With patients, trust comes before engagement (Part 2)
I don't even want to see my doc unless I really have to. She is so busy, the whole time she just inputs data, and then bye-bye. - A patient on a forum.
By the way, did Hippocrates have to deal with MACRA, EULA's, CPTs, ICD-10's, HMO's, PPO's, MCO's, EMR's, MU's and HIPAA? Oh... and Malpractice lawyers advertising their glory on TV? Did not think so. - A doctor on a forum.
Read: With patients, trust comes before engagement (Part 1) for a background.
Often, the healthcare system ignores the quarterback for whom it exists: the patient.
We talk about patient engagement as if it's athing. That can be purchased in the market and implemented.
Practical ideas on re-building trust and engagement
It's not education material or portals or apps that we lack. The missing piece isengaging the patient on her terms, during her time of need.
Coordinating her care. Proactively checking on her. Being transparent with costs. Sharing her medical records. Helping her make treatment choices.
Bring back the conversation
To establish a diagnosis, modern medicine increasingly relies on data from tests and devices. That's good.
But in doing so, listening to the patient has taken a backseat.
Data is taking the place of history-taking and physical-exam, the foundations of patient-doctor engagement. This trend has set us on a shaky path of trust.
Data can sometimes feel like a protective mask from litigation. But for real care to happen, the doctor needs to listen to and reassure the patient.
Bring back the physical exam
Physical exam has become a routine that satisfies checklists on EHRs. We've forgotten its place in healing. In establishing a comforting doctor-patient bond.
With a physical exam, patients are reassured that they are being cared for. That mindset alone can set them up on a faster path of recovery.
Build strong, functional backend systems
Instead of buying that cool new gadget, focus on building information systems that help your processes flow. Today's EHRs send reams of useless information (with the false assumption that it protects providers from audits or helps them code better).
Instead, build systems that help the team access pertinent medical information.
Process before technology
It was Bill Gates who wisely said that technology applied to an inefficient operation will magnify the inefficiency.
Before technology rollouts, fix your process by wearing the hat of a patient. Experience those wait-times. Paperwork. Delays. Wrong billing. The whole deal of patient apathy.
Focus on the first and last points of engagement
Patients come in with a lot of pain. We fill those precious early moments with paperwork and mindless TV.
Engage by gauging the source of their pain, while capturing medications and vitals. You will be surprised how much patients do like to share.
Share your medical records with patients
Benefits of transparency outweigh the risks. Sending patients their chart after the encounter closes the loop of communication. It builds enormous trust in the system.
Structure the medical encounter in a way that allows you to share without concerns.
Design a less-anxious patient experience
Design your surroundings with the objective of relaxing the patient's mind. Functional but at the same time calming.
Remove physical barriers between the doctor and patient. Like that ostentatious table. Sit with the patient, not across her.
Treat patients as patients, not as buyers
A few hospitals have taken this patient-as-a-customer trend to an extreme. By creating shopping malls out of their facilities.
Patients easily see through the facade of making them into customers. A spa can't compensate for a poor medical interaction.
Patients visit a health system to get healed. To reduce pain and suffering.
A story from South Carolina
Shadowing N.S. Murali, MD in Orangeburg, a semi-urban region in South Carolina, opened my eyes to effective patient engagement.
Dr. Murali has found that fantastical combo of high productivity and real human empathy. Technology serves his needs versus the other way round.
For example, a foot-pedal plugs into his endoscopy machine to serve as a mouse-click to capture images. A searchable PDF archival system serves as an EHR.
Staff reaches out to patients twice to collect information ahead of their visit. Wait-times are short. Encounters are efficient but extremely kind.
In the consultation room, Dr. Murali methodically goes through a rhythm. From listening to examining to reassuring patients. Back home, patients receive an email from the doctor with a secure medical record.
They overwhelmingly rate him highly. Trust happens naturally. They engage.