Many of the problems plaguing healthcare today, specifically errors in patient care, reside in poor communications. How many of us need to listen to the entire recorded message tree when calling a doctor’s office or healthcare facility, only to not reach the intended person and as a result giver up trying? Why is it that most people when leaving an office visit do not know their diagnosis or how to take their prescribed medication? How can we best engage patients whose native language is not English? How do we best engage all patients? I will discuss five types of digital tools which address clinical needs.
- Patient handoff tools. Discontinuity in patient care in the hospital or other care facility is necessary. Strictly speaking, a handoff is the transfer of role and responsibility from one person to another in a physical or mental process. An excellent study from 2005 examined multiple areas of communication surrounding the patient handoff. The authors argue for a combination of verbal and written communication. According to the Agency for Healthcare Research and Quality (AHQR), components of an effective handoff strategy should reflect the acronym ANTICipate:
- Administrative data (patient’s name, medical record number, and location) must be accurate.
- New clinical information must be updated.
- Tasks to be performed by the covering provider must be clearly explained.
- Illness severity must be communicated.
- Contingency plans for changes in clinical status must be outlined, to assist cross-coverage in managing the patient overnight.
The role of technology in the patient handoff process is clear. The implementation of one handoff program as reported in the New England Journal of Medicine last year reduced the rate of preventable adverse events by 30%. There are different types of handoff tools which might vary in complexity, specialty, and effectiveness.*
- Caregiver tools. There is finally now focus on technology for caregivers. This makes perfect sense since caregivers are more likely to be digitally connected via smartphones and apps, though at a logistical disadvantage. Technology enables surveillance (both figuratively and literally) of loved ones.
- Language tools. Obviously language becomes a critical barrier when the subject of patient engagement is discussed. The legal framework for language access in healthcare settings is not new. What is different is the significant increase in cultural diversity of the USA. The combination of this diversity as well as the increase in patients with chronic diseases increases the imperative of health literacy for all patients. The lack of adequate language translation might be the difference between life and death. This critical gap has been addressed by multiple translational services, some enabled with video conferencing. One unique company in this area is SpeechMED which utilizes mobile technology for all aspects of healthcare.*
- Telehealth. In a previous post I discussed how I believe telehealth will change healthcare. It will close gaps in healthcare. These gaps include gaps of access due to rural/remote geographical regions or lack of available physicians in certain medical specialties. Telehealth can keep patients in touch with their usual healthcare providers and specialists without an in-person visit.
- Patient-provider messaging tools. Many questions patients have can be answered quickly via messaging. We are used to messaging people in other aspects of our daily lives. Communication tools allow for more prompt responses and will I believe facilitate the rebirth of the patient-physician relationship which has all but disappeared in the harried world of the 15-minute office encounter. People have questions they recall when they leave or think of after a discussion with a caregiver or other healthcare provider. There are many such tools in use and the most utilized fall into the category of patient portal provided by the EHR vendor.
Although this is certainly not an exhaustive review of the topic, technology communication tools in healthcare will become part of our routine. The concept of these tools is no longer something from outer space. Communication is a phenomenon older than mankind itself. What technology does is make it more convenient and should never be seen as a replacement for traditional human interactions. As I say, technologies are tools which only become solutions when incorporated into a humanistic context.
*Disclosure: The author is an advisor to MEDarchon which makes Quarc, a healthcare communications tool and SpeechMed.