FutureCare

Communication Complications

A recently published study in the August issue of Archives of Internal Medicine reveals that there are significant gaps between what doctors think their patients know and what patients say they know. The findings are based on a survey of 89 patients and 43 physicians conducted between October 2008 and June 2009 at Waterbury Hospital affiliated with Yale School of Medicine. Researchers found that some of the discrepancies relate to basic information. For example, two-thirds of physicians thought patients knew their names. But only 18 percent of patients could correctly say their names. Other information gaps are more critical and could affect patient safety and quality of care. Roughly three in four (77 percent) physicians thought that patients knew their diagnoses, while in reality only 57 percent of patients knew of their doctors' diagnoses. Furthermore, while two-thirds of patients reported receiving a new medication in the hospital, 90 percent of them said they had never been warned of the med's adverse side effects. Virtually all doctors (98 percent) said that they discussed their patients' fears and anxieties. Still, only about half (46 percent) of the patients seemed to agree. The survey respondents were older, indigent, and less educated than average. Despite being a small study, these findings potentially have huge significance. If these findings are anywhere near to what we would find if we looked at patients all across the country, it suggests that doctors may not accurately understand, address patient needs nor effectively communicate with some of their patients. On the other hand according to researchers from the University of Maryland, poor communication in U.S. hospitals costs the nation $12 billion per year or approximately 2 percent of national hospital revenue. This represents more than half of the average hospital profit (margin) of 3.6 percent. Researchers say much of this waste could be eliminated by investing in health IT solutions that could streamline communication among hospital caregivers. Consumer Health IT tools may also improve communication among patients and between patients and providers. By 2050 there will be 2 seniors over the age of 65 for every adult under the age of 65 and by that same time the US populace will be composed of more than 50% immigrants and minorities, many of which will be less educated and poorer than the average US citizen and some of these individuals will also possess poor english language skills. Thus without significant improvements in the ability of the healthcare system to reach, understand, address the needs of and communicate effectively with seniors, those less educated, immigrants and racial and ethnic minorities, healthcare disparities among these groups, and healthcare costs for everyone may still be on the verge of significant increase. We may actually “fix” healthcare financing & reimbursement issues yet find ourselves still unable to reduce healthcare costs, effectively address healthcare disparities or improve national health outcomes among large portions of the US populace. If this is indeed the case, can we really claim to have the best healthcare system in the world?

Cyberchondriacs

According to a new Harris Poll of over 1000 adults, the numbers of people going online for health information (cyberchondriacs, eHealth Consumers) continues to increase. In 1998 just over 50 million American adults had ever gone online to look for health information. In the new poll, the number of Cyberchondriacs has jumped to 175 million while the frequency of usage has also increased. Fully 32% of all adults who are online say they look for health information "often," compared to 22% last year. In addition the proportion of those who are online and have ever used the Internet to look for health information has surged to 88% this year, the highest number ever. Over 80% of all eHealth consumers have looked for health information online in the last month while 17% have gone online to look for health information ten or more times in the last month. Most eHelath consumers are satisfied with what they find. Only 9% report that they were somewhat (6%) or very (3%) unsuccessful at finding what they needed. And only 8% believe that the information they found was unreliable. These findings show that, with every passing year, more and more people are using the Internet to look for health information and that the overwhelming majority of these Cyberchondriacs are finding what they want. This has potentially significant implications for providers and health systems who can only communicate or interact with patients, caregivers and potential patietns using traditional print or in person means. In a bid to try to respond to this growing consumer demand, the Mayo Clinic--with its 60,000 followers on Twitter, its medical provider channel on YouTube and its several successful blogs--is launching a Center for Social Media to "accelerate effective application of social media tools" within its own facilities, as well as to help other facilities in their efforts to connect patients and doctors online. Lee Aase, manager of syndications and social media at Mayo, told the Wall Street Journal Health Blog that "There is immense interest from clinical departments--they want to be able to harness these tools to do their business." Although Mayo will charge other hospitals for consulting and giving out advice, the real focus is looking for ways to increase the use of social media throughout the practice at Mayo…To provide in-depth information for patients in a much more comprehensive way, and to create connections between researchers, physicians and staff." While clearly a step in the right direction, there appears to be no goal of improving patietn engagement and or empowerment. While it is still early, I sincerely hope Mayo and other leading health systems will not only embrace these ideas for thier potential to transfer information or improve the bottom line, but also to do the right thing.