Technology boosts doctor-patient communication

By Bernie Monegain
10:47 AM

Caregivers who talk with the patient about their care before, during and after care tend to improve outcomes and avoid readmissions. Technology can help improve how it's done – and documented.

That’s how Aaron Fink, MD, and Tim Kelly see it, and they’ll be offering reasons why when they team up to present a session on Patient-Centered Communications at the iHT2 Health IT Summit, April 24-25 at the Omni Hotel at CNN Center in Atlanta. The session is slated for April 24 at 1:30 p.m.

Fink, professor emeritus of surgery at Emory University School of Medicine, is attending surgeon at the VA Medical Center in Atlanta. Kelly is vice president of Dialog Medical, a Standard Register company.

Dialog Medical has automated the informed consent and patient education processes with its iMedConsent application. The idea is to manage – and record – vital communication across the continuum of care, says Kelly.

Managed correctly, communication with patients improves outcomes, reduces hospital-acquired conditions and lowers readmissions, says Fink, who was co-principal of a multi-site study investigating the potential benefits of “teach-back” within a computerized informed consent program, sponsored by VA Health Services Research and Development.

The teach-back method is simple, Fink says. It’s asking the patient to repeat what he heard the doctor say about an upcoming procedure, treatment or surgery. After Fink described the upcoming procedure to the patient, “I would then ask the patient to repeat it back in his own words,” he says.

That may seem simple, he says, but it can also be extraordinarily effective at avoiding misunderstandings, promoting efficiency and avoiding hospital readmissions – especially when coupled with technology. That’s where iMedConsent comes in.

What it does, says Fink, is “enhance (communications) even further by No. 1 providing electronic support for that teach-back process. No. 2, it also documents the fact of the comprehension.”

“They designed it such that it would include an additional documentation in the patient’s medical record – not only about the details of the discussion, but that confirmed that the patient indicated satisfactory comprehension of such and such an event, Fink says, “which I think just further enhances the medical record’s documentation of the events that transpired.”

“Having an automated system that can provide the script for the provider, do the documentation of that process in the background, automatically send notes to the electronic health record – all of that frees up the provider to spend more time with patient communications – as opposed to charting notes,” says Kelly (pictured at right). “And, that’s sort of the nifty aspect of the technology.”

“Patient- centered communications are absolutely going to be foundational to accountable care organizations, Kelly notes. “We’re looking for strategies to reduce readmissions because those are going to become very quickly penalties for hospitals. We want to – although they don’t tend to get a lot of attention because there’s not a reimbursement impact – reduce preventable cancellations," such as having a patient go through a fast-food drive through just before a scheduled surgery.

During their talk on April 24, Fink and Kelly will discuss four strategies for leveraging existing health information technology to better inform and engage patients in their own care:

  • pre-procedure instructions to reduce cancelations;
  • consent documents to avoid medical errors;
  • a National Quality Forum-endorsed Safe Practice to ensure patient understanding; and
  • discharge instructions to reduce readmissions.


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