Connected Health: Speaking the patient language

BOSTON—Providers aren’t always the best when it comes to giving patients clear instructions and that can discourage them from engaging with their health. Panelists of an Oct. 25 presentation at the 9th Annual Connected Health Symposium shared insight into ways providers can increase patient comprehension and motivation.  

“Even for the most motivated patient, if they don’t understand what it is they need to do, they won’t know what to do in order to improve their health,” said Orli Frenkel, MD, MPH, an advisory board member at Telesofia Medical, a company that makes patient education videos based in New York and Tel Aviv. She estimated that nine out of 10 patients don’t have the skills to manage their health conditions as best they could.

Part of the reason is that medical information for patients too often is delivered to them in clinical terms and almost never personalized. “It is our responsibility as clinicians and part of the healthcare system to ensure that our patients are really understanding the information they need,” Frenkel said. “We know that that medical information should be delivered in a concise message that’s culturally appropriate and that contains simple, easy-to-use language.”  

Rather than providing written instructions, healthcare should be utilizing video much more than it is now, Frenkel said. Color, motion and sound can all be used to demonstrate complex concepts and instructions in video. Additionally, video is scalable and can be viewed by patients on any screen in any location at anytime, unlike the written instructions they may have forgot on a week-long vacation.

Even when information is presented in lay terms, it isn’t always addressing patient needs. When Mary Beth Chalk, chief engagement officer for Healthrageous, an Austin, Texas-based provider of a digital health management platform, examined patients’ written reasons for wanting to improve their health, less than 1 percent said they wanted to better manage their diabetes, maintain better adherence to their medication or follow their providers’ instructions. They were much more likely to say they wanted more energy to spend time with their families.

Increasing shared decision making and spending time learning about patient preferences can improve comprehension and motivation, according to Michael Barry, MD, medical director at the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital in Boston. While there is often only one route to take with certain conditions, such as appendicitis, there are multiple ways of dealing with most medical conditions.

“Only by knowing patients’ preferences surrounding these options can you achieve the goal of making the right decision for that person,” Barry said. “People too often don’t know there are multiple options for dealing with a condition, don’t know the basic facts about what they’re getting into and don’t know how important their preferences are to making a decision.”

Providers may think their patients aren’t intelligent enough, don’t want or will make bad decisions because of shared decision making, but Barry believes none of that is true. Based on his work with patients of providers partnered with the John D. Stoeckle Center, Barry said the least knowledgeable patients have the most to gain, only 5 percent of informed patients allowed providers to make unilateral decisions and patients generally turn down costly, aggressive options when presented with multiple options.

Those are compelling reasons, but “the real reason to implement shared decision making is that it is simply the right thing to do,” Barry said.