice; some people want to make decisions with family or caregivers, while others prefer to speak privately.
More communication is not always better
Automated reminders and messages can help people keep track of next steps, but poorly timed or unclear notifications can create confusion and burden. Teams should clarify what channel is being used, who reviews replies, expected response times, how opt-outs are handled, and what patients should do if the issue is urgent. Messages should use plain language and avoid revealing sensitive information in an unsafe channel.
Privacy, trust, and transparency
Digital engagement depends on appropriate handling of health information. Explain what data a tool collects, how it is used, who can see it, and where to get help. Review vendor and organizational responsibilities rather than relying on a broad claim that an app or platform is “secure.” Patients should know how to access information, correct inaccuracies, and raise concerns.
