- In the healthcare space, there are currently two prevailing themes – the drive for patient-centered care with provider empathy and the push for more health IT use. Although both goals are integral parts of hospital missions and healthcare policy, they do not always go hand-in-hand.
On the surface interpersonal patient-provider relationships and health IT appear to work against one another. How can a provider be empathetic when she is fulfilling reporting requirements on her EHR? How can a patient forge a deep relationship with his primary care physician when he primarily relies on patient portal interactions?
Recent data indicates that physician empathy and compassionate healthcare are still lagging. Sixty percent of patients said the industry is moving in a more patient-centered direction, while 47 percent of physicians said the same, according to a new survey from the Schwartz Center for Compassionate Healthcare.
Forty-two percent of nurses said the industry is embracing the patient as a healthcare stakeholder.
Over two-thirds (69 percent) of physicians also reported that current policies within the healthcare industry make it more difficult to deliver compassionate, patient-centered healthcare.
Perhaps most telling, patients and providers are seeing a decline in communication and emotional support in the past five years. Sixty-three percent of physicians and nurses have seen a decline in compassionate communications, while 42 percent of patients reported the same.
Survey administrators from the Schwartz Center suggested that hospital culture will be a significant driving factor in improving physician empathy in the digital age. Additionally, better support for the healthcare workforce may also drive more clinician compassion.
Although the survey did not indicate any specific industry policies affecting patient-centered, compassionate care, many experts suggested health IT is a probable cause. Through meaningful use, MACRA, and other regulatory requirements, healthcare professionals are facing increasing calls to integrate more technology into the clinical encounter and patient-provider relationship.
Health IT, EHRs hinder patient satisfaction
While there are several factors influencing patient engagement and clinician empathy, emerging health technology has garnered a reputation for placing a barrier between the patient and the provider. Integrating EHRs into the clinical encounter, for example, has drawn concern about patient satisfaction.
A 2015 study showed that clinicians who looked at their EHRs less often yielded higher patient satisfaction rates. The team observed notable differences after reviewing videos of care encounters during which the provider heavily or moderately used the EHR.
Eighty-one percent of patients in moderate EHR use encounters reported high satisfaction, while only 47 percent of patients in the heavy EHR use encounters reported the same.
The study suggested that providers take the time to acknowledge patients, make eye contact with them, and take a break from EHR documenting to forge deep patient relationships.
Emerging strategies to integrate health IT use and empathy
The industry push for health IT use is likely not going away. Thus, healthcare providers must learn to reconcile these tools with their efforts to drive physician empathy.
Research suggests gaining patient buy-in is a key step to driving compassionate healthcare amidst a digital health push.
In the above-mentioned study, investigators suggested providers explain to patients the premise of the EHR and how it will improve clinical care. Patients who understand the function of various clinical tools are more likely to embrace the technology than those who are unfamiliar with the tools.
Nurse leaders suggest taking a two-minute break from not only technology but also the usual hospital hustle, to forge a meaningful relationship with patients.
“There is so much to do, so much to accomplish, so many checklists to fulfill that the connected nurse is going away and becoming a lost art,” said Press Ganey Chief Nursing Officer Christie Dempsey, MSN, CNOR, CENP. “I wanted to help nurses understand that it doesn’t take more time to connect. Instead, it’s how nurses connect that makes a difference.”
In just 56 seconds, nurses can connect with a patient about common hobbies, family matters, or another personal anecdote that is important to the patient. Every nurse has 56 seconds to spare, Dempsey said in an interview with PatientEngagementHIT.com, and doing this will enhance whatever relationship may have been hindered by clinical technology.
But for many providers, reconciling the patient-provider relationship and health technology is not about taking a break from the tools. Instead, the relationship is about using tools to drive the patient experience.
Technology regulations in meaningful use and MACRA require providers to exchange direct messages with patients, a means to drive a better digital and interpersonal relationship.
While current regulations only ask providers to exchange messages with one unique patient, health IT experts say that this practice can help providers forge deep relationships with patients, especially those who do not frequent the clinic often.
Even though patient portal messages occur outside of the office, athenaResearch manager David Clain said that this still contributes positively to the patient-provider relationship.
“If you are a patient at primary care practice or you have some cardiac issue and you have an ongoing relationship with a cardiologist, I think it’s really helpful to be able to continue the conversation outside of the office,” Clain explained in a past interview. “And once you’ve done that a couple of times, you feel that connection to your provider, you have a sense that they are committed to your health and to ensure that you have good outcomes.”
Health technology is likely not leaving the industry. As healthcare policymakers continue their push for patient-centered care, it will be integral for providers to learn to integrate these tools with principles of physician empathy. Ultimately, this will help create a modernized and consumer-centric experience that is both clinically efficient and satisfactory for patients.