For many, the ideal healthcare experience involves face-to-face interactions with physicians who listen intently. With the advent of the EHR, however, many clinicians find themselves focusing on their laptops, barely making eye contact with patients as they struggle to document everything that is said.
During a February roundtable hosted by Becker's Hospital Review and sponsored by Nuance, a panel of healthcare executives discussed the current state of patient-provider interactions and explored how technology can foster more personalized care.
Five takeaways:
- Patients are frustrated with the fragmentation and lack of transparency in healthcare. Even in health systems that offer a patient-centered medical home, a significant amount of fragmentation exists between different services. If test results are delayed, there's no feedback loop for the patient. In addition, there's no price transparency.
As the CMO of an independent, acute care community hospital in the mid-Atlantic region noted, "Patients come out from an appointment or a hospital stay and sometimes they understand what happened, but most times they don't. That creates an environment where patients aren't engaged. Even if they want to be, the system makes it too complex." - Documentation requirements undermine meaningful experiences between patients and clinicians. During office visits, most physicians are busy entering data into EHR systems and submitting information to insurance companies for approval. "One of the top complaints in healthcare is that the burden of documentation has taken us away from face-to-face interactions," said the CMO of a behavioral hospital in the Midwest. "If the first interaction with a patient is meaningful, that builds the therapeutic bond. The clinician also trusts that the patient will participate in their care model. If you don't have that buy-in from the get-go, everything else is off."
- Ambient clinical intelligence has the potential to personalize care. The goal of ambient clinical intelligence technology is to document everything, so clinicians can focus on patients and observe cues as patients talk. According to Jared Pelo, MD, chief clinical product officer at Nuance, "In the first two years after the release of our Dragon Ambient eXperience solution, 80 percent of patients said their physicians were more focused on them and more conversational. They spent less time on their computers, which is the outcome we're trying to achieve."
The roundtable participants were hopeful about technology's potential to improve the patient and clinician experience. "Maybe AI can help us get a grip on what our patients need," said the vice president and CMO at a mid-Atlantic hospital serving patients with medically complex developmental disabilities. "Technology should be leading us to more face time with patients, rather than typing." - Health systems are exploring other forms of technology to support providers and improve patient satisfaction. During the pandemic, an academic medical center on the East Coast used tablets to connect hospitalized COVID-19 patients with their families. Nurses also communicated with COVID-19 patients using the tablets. This enabled the hospital to conserve personal protective equipment, since staff could identify what patients needed before entering the room.
To transform care delivery, healthcare organizations are considering other innovations as well. "We are looking into a pilot that would integrate dietary department menus into a voice-activated device," the CMO at a Midwest hospital said. "Medication information at the time of discharge is also a major issue, so we are implementing multilingual informational videos so patients can learn about their medications at any time by scanning a QR code." - Technology education is essential to address clinician concerns and skepticism. Some healthcare providers fear change and the unknown. Proactive education about technologies like artificial intelligence can improve clinician engagement when clinicians are provided with new tools and technologies. "We offer a monthly artificial intelligence orientation course," the chief intelligence and innovation officer at a West Coast children's hospital said. "The goal is to educate with the clinician in mind. The American Board of AI Medicine also offers a monthly Intro to AI course which attracts about 50 people each month."
When discussing the future of healthcare, the roundtable participants were optimistic about AI and other technologies. "We're at the beginning of the AI journey. There are some really useful functions today, but it's a strong rising tide," Dr. Pelo said. "Five years from now, I think all of us will rely on these tools to make our lives and the lives of our patients better."
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