Posts Tagged with communication

posted by adgrooms on June 7, 2019

When a patient makes an office visit, the provider may send home information, prescribe medicine, and schedule a follow-up appointment. What patients lack are points of accountability and reminders to help stay on track in order to make health improvements. Patient care should not have to stop at the clinic door, and it does not have to add to provider workload. In fact, messaging can reduce it.

A recent review of studies on SMS health reminders showed a range of positive outcomes for patients. Automated messaging improves compliance through appointment reminders, immunizations, and prescription reminders. Behavioral reminders for smoking cessation and diet reminders for patients with diabetes or heart disease are also shown effective.

The study references articles showing "major financial savings" in the reduction of missed appointments, alone. Reminders can be automated for frequency, duration, and helpful custom information, such as addressing each person by their first name. Even two-way messaging can be automated using chatbot technology. This can be the first line of communication to answer patient questions, with a path to escalate to a provider, if needed. More sophisticated integration of messaging with EHR can measure the effectiveness of messages to hone the system.

SMS is not encrypted and not a secure method of communication. Although text messaging is an accepted daily risk for most people, reminders must be crafted to contain no PHI. Care should be taken to obtain permission to use this channel of communication. It is also important to inform each patient of the risks to their personal information and the types of messages you intend to send. Examples of the types of messages and the information they will contain will be helpful for patients to make an informed decision.

Automated messaging is a low-cost method of communication that has been shown to improve patient compliance. There are still more areas where this approach can be explored.

posted by adgrooms on June 6, 2019

Healthcare providers need great tools that facilitate their work and empower them. IT teams need to stay ahead of risk to their organizations; this includes all forms of system resilience, especially security risk. Leadership needs cost-effective solutions and reliable systems. To this end, healthcare IT departments have oversight of all software used in their institutions. They are charged with protecting patient data, efficient use of resources, and the overall security of computer systems; therefore, they review and approve every piece of software used. Sometimes employees find the approved software to be inadequate or prefer using solutions not provided by the institution. The use of unauthorized software without disclosure is known as "shadow IT". What are effective ways of addressing shadow IT?

Some healthcare employees may not know what a security risk shadow IT is or the HIPAA policies they are violating. For example, one common use of shadow IT is communication. Providers looking for a more efficient way to share patient health information amongst themselves could be using their personal device for messaging. It seems like a pragmatic and reasonable solution, but in reality, this is an insecure method and highly vulnerable to a data breach. How can these instances be addressed?

Many times it is the lack of a good clear process towards getting a better solution implemented. Any large organization has many rules and processes, and it is hard to be aware of the relevant steps. A solution-seeking provider may not know where to go to get the software approved. Is it an IT committee? The IT department itself? The CTO? Having a defined and published process with a clear entry point gives the progress-oriented people on the front lines a path to work within the institution's guidelines. A step beyond this is to develop an innovation committee. All approaches should show appreciation for the inclination toward improvement and steer creative souls into constructive, informed steps in partnership with IT.

Maybe you are an IT team member reading this thinking "We have a process. We still have this problem." This is an indication that a process audit would be helpful. Can you view the steps from the perspective of a healthcare provider in your organization? What are the steps to discovery? How do they become learn how to work with you? Is the process time-consuming or confusing? Can it be more clear or streamlined? Are innovators encouraged? Discouraged? Punished, even?

Shadow IT may not be any single department’s fault. Conflicting interests between leadership, IT, and the providers can cause the adoption process to be slow and painful, leading to more shadow IT. Creating and refining a collaborative and encouraging process will go a long way to reducing shadow IT, increasing security, and encouraging innovation.

posted by adgrooms on May 24, 2019

A trip to the hospital can be a stressful and overwhelming experience. While the patient is already unwell and concerned, they are also receiving information and guidance about their current and future care from physicians and therapists. Upon discharge, the patient or caretakers must take this information and continue self-treatment at home. But how is the patient to keep track and apply all of the advice and instructions - some spoken, some printed?

Patient portals may contain notes about the visit, but often don’t have detailed information that a patient was given in person. Many patients lose printed discharge information and reasonably resort to looking for the information online. However, this is lacking the specific input from the various specialists and therapists that all provided direction.

An ideal solution would be an after-visit summary that consolidates information from all points of care and a patient could access at any time in their portal. Of course, producing these notes for every patient in language that they could understand would be extremely time-consuming for a physician. This is another area that could be helped by dictation systems. Capturing the instructions as each care provider speaks them to the patient and providing both the audio and transcribed text would help a patient remember what was conveyed.

Additional information could be automatically supplied with libraries of information tied to medical coding. Instead of asking patients to remember to ask for key information and keep track of the answers, these formats could become electronic templates and filled with specific details. This could be further enhanced with the ability for physicians to include additional instructions as needed. The information library could be made take into account the specifics of a patient such as prescription information, health numbers to monitor and aim for, and dietary instructions/goals.

Outcomes can be improved with better patient discharge information. Providing the information in an understandable and accessible way can benefit communication and help a patient take an active role in their recovery.

posted by adgrooms on May 15, 2019

The other morning for breakfast, I ordered eggs and a biscuit, but they brought me eggs and bacon. It seems like a pretty minor mistake in the grand scheme of things, but when messages are miscommunicated in a clinical environment, it is patient safety that takes a toll. So, what can technology do to help in a clinical setting?

We always talk about face to face communication being hampered by technology because technology distracts people and blocks them from engaging. What if we used it to enhance verbal communication?

Everything old is new again. Medical transcription has existed for more than a century. It originated with medical stenographers taking dictation into shorthand. Onsite stenographers were replaced when recording devices became widely available, but human transcribers still recorded the notes, if asynchronously. When EHRs were introduced, they seemed to take transcribers out of the process, which placed the burden of data entry on physicians. But now the misstep seems to have been caught and transcription is returning in all its forms and more. The new approach is to use voice recognition in dictation. Instead of using a transcriptionist, a doctor can dictate to the software and have notes entered into a patient record, which, arguably increases speed and accuracy.

Even the best of listeners, in a noisy, confusing environment, can get words mixed up. Headsets can be used between team members to take away background noise and improve clarity in conversations. This increases the mobility of a team as the headset would allow them to coordinate as they move between rooms. And it decreases the time it takes to connect with a team member.

Recording patient interaction is a good way to document how a patient is vocalizing how they are feeling. Sometimes reviewing the conversation or having someone else hear the interaction can bring to light nuances or words that were missed during the live interaction. This can also be used as a valuable teaching tool when trying to improve provider-patient interaction.

Where else can we use technology to assist verbal communication? There will always be verbal communication in a clinical setting, and we can continue to implement and improve technologies that help fill in the gaps where communication is falling short.

posted by adgrooms on May 9, 2019

Meaningful positive changes in medical technology require input from the people who use it. With a full clinical schedule, it’s hard for healthcare providers to find the time, and this leads to a medical technology bottleneck.

A health care practitioner's time is valuable, arguably best spent providing care. They might get to vent about a software problem around the lunch table with colleagues...Or an EHR improvement insight might bubble up in transit to the next round. The ideas that need to be heard by the tech firms beyond hospital walls rarely get there.

Cultivating relationships between the medical staff and the internal IT department could be a step towards transmitting ideas for improvement. The IT department manages the software and systems that the frontline staff use every day, and are more likely to hear about problems and areas for improvement...But formalizing time for the two groups to come together and fostering a culture that encourages feedback increases the chances of fruitful exchange.

The AMA has recognized the need for physician/tech collaboration and has taken action. They have created a resource called Physicians Innovation Network. This is an online forum for physicians and tech companies to join together and develop innovations in healthcare technology products and services, including paid and volunteer opportunities to participate.

Creating forums and platforms for communication, as well as encouraging and protecting time for medical practitioners to participate is all necessary for this to work. In the end, it is all about collaboration, communication and providing busy healthcare workers an outlet for their voices and needs to be heard.