by Internet Medical Society
Over the years, time and efficiency pressures on doctors have created an ongoing sense of urgency which has led to hurried, interrupted or completely missed patient communications.
Research evidence shows that there is a strong connection between a healthcare provider’s communication abilities and a patient’s capacity to follow his medical recommendations and adopt preventive health obligations. The physician’s communication skills have a profound impact on the functional and biological health outcomes of a patient.
With the introduction of episode-based value care models, and patient engagement software, patients are beneficiaries as they themselves are expected to participate in their treatment procedures. For an episode of care, our interests are much beyond just an initial dialogue between the patient and the provider. The intent is to closely monitor patient’s treatment progress and be available whenever the patient is in need — throughout the patient’s continuum of care.
It is not just about the initial communication— there has to be a structural approach to the patient-provider communication that ultimately improves healthcare delivery. Digital health and value-care are the trend of today and even healthcare has moved toward digital to an extent where patients and providers do not meet in person, still are so closely connected and the exchange of documents, disease summaries and patient history is performed virtually. There are some software platforms that bring everyone together – the health-care givers and patients — and allow them to have a dialogue, share information, and schedule virtual meetings and visits.
This is not easy to accomplish - matter of fact, this is the most difficult challenge for providers — how to coordinate a patient across providers throughout the patient’s continuum of care, understand patient’s treatment adherence, and gain visibility of related episode costs. This specific problem is Lifecycle Health platform’s focus — helping the provider follow the patient throughout the patient’s continuum of care.
Today, most of the patient-provider relationship is made during the diagnosis phase, which is the initial most interaction between the two parties. Diagnostic procedures and decisions are usually made after the history-taking component.
Patient portals have made it possible to send images, reports, and other medicine information that is critical for the physician to know before initiating the therapy. A quick note on our viewpoint of patient portals - a portal is not “patient engagement” as some EMR vendors claim. From our viewpoint, a portal is more of a self-service tool and not a very effective way of engaging in a 2-way exchange with a patient. Are patient portals valuable? Yes - absolutely, or at least they can be - if the user experience of the portal is easy and intuitive. (This is a separate blog topic altogether).
These initial patient diagnosis activities are a critical phase for the doctor-patient relationship because this time is when the patient starts building trust in the healthcare provider. However, studies revealed that patients are often not allowed to share complete details of their medical history; rather the physicians interrupt with a quick diagnosis or explanation, which leads to potential diagnostic inaccuracy but more importantly, when patients are interrupted, it hinders the relationship at the first visit.
ADHERENCE TO TREATMENT PROCEDURES
The extent to which patients conform to the doctors’ recommendations is called “treatment adherence”. Certainly, this is one of the most common practice issues in healthcare – patient non-adherence. Some disagree with the clinician’s terms, some worry about the cost, some find the instructions too difficult to follow, some cannot handle with inconvenient locations, and some feel that the prescription is against their personal beliefs.
Episode-based care has placed even more importance on this monitoring of treatment adherence, or treatment compliance by patients because the outcome — financial and the health outcome — depend on the patient’s adherence.
Currently in healthcare, many physicians only know if a patient is following suggested treatment actions after the next patient visit — after weeks pass by — and some may never know. Even if the physician can find out before the next visit, it is probably through informal mechanisms such as if they remember to contact the other downstream provider (if they have the time, and if it is convenient), or ask the patient in the next visit. Some challenges occur when asked during the next visit as it depends on the patient telling them the exact truth— think about your typical answer of “flossing” given to your dentist — not always the most accurate when the direct question is asked during a visit.
With episode-based or value-based care, the hospital or responsible physician has more responsibility to follow the patient activities and adherence patterns, and also has more risk (financial and outcome risks) if there is treatment non-adherence.
PATIENT SAFETY & SATISFACTION
Communication among the people involved in either side of the treatment procedures plays an active role in strengthening the relationship leading to a better healthcare service. Any kind of miscommunication may lead to dangerous results in patient care. When patient-provider communication is clear and effective, patients are expressive and more participative in the treatment procedures resulting in an overall positive therapy. Outcomes are better — physician ratings are better.
Patients want to be better informed about their medical condition, care methodology, specific care paths, and the care provider team members involved, so that they know they are in safe hands and are continually observed. With innovative care models, patients are becoming more knowledgeable and satisfied with the care episodes they come across. Even though there is a lot of medical expertise involved throughout the patient’s continuum, communication barriers may ruin the patient-provider relationship.
We continue to hear that most patients get information about their procedure, condition, and what can be medically accomplished — from a tactical perspective, when they speak with their physician. However, most patients would enjoy and take great strides in participating in their care path — if they simply knew what the path was, and received more information about that path from their surgeon or initiating care provider. Much of this topic is around better pre-procedure planning, and care path planning (episode planning).
Most of the times doctors listen to their patients only to be able to respond — not to simply understand the patient’s concerns or context of their questions. By understanding the context and the “why” behind the question, you may be able to get the patient to understand why adherence is not only an physician expectation, but also why care path engagement and treatment adherence is important for the patient themselves.
You cannot just rely on the symptoms about the actual medical condition of the patient. You need to ask some questions too. It is well known of the statistic of physicians interrupt their patients within 20 seconds of describing their symptoms. Sometimes a physician may be able to diagnose better if resisting the urge to interrupt and conclude a diagnosis, and ask for a little more context on the patient’s habits and surrounding circumstances.
Sometimes even though the physician may be correct in his diagnosis within 10 seconds, but another 45 seconds in patience and listening may buy much more patient trust through feeling empathetic, listening to their concerns, and also gain longer-term loyalty (not to mention that these patient trust aspects lead to referrals which lead to more revenues).
Be fair enough to make patients understand the causes of their illness, be honest to what you feel, acknowledge their emotions, and involve them in certain decisions so that they feel an important part of the treatment procedure. Healthcare is now measurable with the generation of figures and statistical data of how the treatment has progressed, and statistical outcome measurements.
All care team members involved in the patient’s continuum, including the patient themselves, need to be coordinated and active in all the conversations to complete their part of the job and in order to get a comprehensive episode of care outcome.
This is not easy to accomplish - matter of fact, this is the most difficult challenge for providers — how to coordinate a patient across providers throughout the patient’s continuum of care, understand patient’s treatment adherence, and gain visibility of related episode costs.
This specific problem is Lifecycle Health platform’s focus — helping the provider follow the patient throughout the patient’s continuum of care.
No two patients are same. It is important to treat every individual patient with utmost care, and also be able to utilize different communication techniques that are most appropriate for the individual. It is vital to communicate with every patient with a new perspective, and be effective in that care path communication — and not just by only understanding the individual’s medical condition. It is only when you build the patient trust and rapport that you will be able to have your patients invest in their healthcare through knowledge sharing, treatment adherence, and engaging with providers along the care continuum.
There are software technologies to enable physicians and providers to customize the communications to the most appropriate and effective for their patients - email, text, app messages, phone alerts, and also other aspects for frequency and language preferences. Communication starts in the office visit - but it doesnt (and shouldn't) stop there in today's connected world.
LifeCycle Health empathizes with this important criterion in the healthcare providers and patient’s episode care path. To know more about our ways of improving patient-provider communication and coordination throughout the patient’s continuum of care, visit our website http://www.lifecyclehealth.com/. We take pride in strengthening bonds between providers and patients within the healthcare industry.
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