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Do Patient Engagement Measures Address Privacy Concerns?

By Vera Gruessner

- With patient engagement measures playing a significant role in the recently released Stage 3 Meaningful Use proposed ruling, it becomes more imperative than in prior years to better understand how to effectively engage patients in their own healthcare. More companies are conducting market research surveys and other polls to find out how health IT and healthcare reform is perceived from the patient perspective.

Physician Telehealth

Nuance Communications is one such company that has polled approximately 3,000 patients from the US, the United Kingdom, and Germany to learn more about patients’ views on healthcare technology. The survey, called Healthcare from the Patient Perspective, found that patients in Germany value privacy during a physical exam while those in the UK and the US care more about the physician being fully engaged and showing eye contact during a visit. Important findings like these may need to be further addressed within patient engagement measures.

Dr. Nick van Terheyden, Chief Medical Information Officer of Nuance Communications, spoke with EHRIntelligence.com about the findings from this survey. Since van Terheyden is passionate about both clinical and patient advocacy, he was pleased with the survey results.

“One of the biggest surprises came from the differences between the countries. The UK and the US were similar in people’s perspective around technology and the physician interaction as well as what troubled them about it,” said Dr. van Terheyden. “In many instances, patients feel this technology is reducing their quality time with the clinician. From the German side of the survey, their primary concern with the introduction of technology was the security and confidentiality issue.”

“There was a concern about having additional people like scribes in the office,” he continued. “For me as a clinician, I think we take for granted the interaction that we have with our patients. They walk in with an incredible level of trust with their clinician. Patients lay their heart out to their physician to help him or her understand your problems and to share deep, personal details about one’s clinical condition. The fundamental basis of clinical medicine is honesty between the patient and the clinician.”

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The Chief Medical Information Officer explained that adding an extra individual such as a scribe, nurse, or other healthcare professional into the exam room has made some patients, specifically those in Germany, less likely to open up and share all of their health issues with the physician.

“[This finding] needs to be taken account of as we try and support clinicians and patients in the office setting,” stated Dr. van Terheyden.

While there may be some concerns with the use of scribes among patients from Germany, there are also some benefits to having another professional document the patient-doctor interaction, especially with regard to reaching patient engagement measures. For example, the use of scribes could allow physicians to focus on the patients instead of data entry and essentially give both patients and doctors more time to interact.

The use of scribes is “one of the emerging trends under a great deal of discussion. From a clinician standpoint, one of the things they see is supporting infrastructure around them that allows them to focus on the patient,” said Dr. van Terheyden. “What came out clearly from the survey is the feeling of being rushed. Forty percent of patients feel rushed during their visit. If asked to classify the quality of the interaction, it was about the focus of the physician, eye contact, and attention to the patient. All of this technology has detracted from that.”

The use of a scribe or possibly recording tools could solve some of the issues surrounding the patient-doctor relationship. However, both privacy and documentation quality concerns of a scribe may need to be addressed before healthcare providers adopt this service, the Nuance Communications CMIO explained.

The survey showed that a significant number of patients spend less than 10 minutes with their physician during an average visit. Dr. Nick van Terheyden went on to offer solutions on ways to increase the amount of time and quality of time doctors spend with patients.

The healthcare industry would benefit from doctors “using other clinical resources to take on activities, using technology to become more efficient, [and] using telemedicine.”

“Sometimes the interaction that occurs in a patient’s home using a video exchange can be perceived as high quality because they didn’t have to spend 40 minutes waiting or driving. Technology can apply some potential solutions that might improve the amount or quality of time physicians spend with patients,” stated Dr. Nick van Terheyden.




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