Digital Healthcare Should Not Mean Losing the Human Connection-The HSB Blog 8/23/21
Our Take:
To fully complete the transition to the digitalization of healthcare we must incorporate greater humanity, compassion, and empathy in the care we deliver. While there was a rapid shift from in-person care to telemedicine and digital health during the pandemic, it is essential not to lose sight of the importance and differences in the expression of compassion, humanity, and empathy between digital and in-person care. In a period where social isolation and fear of seeing clinicians in person, even when sick, has led to a reduction in preventive care visits, telehealth has played a key role in maintaining that much-needed connection among patients, clinicians, and care-delivery networks. Digital health has and will make it easier for patients to communicate with doctors without having to travel, saving them time, energy, and cost, therefore enhancing access in a myriad of ways, however, caregivers cannot lose sight of the need to blend the use technology with the need for old-fashioned authentic human connections with their patients.
Key Takeaways:
Clinicians routinely interrupt patients after only 11 seconds when patients are describing symptoms, yet patients generally provide relevant diagnostic information if they are allowed 35 seconds to speak.
Educational training that included self-reflection and reflective writing aimed at increasing empathy showed 100% of students experienced a positive change in empathy.
Raising awareness about digital empathy is the first step in educating trainees and preparing them for this technologically driven world.
More than 80% of diagnoses are made on history alone while less than 40% of patients give given the chance to talk about why they came in for their visit.
The Problem:
The patient-provider relationship revolves around trust, human connection, and compassion between patients and doctors. Many clinicians believe that over 80% of diagnoses can be discovered by doing the patient history alone. Therefore it is important for clinicians/ providers to determine what they need to prepare for during their visits. It is not only about the patient as a person exhibiting symptoms of a disease, but also the process of understanding those symptoms within the context of the patient’s life by taking a brief moment to communicate and connect with the patient. For example, studies have shown that on average doctors routinely cut off patients within 17 seconds of patients describing their symptoms when in fact if they had let them talk for only 3 minutes patients would have given them relevant diagnostic information. By allowing patients this time and letting them open up, they can explain their unique circumstances which can contribute meaningfully to the diagnosis. Digital healthcare has many advantages and has given patients greater access to clinicians who are now more available and approachable in some ways than they were before, but clinicians must make sure they are present, focused, and actively listening to patients to create the same bond as in-person care. The use of technology to establish a communication channel between patient and provider should not be an excuse for the loss of compassion and emotional connection between them.
The Backdrop:
According to a recent McKinsey report entitled, “Telehealth: A Quarter-Trillion-
Dollar Post-COVID-19 Reality?” 76% of consumers were interested in using telehealth in the future, up from 11% in 2019. In addition, the report also found that 57% of healthcare providers viewed telehealth more favorably than they did prior to COVID. While telehealth and digital healthcare tools had been around for years, given the fact that both providers and patients had to transition to virtual care almost overnight, the transition was not smooth. Both patients and providers had to acclimate themselves to this new normal. For seniors, for whom medical and social care was a primary form of in-person interaction, the lack of in-person medical care contributed to feelings of social isolation, loss of a bond, and the loss of empathy that many patients felt deeply. For years clinicians have recognized the role of empathy in patients’ care. As noted in “The Emerging Issue of Digital Empathy”, published in the American Journal of Pharmaceutical Education, empathy increases both patient satisfaction and compliance and enhances a practitioner’s ability to treat patients. The article goes on to note that empathy has strong positive effects on patient’s health outcomes and helps reduce the risk of malpractice litigation. Digital communications are often devoid of many of the non-verbal cues typically associated with in-person interactions which can lead to more impersonal interactions. Consequently, clinicians must pay careful attention to how they relate to patients in digital visits. As noted by Charles Alessi, MD, Chief clinical officer at HIMSS, COVID-19 forced us to jump into digital modalities to deliver care, but empathetic care isn’t just about care related to COVID-19, it is really is about the care we give in our everyday interactions with patients and citizens. As he stated, ”virtual platforms were made available quicker than we can imagine yet it was reported that patients were scared and wanted more authentic human interaction when seeking information. Patients not only wanted to be seen and heard but also listened to.” Along those lines, a study published in the Journal of General Internal Medicine reported that only 36% of patients are given the opportunity to speak up about why they came in for their visit; while only 20% of specialists actually asked their patients what was wrong. While many clinicians struggle with communication even with in-person settings and maintaining two-way communication seems difficult, human touch can often cover up a lack of effective communication skills. However, when dealing with digital interactions, clinicians must call on an entirely new skill set. Caregivers need to recognize, understand and resonate emotionally with the patient’s complaints, distress, and pain. Compassion and empathy in the digital health platform will provide a strong foundation in building this ever-growing virtual health platform. Efforts to address the issue of digital compassion, empathy, and communication should be integrated into clinical training and must be a building block to delivering optimal patient care.
Implications:
While empathy, compassion, and active listening can come easier to some than others, it is not an innate skill. For example, as noted in a recent article entitled, “How Technology Can Advance Empathetic Care“, empathy can be taught to nurses and doctors, with new ways of communicating that add more to the overall care of a patient. Moreover, although technology can seem like a barrier to human touch, technology can also be deployed to help train the skills that improve empathetic care. Virtual reality and augmented reality tools have been shown to help nurses who have recently received academic training but have not received practical experience directly working with patients. Augmented reality scenarios can teach clinicians how to handle difficult conversations and deliver bad news. In addition, technology allows facial recognition technology to provide instant feedback to clinicians on their effectiveness in reading a patients’ demeanor via the computer. Clinicians must recognize that technology used in a healthcare setting is usually biased in their favor to give them insights into a patient’s physiological condition and may also provide insights into their emotional state. For example, so-called “Compassion tech” which Andy Shin the Chief Operating Officer of the American Hospital Association Center for Health Innovation proposes defining as “knowledge-based products or services that improve the ability of users to recognize, understand and resonate emotionally with another’s concerns, distress, pain or suffering” can aid in gaining insights to a patient but are not a substitute for establishing strong solid communication with that patient. While technology can be used to bridge the gap between provider-patient relationships we continue to recommend 5 steps for connecting with patients via digital health, these include 1) staring into the camera when you speak with a patient; 2) don’t interrupt and instead allow patients to tell their story; 3) where possible use visual clues from a patients surroundings to learn more about their situation; 4) learn the art of the pause, actively train yourself to stop and listen to the patient; and, 5) embrace natural interruptions on video (ex: kids, dogs, etc.) on both sides of the interaction, they humanize it. All of these actions allow you to create a stronger, more lasting connection with your patient (please see our webinar entitled “Transforming the Digital Health Experience to Build Consumer Engagement, Loyalty, and Brand” with Ingrid Lindberg, Co-Founder, aubreyAsks & CXO of Chief Customer).
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