- mHealth and other health technologies may be the key to improving patient-provider relationships by drawing them closer together between office visits, according to the authors of a recent opinion piece in Physician Medicine and Rehabilitation, despite worries that laptops and smartphones interfere with a provider’s personal touch.
As health IT permeates the industry, stakeholders have expressed concern that these tools may get in the way of deep interpersonal relationships between providers and their patients, said Sophia Wang, MD, Dan Blazer, MD, PhD, and Helen Hoenig, MD, MPH.
“The constant presence of such technology can consume health care providers, sometimes requiring that they spend more time with electronic health records and software to support medical decision making than seeing patients face to face, which, in turn, is perceived by patients as less effective,” the trio wrote.
This trend may be problematic as evidence increasingly shows that strong interpersonal relationships help with rehabilitation. When patients feel more connected to their providers, the authors explained, they are more receptive to treatment.
In order to overcome this issue, Wang and her colleagues suggest clinicians leverage the very thing that is getting in the way of their patient-provider relationships: health technology.
“It is critical that as a field we are aware of new and developing eHealth technologies that might help to foster patient-provider connection and patient-centered health care in the context of rehabilitation,” the three asserted.
In an effort to publicize available technology and its potential patient-centered benefits, the authors discussed the use of telehealth, communication tools, and mHealth in improving patient-provider relationships in rehabilitation.
Utilizing telehealth to connect with patients at home
Seeing and treating patients in the context of their everyday lives is an important component of rehabilitation care.
In the past, clinicians conducted home visits to see patients in their usual environment and subsequently assess their unique treatment needs. However, home visits were phased out due to cost and inconvenience, leading to a potentially detrimental disconnect between patient and provider.
“That disconnect can affect the patient-provider relationship either during treatment, when the patient does not feel fully understood, or on return home, when disparities between the hospital-/clinic-based therapeutic plans and reality become apparent. Teletechnology offers a potential solution,” Wang et al wrote.
By communicating with providers through telemedicine, patients can work with them in their typical environments. This will help providers target rehabilitation treatments to specific environmental challenges and help providers cater to specific patient needs.
Leveraging communication, education technology
With clinicians often in a time pinch, they may face difficulty in adequately communicating with their patients and educating them about various treatments. Using health IT, such as patient portals and other messaging tools, clinicians can continue the conversation, ensuring that patients understand their health needs outside of the office.
“Electronic technology has the potential to increase opportunities for communication and education, with technology ranging from simple home messaging devices that query patients periodically… to sensor-based systems to sophisticated interactive systems,” the authors said.
At the Department of Veterans Affairs and Department of Defense, for example, providers are utilizing mHealth technology to keep patients in the loop outside of the point of care, the trio wrote.
Providers can also use technology to reinforce patient understanding.
“Interactive patient educational systems are another example, having been shown to improve outcomes for diverse medical populations, and they seem promising for use in rehabilitation, given the central role of patient education in many rehabilitation interventions,” Wang, Blazer, and Hoenig said.
Technologies that reinforce shared goal-setting
In addition to facilitating patient education, these tools can also facilitate shared goal-setting. According to the authors, mHealth technology is useful in reinforcing those shared goals and using them to motivate better patient behavior.
This is critical considering the importance of treatment adherence to overall care outcomes.
“Adherence and outcomes in rehabilitation can be improved by shared goal setting and action planning, personally tailored educational interventions, and feedback to patients’ about their performance,” the authors explained.
For example, clinicians and patients can decided on a set of wellness goals during an office visit and enter them into an exercise app. Days later, that app can remind the patient of her goals and send alerts when she achieves them. In this instance, the exercise app acts as a middleman engaging the patient between clinical encounters.
Integrating health IT into patient care may not come without its challenges, the authors recognized. For example, many users may be concerned about privacy and security. Clinicians should consult with privacy officers or other counsel to determine the best protocol for deploying health technology to ensure patient safety, the authors said.
Users may also face financial barriers, especially with regard to reimbursement. While reimbursement remains a significant obstacle, policy makers are reportedly working on making it less prohibitive.
Ultimately, the healthcare industry needs to recognize the potential of technology in improving patient-provider relationships. From there, stakeholders can work toward eliminating the obstacles some users may face in adopting these tools.
“We believe that eHealth technology has broad potential applicability in rehabilitation and that it is particularly germane to the patient-provider interface so critical to successful rehabilitation,” the authors concluded.
“Rehabilitation providers have significant expertise and comfort with technology and they have broad expertise in effective patient-provider communication, which means the field is well-placed to take a leader role in use of eHealth technologies to enrich the patient-provider relationship.”