Why is Enablement Important?

Traditional reactive care based on diagnosis and treatment is not always the best approach in this new environment. Managing long-term conditions requires a focus on prevention, proactive care, and self-management skills. To meet current and future healthcare needs, we all, consumers, communities, clinicians, services, systems and governments, need to rethink how we deliver healthcare.

Increasing consumer enablement is one way we can work smarter to achieve better healthcare experiences and outcomes for patients, more rewarding experiences for healthcare workers, and a more efficient healthcare system. Consumer enablement is not new. You probably already use some approaches in your practice. It challenges you to rethink the way services are delivered, so people can effectively self-manage their chronic conditions.

People with high levels of enablement are more likely to:

• have better outcomes for chronic disease
• have better physical and psychological health
• actively manage their own health
• feel in control (can self-refer, initiate and prioritise actions)
• be highly aware of their health state
• self-advocate
• remain in good health
• avoid going to hospital
• participate in research
• increase their health literacy
• be familiar with their healthcare providers
• use technology for monitoring, management and education.

People with lower levels of enablement are more likely to:

• have complex problems and life circumstances
• have significant issues in cognitive capacity, psychological status, physical disability or incapacity, and family or community support
• have poor access to services, language barriers, different cultural norms, and previous negative experiences with health services
• not know their healthcare providers well.

Health systems are focused on improving efficiency to manage demand with limited resources. By rethinking the way we deliver healthcare, we can work more efficiently and improve the health outcomes of the people in our care.

The Institute for Healthcare Improvement identified three aims, the Triple Aim, to optimise health system performance and meet the future healthcare needs of the population. This has since been expanded to the Quadruple Aim, which recognises that improving provider experience is key to achieving the other three aims. Consumer enablement contributes to all four goals of the Quadruple Aim.

While the strategies in this guide have shown to improve chronic disease management outcomes, it is important to understand the limitations of the evidence available.

Results of studies that try to increase enablement as a means to influence outcomes are mixed and often short-term.

Studies of approaches to increase enablement have been somewhat limited to people with high enablement, as they are more likely to participate in this kind of research.

There is a lack of definitive guidance about what approaches and strategies should be used for people with different needs, abilities and circumstances.

Further research is needed in some areas, to determine the effectiveness of interventions for people with low enablement and in special needs and vulnerable groups.The evidence for consumer enablement continues to evolve, but this guide presents approaches that are best supported by evidence at the current time.