Patient engagement technology and mHealth have long shown promise for many providers looking to activate their patients in their care. But for some providers, the days of simply considering the potential of patient engagement technology are over – patients are starting to demand it in the doctor’s office.
Such was the case for John Tiberi, MD, a Los Angeles-based orthopedic surgeon who specializes in hip and knee replacements.
“I have definitely noticed in the past several years that there has been a growing interest in different types of technology and an increase in patient access to their own technology,” Tiberi told PatientEngagementHIT.com in a recent interview.
To answer his patients’ needs and satiate some of his own curiosities with patient engagement technology, Tiberi adopted PeerWell’s PreHab program.
Accessible through a smartphone, the app provides step-by-step preparation for patients undergoing joint replacement surgery. Each day, patients complete a module geared toward physically and mentally preparing themselves for surgery, ensuring optimal outcomes and a more relaxing process for the patient.
When first adopting the technology, Tiberi said he was concerned that his patient population, which tends to be older, would not be receptive. However, he soon found that wasn’t the case.
“It’s all kinds of patients who are asking for technology,” he explained. “When I first started using this application, I had a lot of thoughts about whether it would be prohibitive for patients who may not be as familiar with technology, particularly with my patient population – elective hip and knee replacement tends to be older people. But I’ve run into almost no instances of that.”
This could speak to the ubiquity of technology among different patient populations. During surgery prep or post-operative check-ins, Tiberi has seen more and more patients with smartphones and tablets plugged into their bedsides, opening up interactive patient engagement opportunities.
And just as different patients are asking for more technology, they are all benefitting from it, albeit in very different ways.
“Utilizing technology allows the patient who otherwise might show up to the hospital on the day of their surgery having done or thought of nothing to be more prepared and have a better outcome,” Tiberi explained.
“It also gives the patient who otherwise might’ve put the thought and preparation into their own recovery get even more out of it,” he continued. “I really think that everyone benefits, but in different ways and to different degrees.”
Patient engagement technology has solved more than one problem for Tiberi. Not only has it answered patient needs, but it has replaced previous engagement strategies that were often insufficient and inconvenient.
Prior to introducing the technology to his practice, Tiberi says many providers relied on pre-surgery prep classes.
“Those are tough,” he said. “They’re time prohibitive, they’re location prohibitive, and those classes are really generic. They’re taught based on experiences of many different patients and preferences of many different doctors.”
When providers didn’t conduct preparation classes, they packed all necessary information into a thick packet, asking patients to bring it home to review. The enormity of that task, however, was something patients were typically disinterested in, often opting not to prepare for their surgery at all.
Instead of the one-size-fits-all approach of these classes and packets, Tiberi’s tool allows him to customize education to both his and his patients’ preferences.
“This is an application that can be highly customized to individual patient and surgeon preferences,” he noted. “It allows wider ranges of patients to get more out of its use rather than just having a standard one-time event that is fairly generic.”
As a result of this technology, Tiberi has met a number of his outcomes-based goals. Although he has not collected and published his hard data yet, he has anecdotally noticed a drop in length of hospital stay, number of patients discharged to skilled nursing facilities, and number of patients requiring home health or home physical therapy.
He has also seen some secondary effects.
“I’ve been pleasantly surprised by the number of patients who have told me in varying ways that they are satisfied,” Tiberi noted. “One patient told me, ‘the fact that you use this really made me feel like you cared about my preparation. I appreciate that you would go through the trouble to set this up for me and have me do this on a daily basis.’”
In hindsight, Tiberi says it’s not surprising the technology has improved patient satisfaction because it is significantly more convenient for his patient population.
By replacing massive informative packets and giving patients a manageable regimen to prepare for their surgery, the technology has made patients’ lives easier. And by offering the technology right on the smartphone, Tiberi has helped patients integrate their preparation strategies into their everyday lives.
“I think the patient really likes that because they’re using smartphones anyways,” he said. “For both receiving information as well as transmitting information, I think it’s a really nice thing for people just to have that level of convenience and not deviate too far from familiarity.”
In the long-run, satisfaction and convenience are coming to the forefront of medicine, Tiberi says.
“I think satisfaction is one of those things that everybody knows is important. Not only does it affect someone’s generalized outcomes, but in medicine it’s becoming something that is being held at a higher standard,” he said. “That’s a good thing. It should be.”
Going forward, Tiberi is working on a post-surgery rehabilitation component to his current technology. And just like his first foray into patient engagement technology, this step is coming partly as a patient request.
“Patients are also asking for it,” he said. “They’re saying, ‘this app was great, it helped me stay on track to get ready and be in better shape than I was in before. I wish there was something like this that I could use after surgery.’”
In the end, patient preferences for mHealth apps and patient engagement technology is what matters, Tiberi said. When considering using patient engagement technology, all providers should be keeping patient needs top of mind, ensuring that the newly deployed tool maximizes outcomes for patients and providers alike.
“To ignore that these things are wanted by the patient and improve outcomes would be a mistake,” Tiberi concluded.
“Certainly technology is something that will continue to advance and is here to stay. Over time, patients will be more and more comfortable with it. I would really encourage everyone to figure out how to use technology to their advantage and to their patients’ advantage.”