By David Mayer, MD, CEO Patient Safety Movement Foundation, Executive Director MedStar Institute for Quality and Safety
Engaging with patients is a time-honored tradition in medicine, and by no means a new concept. A great physician-patient relationship is something that every patient would love to have. Back in the day, the physician was like Marcus Welby – they would visit your house and know all about you and your family. This arrangement was not only great for improving the physician-patient relationship, but also improved health outcomes by providing the most patient-centered care possible.
Today, many medical professionals face some new challenges in making that all-important connection. These days, doctors are pressed for time and don’t have that same one-on-one relationship with their patients. While doctors can pull up a chair and speak to the patient at eye level, technology is playing a greater role these days. The increasing role of technology in healthcare has been advantageous in some ways, but has posed new challenges, too.
Technology Has Simplified Information Management in Health Care
Technology has helped healthcare providers communicate with patients and provide them greater access to their information. Used appropriately and with the proper discretion, digital tools such as Electronic Health Records (EHR) and patient portals help us empower patients to have more say in their treatment. At the same time, if we become overly dependent on these platforms, including Electronic Health Records (EHR) and patient portals, we lose that interpersonal connection as well as the skills required to connect with patients. The dramatic advances we’ve seen in medical technology have greatly improved our ability to care for patients, and have added some layers of complexity to overcome.
Technology is both helping and hurting medicine. It remains to be seen how technology can be best adapted to the workflow.
Challenges of Electronic Healthcare Tools and the “Digital Divide”
Doctors are pressured by our healthcare system to complete various electronic tasks which pose a challenge to the physician-patient relationship. For example, they have to see a certain number of patients, and are burdened with loads of paperwork. This workload is directly at odds with time that could be spent getting to know the patient better. For example, Instead of spending the time at a keyboard looking at a screen, the physician could record the conversation with the patient, and later on, transcribe it into EHR.
This issue is particularly acute with young professionals who are far more comfortable with digital communication than past generations. For these young healthcare professionals, digital communication has become a preferred mode of communication, which has eroded our ability to create and nurture relationships. A direct effect of this so-called “digital divide” is that many young healthcare professionals feel unfulfilled or unsatisfied in their careers due to that disconnection.
This “digital divide” is also evident from the patient’s perspective. Patients want to be informed and involved in decisions relating to their care. We need to engage them to ensure we provide them with the best care possible and avoid misdiagnosis or treatment. Listening to patients typically leads to a more accurate diagnosis and treatment, which is what we all strive for. Having that additional information also means we’re less likely to make a mistake. It’s no surprise that a recent study, published by PubMed Central, found that patient engagement improves a patient’s perception of care and reduces readmissions.
The study also found that nurses, particularly millennial nurses, needed that connection with patients to feel satisfied in their careers. Those unable to bridge this gap typically found new careers. Think about this: when we sit with patients, we spend a good amount of time at a keyboard looking at the screen asking them to answer questions and updating records. In many cases, when we’re finished typing the updates, we simply get up, thank them and leave the room. We’ve missed an opportunity to listen to the patient, get to know them just a bit more, and hopefully help them to a better outcome. Just as importantly, we’ve missed the chance to find a greater degree of satisfaction in the work we do.
Adapting to a High-Tech Healthcare System
So, how do we improve this situation and create an environment that is more beneficial to the patient and to healthcare providers? Like anything else, we learn and practice. We can learn these skills by watching others and through roleplaying, by simulating interactions with patients and using new skills we acquire in our daily lives.
The little things can matter a lot in this process. Healthcare providers can pull up a chair and sit down, versus standing at the foot of the hospital bed, before beginning a conversation with the patient. Physicians and nurses who sit down versus stand are perceived to spend twice as long talking with the patient than when standing.
It’s true that patients like to be engaged in their healthcare decisions, but there has to be a proper rapport with the doctor. Ideally, a doctor could spend 30 minutes with their patient, talking about life habits, exercise, anxiety and stress, and so on. Shorter visits in the doctor’s office are less useful, though they are becoming the norm. One way to improve patient-centered healthcare using technology is to use the Patient Portal to communicate with the physician prior to the visit to get the most out of the limited time the patient spends with their healthcare provider.
As you can see, technology has the potential to improve health care, if we can apply it in creative, new ways.
Improve Patient Engagement with the PSMF Patient Safety Curriculum
To help you improve your ability to connect with patients, the Patient Safety Movement Foundation includes patient engagement in its Patient Safety Curriculum. The goals include:
- Develop improved knowledge of the science, as well as the human side, of patient safety and empathy
- Value the role of patients and families as members of the healthcare team striving to deliver patient-oriented safe care
This curriculum can be easily integrated into development programs in its entirety or used selectively to incorporate specific coursework. It includes a section focused on relationship-centered communication.
The ability to listen and connect with patients is as important to your success – and patient outcomes – as the many other skills you will acquire during your training. That’s why it’s important to take the time to hone this important skill as a healthcare provider.