Technology has the potential to make the practice of medicine more efficient, but technology can also create a barrier between doctors and patients, who often report wanting their physician to spend more time with them during office visits. Here, an expert lays out the case for how technology and patient experience can work together.
A recent 3,000-person survey conducted across the US, UK and Germany confirmed that the physician-patient relationship plays a primary role in driving patient engagement—regardless of country or the difference in healthcare cultures.
The good news, according to the survey that was conducted by Nuance Communications, is that 97% of patients are comfortable with their physician using technology during a consultation.
But that figure is in sharp contrast to a 2013 RAND Corporation study that showed technology challenges are at the heart of many physicians’ frustrations. The RAND study revealed that 43% of physicians say Electronic Health Records (EHRs) slow them down, and 36% say EHRs interfere with face-to-face care. In addition, the Nuance survey found that 40% of patients feel rushed during physician encounters.
And therein lies the interesting conundrum, says Nick van Terheyden, MD, Chief Medical Information Officer for Nuance Communications.
“The survey told us that people like technology; they just don’t like the way it’s being used with the patient-physician interaction,” he says.
Assessing the Conundrum
According to the Nuance survey, more than a third of patients report spending less than 10 minutes with their physician during an average visit.
“That’s awful,” van Terheyden says. “Quality time is what the patients want, what physicians want, and what delivers the value.”
To help counter the limited time with their physicians, patients are seeking information and embracing technology outside of the doctor’s office in order to come to appointments prepared. The survey found that 68% of patients bring a list of questions to each doctor’s consult; 39% have checked WebMD or another online source in advance; and 20% bring personal health data from outside monitors.
“Patient engagement is more than just a buzzword of the moment—it’s a key to unlocking a healthier population and fixing some of the widening cracks of the healthcare system,” van Terheyden says.
Bridging the Gap
According to van Terheyden, there are several methods of addressing this issue. One of them is increased use of telemedicine, or video consults. He points to a figure he saw in Eric Topol’s book “The Patient Will See You Now,” indicating that approximately 80% of physician-patient consults can be done remotely.
“Telemedicine can ease some of this burden,” van Terheyden explains. “Do we really need to have a patient come all the way to the office and sit in the waiting room?”
Technology, such as remote monitoring devices, can also help in the gathering of information. Van Terheyden notes that with many patients already deeply engaged in their own healthcare, it makes sense to have them included in the information-gathering process.
“That way, when the patient comes into the office, the physician is not spending time accessing information because he or she will already have it,” he says. “That allows the physician to deliver high-value interactions that patients are looking for.”
Van Terheyden also refers to a technique some physicians have employed when engaging patients while making notes in an electronic medical record. The screen on the computer is on and turned toward the patient. That provides for additional education, increases interaction and offers the patient an opportunity to question things they don’t understand.
“It generates high quality physician-patient interaction.”
Many physicians also create a note describing or summarizing the patient’s visit, and make it immediately available on the medical practice’s portal. That, he says, gives patients an opportunity to better digest the information while reducing some of the administrative burdens that occur with the creation or capture of information.
Time and Economics
Van Terheyden agrees that many physicians are still driven by the need to see as many patients in a given day as they can. However, time is limited, and there are only 24 hours in a day.
“And nobody works 24 hours,” he says. “So it backtracks to a more fundamental question about the sort of methodology used in the way we compensate or reimburse physicians.”
He recalls a clinician who treated many elderly patients, who would look at their hands, or ask them to remove their shoes. He was assessing the ability of the patient. And in doing so, gained a better understanding of the patient’s capabilities, and the kind of support services they might need.
“That takes time,” van Terheyden says. “We have to change the model of medicine to adapt to that. Physicians can still be sufficiently compensated, but it can’t just be a measure of the number of patients they see. And potentially, saving money is part of that. Because if we can keep those patients out of the hospital, we’re not only saving money, but we’re providing people with better care and a better quality of life.”