1. Have patients start to monitor their health metrics with pen and paper.
One example in which I as a cardiologist engage patients initially is to have them start to manually keep track of their blood pressures (if a diagnosis of hypertension is suspected but not made, if medications are changed which might affect BP, or to attempt to correlate symptoms with BP). I observe a compliance rate of 100% with a request for a two-week log. At follow-up (either via the patient portal or in person) I review the record (I supply the patient with a pre-printed chart to fill out), reaffirm the importance of the data, and then perhaps move to discussions about monitoring via simple apps that they or their caregiver might use (even if unrelated to blood pressure).
2. Introduce mobile health apps for wellness first.
When discussing diet, medication adherence (especially when prescribing a new one), disease state education, or perhaps smoking cessation, I make it know that there are apps to assist in those areas. I give a list of the best ones and suggest that their caregiver if needed help with the download or use of the app. I show sample snapshots from the app store on my own phone. I believe that wellness apps are easier to introduce as engagement tools than specific disease apps (at least to the less digitally literate).
3. Discuss your philosophy as a physician.
After I introduce myself to a new patient (with the same degree of attention to the caregiver in the exam room), I discuss my practice philosophy of only recommending the minimal degree of testing and prescriptions (many patients mistrust physicians as prescribing testing or drugs because of financial incentives). I then go on to stress shared decision making which requires a partnership of honesty and listening. I believe this to be imperative as it not only sets the tone in a positive manner but establishes the importance of patient participation.
4. Learn about the patient as a person.
Knowing the caregiver support (or lack thereof) around a patient gives a physician the milieu in which shared decision-making is to play out. Critical barriers might exist which will ever prevent success without adjustments by the provider and/or the patient. Caregivers should be involved whether it is a near or distant interested relative, friend, acquaintance or other professional involved with the patient. A patient’s former or present occupation or hobby might impact treatment plans or give insight into educational and levels, and degree of independence.
5. Create buy-in from physician colleagues.
Discussing patient engagement within the context of everyday professional interaction is a great way to change culture one person at a time. In correspondences or conversations regarding a patient, “The patient, family and I have decided”, “I found the BP diary the patient filled out for me very useful” or “I recommended that the patient consider using such and such diabetes app” are non-threatening or proselytizing ways to convey how I view positively and embrace engagement.
I do understand that doctors and nurses are drained of their ability to show compassion by a system that puts them in an adversarial relationship with patients, hospital administrators, insurance companies, lawyers, and their fellow doctors ...
I found it deeply reassuring that the hospital scheduled consultations so that we could have closure with each one. (We hope this is what your experience has been like at MVS; a patient centered, communication oriented visit...
Health literacy is a relatively new concept in health promotion. It is a composite term to describe a range of outcomes to health education and communication activities. From this perspective, health education is directed towards improving health literacy. This paper identifies the failings of past educational programs to address social and economic determinants of health, and traces the subsequent reduction in the role of health education in contemporary health promotion. These perceived failings may have led to significant underestimation of the potential role of health education in addressing the social determinants of health. A ‘health outcome model’ is presented. This model highlights health literacy as a key outcome from health education.
If you’re like many doctors today, you may find yourself with more complex information to convey in shorter visits. Adding to the problem, patients are famously bad at retaining verbal information. Those who don’t understand or remember information are more likely to keep making the same mistakes, or not follow through on a treatment plan. Thus, you may wind up explaining the same things over and over to the same patients during office visits.
Luckily, there’s an app for that–several, in fact. Mobile apps provide a simple, low-cost opportunity for you to educate patients more efficiently and effectively at the point of care.
The use of standardized or simulated patients (SPs) in medical education for the teaching and assessment of clinical skills has enormously expanded the opportunities for medical students and residents to develop and practice their skills in...
The day before the ultrasound the tech called and asked if we still wanted the test, as an abdomen CT had just been done by another physician for a different reason. Since a CT is as good or better at looking at the aorta, we ...
An impromptu in hospital video by a 15 year old took healthcare social media by storm last week. Posted on Forbes.com on Thursday, by the ev ((Thanks, @JHFordII!) Defining "patient-centered", from the mouth of a 15-year old patient.
There are lots of medical apps available for smart phones and tablets, many of which are free or inexpensive. But how do you incorporate them into clinical practice? The good news is you don’t have to invest in fancy equipment.
Current efforts of clinicians, hospitals and researchers to make health care more “patient-centered” include inviting some of us to advise on research priorities, care organization and delivery under the assumption that, as patients, we understand...
The use of smartphones – including mobile apps – for improving patients' health has been a topic of interest for several years, but a recent report suggests that patients are currently using mobile apps for fairly limited purposes ...
Experiences of health interactions after diabetes patient education: a qualitative patient-led study
To explore the impact of patient education on the lives of people with diabetes, including the effect on interactions with doctors and other healthcare professionals.
Qualitative user-led study using longitudinal interviews and 146 h of participant observation. Data were analysed using a narrative approach.
21 patients with type 1 diabetes, those either about to attend a patient education course or those who had completed the course in the previous 10 years.
Established patient education centres in three UK teaching hospitals teaching the Dose Adjustment for Normal Eating (DAFNE) course.
Both postcourse and several years later, most participants spoke of the experience of taking part in education as life-changingly positive. It helped them understand how to gain control over a very complex disease and freed them from dependence on medical advice and restrictive regimes. However, interactions within the health system following patient education could be fraught. Participants emerged from the course with greater condition-specific knowledge than many of the healthcare professionals they encountered. When these professionals did not understand what their patients were trying to do and were uncomfortable trusting their expertise, there could be serious consequences for these patients' ability to continue effective self-management.
Patients who have in-depth knowledge of their condition encounter problems when their expertise is seen as inappropriate in standard healthcare interactions, and expertise taught to patients in one branch of medicine can be considered non-compliant by those who are not specialists in that field. Although patient education can give people confidence in their own self-management skills, it cannot solve the power imbalance that remains when a generalist healthcare professional, however well meaning, blocks access to medication and supplies needed to manage chronic diseases successfully. There is a role for those involved in primary and hospital care, including those supporting and training healthcare professionals, to recognise these problems and find ways to acknowledge and respect chronic patients' biomedical and practical expertise.
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