20 Keys to Better Digital Patient Involvement in Healthcare

By Cristina Vaz de Almeida, PhD

Patients increasingly demand a digitized healthcare experience, but sometimes healthcare facilities fall short in delivering it.

We know that meeting patient expectations is essential to improve patient satisfaction. Better access, understanding, and use of health resources exponentially increases patients’ well-being, boosts the quality of patient service, and encourages patients to actively participate in the health system.

The Forrester Group reports that the healthcare sector is lagging in customer experience and digital transformation. It also notes that “patients are eager for better experiences that mirror the level of service and ease they’re used to from consumer experiences” (Forrester, 2022).

According to Forrester data, 76% of consumers are happy to receive medical care or text message advice, but there is much more behind ensuring an effective journey through the digital health system.

Addressing digital requirements and improving the delivery of healthcare requires health organizations to develop a set of tools and contact instruments to accompany the patient on their health and well-being journey. The following 20 keys are essential to meaningful access, understanding, and use of digital health resources, and to promoting active and empowered participation among patients to help them take control of their health decisions (Vaz de Almeida, 2020).

  1. Provide platforms that allow self-scheduling.

Digital health requires a digital platform that is specific, clear, easily navigable, and facilitated to those who have more difficulties and less health literacy (Vaz de Almeida, 2020; Vaz de Almeida, Coelho, Martins & Guarda, 2021). This platform must enable patients to schedule consultations and monitor their health status. Every day, patients must feel like they are connected to the health system and can reach out if necessary. An appealing, informative communication channel between the health organization and the patient/caregiver will help keep patients and families satisfied with their care.

  1. Keep platforms accessible, simple, and clear.

People want a platform that is easy to use and that allows them to, in a few steps, navigate to the services they need. The platform’s contents must be clear, assertive, and positive in a way that can lead to the intention of behavior and then to action.

  1. Consider social inequities that might make digital health more difficult.

Not all patients can access an online platform because of lack of computer literacy or easy access to a computer or mobile phone; therefore, it is necessary to find other ways to include these patients and prevent health inequalities that can accentuate social inequalities. Assessing the paths to digital access these people may have—for example, making an appointment from the local public library, or from the church or sports group they attend—could help create more cohesive digital networks and promote equity.

  1. Communicate well by analyzing patients’ digital health literacy.

If patients cannot understand health messages, there is no guarantee of the effectiveness of their treatment or of any following self-care. In addition to providing care, prepare patients for future situations in which they can control their state and make appropriate health decisions, such as by measuring blood pressure or oxygen level, or by staying adherent to a medication regimen. Effective healthcare is complex, and reaching patients can be an involved process. To develop interventions that work for a patient population, analyze the health literacy of patients who are making full use of services and consider how to extend that level of use to additional patients (Nutbeam, 2008).

  1. Deploy omnichannel communication.

The various generations—baby boomers (born 1946–1964), Generation X (born 1965–1980), millennials (born 1981–1996), Generation Z (born 1997–2010), and Generation Alpha (born 2011 and later)—all use different forms of digital contact (Vaz de Almeida, Coelho, Martins & Guarda, 2021). Omnichannel communication should therefore offer a combination of platforms and systems, including telephone contact, text messages, synchronous and asynchronous chat, and email. Messages should also be tailored to the patient population they’re intended for.

  1. Send timely and informative reminders.

Brief and clear reminders of appointments help keep patients and caregivers organized. Send regular reminders close to visits, and include information to help the patient prepare—for example, remind the patient to bring their analyses or reports they’ve received from other doctors (Vaz de Almeida, Coelho, Martins & Guarda, 2021).

  1. Provide longer-term information to keep patients oriented on their health journey.

In addition to reminders, health organizations should provide information on treatment, analysis, and longer-term care. This information should be structured in an organized manner according to the principles of health literacy, such as through the “chunk and check” technique.

  1. Use precision nudging.

This idea is taken from the Forrester Group, which defines precision nudging as the act of notifying or sending a message that requests an action from the patient, done at the right time and place to overcome barriers and promote scalable and sustained behavior change (Thaler and Sunstein, 2018).

  1. Turn dry scheduling systems into appealing messaging.

Most online scheduling systems have technical and unappealing online forms. Thus, it is important to turn these forms into opportunities for the patient to interact with the organization, such as by allowing the patient to initiate a conversation or get prompt answers to questions.

  1. Issue satisfaction questionnaires that patients want to answer.

Patients will respond to a digital survey if they feel that doing so will improve the service they receive.

  1. Make online booking as simple as possible.

People want easy and simple processes, with few steps. Offering appointment scheduling, preparatory information, and alerts all through a patient’s mobile device gives the patient an effective way to access and monitor their interventions and participation in health.

  1. Integrate appointments into the patient’s calendar.

For any number of reasons, patients sometimes forget about appointments they’ve made. A digital platform can automatically integrate appointments into the patient’s calendar (Google, Outlook, etc.) to help them adjust their schedule accordingly and give them the best chance of remembering to attend.

  1. Encourage preventive care with each message.

Patients want to be healthy and to improve their biological and psychological state, in addition to social, spiritual, economic, and other issues related to well-being. Easy access to health information—on the website, in their email, via text—coupled with positive messages about preventive action will increase their knowledge and awareness, and therefore promote intention for behavior change.

  1. Focus on high-risk patients.

High-risk patients face various barriers due to social determinants of health and have complex health conditions. They need continuous reminders to follow up on care, go to appointments, take medications, and make decisions about their health.

  1. Learn more about patients.

Digital health can improve the organization’s relationship with the patient and vice versa. A better understanding of the patient’s context and needs allows the organization to learn how the patient prefers to be contacted and treated. This can include not only basic items like insurance and contact information, but also things like the patient’s hobbies or interests. Ensure that any information collected respects confidentiality and data protection statutes.

  1. Enable prompt scheduling, preferably without delays.

Enabling online scheduling for some services, with alerts on the day of the appointment, allows for better time management and helps avoid stress for all involved parties (Vaz de Almeida, 2020; Vaz de Almeida, Coelho, Martins & Guarda, 2021).

  1. If there are delays, keep patients in the loop.

Patients and caregivers suffer whenever they must wait for information on what the hospital or health system is doing (Lee, Low, & Ng, 2013). Providing information electronically about a delay can relieve this situation—in fact, it is almost mandatory for patient satisfaction. Providing regular text message updates to family members in the waiting room about the status of the patient’s care, what analyses and treatments are being done, how long the wait will be, etc., can relieve stress and reduce complaints.

  1. Leverage campaigns to clarify the steps for digital access.

Information campaigns, learning courses, or tutorials that walk patients through digital health access are essential elements of a smooth patient journey through the health system.

  1. Tailor patient communication as you learn about patients.

Health communication should be focused on the continuum of care. By following the patient’s relationship with their health provider over time, organizations can understand when and how the patient prefers to be contacted; at what time they are most likely to access the digital health system; when and how they prefer to receive information from their provider (e.g., video call or phone); and what kind of information motivates them to take better care of their health.

  1. Use digital tools to advance health literacy.

Organizations can use digital communication as an educational tool to support, inform, and ethically influence the patient. This communication can improve the health and health literacy of patients, family members, and the community. Messaging that accompanies the digital contact should supply clear calls to action, not just serve as “promotional teasers.” In this process, digital education is essential for both patients and health professionals.

Cristina Vaz de Almeida, PhD, is president of the Portuguese Society of Health Literacy.


Lee, Y. K., Low, W. Y., & Ng, C. J. (2013). Exploring patient values in medical decision making: A qualitative study. PLoS ONE, 8, e80051. https://doi.org/10.1371/journal.pone.0080051

Forrester Group. (2022). Healthcare trends. https://www.forrester.com/blogs/category/healthcare/

Nutbeam, D. (2008). The evolving concept of health literacy. Social Science & Medicine, 67(12), 2072–2078. https://doi.org/10.1016/j.socscimed.2008.09.050

Thaler, R. H., & Sunstein, C. R. (2021). Nudge: Improving decisions about health, wealth, and happiness. Penguin Books.

Vaz de Almeida, C. (2020). Digital health literacy: A future healthy choice. International Journal of Mobile Devices, Wearable Technology, and Flexible Electronics, 11(1). https://doi.org/10.4018/IJMDWTFE.20210101.oa4

Vaz de Almeida, C. (2020, November 3). Digital health: Using technology to improve patient care. PSQH. https://www.psqh.com/analysis/digital-health-using-technology-to-improve-patient-care/

Vaz de Almeida, C., Coelho, I. D., Martins, P., & Guarda, L. (2021). Digital health in times of pandemic. To find the meaning of space, communication and proximity of health face-to-face, respecting differences. https://doi.org/zenodo.4522750