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The Beryl Institute invites members to submit posts on patient experience related topics. For guidelines and information on submitting a post for consideration, contact michelle.garrison@theberylinstitute.org.

 

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Techniques for Bringing Compassionate Communication to Telehealth Interactions

Posted By Anthony Orsini, D.O., Wednesday, May 16, 2018
Updated: Wednesday, May 16, 2018

One of the hottest topics in medicine today is the continued growth of telemedicine.

According to a survey by Jackson Healthcare, Telehealth is expected to grow in the U.S. by 27.5%, reaching $9.35 billion by 2021. It is estimated that by the end of this year alone, the number of patients using telemedicine services will reach 7 million, with 44% of private practices making the development of telemedicine services, their number one priority. This approach is especially popular in rural areas where accessibility to physicians can be difficult.

As an increasing number of patients choose telemedicine as a more convenient option than emergency or urgent care visits, the challenges that physicians and other healthcare professionals face to build relationships with patients have become even greater.

The communication techniques healthcare professionals use to build trust are even more important during physician-patient video conference calling. The impersonal nature of communicating via screen amplifies the need to focus on communication techniques that build trust between the physician and patient. Without trust in their healthcare provider, patients are less likely to follow their treatment and have poorer outcomes.

Healthcare providers can use the following communication techniques to build trusting relationships with patients during telemedicine visits:

  1. Give the patient your undivided attention - It is easier to forget during videoconferencing that the patient is watching and interpreting your body language. Remember that 70% of all language is non-verbal. Take limited notes during the conversation. Writing or entering data in the EMR (electronic medical record) during conversations is perceived as multitasking and not interpreted by patients as being thorough. Be aware of your facial expressions. Since the patient cannot see your body positioning, he/she will be watching you even more closely than if you were in the same room. Your facial expressions can either be interpreted as compassionate, disinterested or rushed. The perception of eye contact can be felt even through video.

  2. Remember that each interaction with a patient is a conversation and not an interview. Don’t interrupt or ask follow up questions before the patient has finished speaking. Patients are even more sensitive to the feeling of being rushed during telemedicine. It is very important to let them feel that even though you may not be in the same room, they are the most important person to you at that moment.

  3. Be a genuine person. Although healthcare professionals will often be video conferencing with patients they have never met before, there is still an opportunity to form a trusting relationship in a short period of time. Today’s patient wants to interact with their healthcare professional on a personal level. Avoid the “all business” attitude. Relate on a personal level. Ask the patient where they are from and find a common interest if possible to help form that relationship.

By all accounts, telemedicine will play a large part in the future of healthcare. It has the potential for dramatic cost reduction, increases in healthcare accessibility and improved patient satisfaction. It should not be a replacement for the strong relationship between a patient and his/her healthcare provider as that is critical to any healthcare visit. By learning proper techniques in compassionate communication, healthcare providers can build relationships even through video conferencing.

Dr. Anthony Orsini, Founder and President, BBN, is a full-time neonatologist and expert in compassionate communication in medicine. He is currently the Vice-Chairman of Neonatology at Winnie Palmer Hospital in Orlando, FL. He also serves as the President of BBN, the organization he founded in 2012 that offers training services to educate professionals in the art and science of compassionate communication.

Tags:  access  communication  improving patient experience  physician  telemedicine  trust 

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What About Deaf Patient Experience?

Posted By Kate O'Regan, Friday, September 22, 2017
Updated: Monday, September 25, 2017

I recently read Dr. Cordovano’s compelling case for a patient centric comprehensive medical records system in her recent blog. She opened with:

A patient was recently discharged from an exceptional hospital after a 2-day stay. During those 2 days, he saw endless doctors, attendings, residents, fellows, interns, nurses, nurse practitioners, nursing students, TV and phone service staff, physical therapists, social workers, case managers, housekeeping staff, spiritual chaplains, food and beverage staff, transport staff and discharge planners. Forgive me if I’ve missed anyone. All of these hospital employees play an essential role in a patient’s care at the hospital. There was just one person missing…

As my eyes honed in on the words “there is just one person missing,” I immediately think of the historically marginalized deaf community who continue to receive unequal and ineffective communication access to healthcare, something that can be achieved by using an effective and trusted interpreter. But the most critical piece, is an effective and trusted system of communication access that is patient-centric.

I want to recognize The Beryl Institute truth that healthcare can change by advancing an unwavering commitment to the human experience. I witness, too often, the deaf experience that is framed as less than human and that is fundamentally problematic.

Every day globally, deaf people experience a lack of an effective system, of awareness and of respect as humans. It is time to start to listen, advocate with and provide (give back) leverage to deaf patients, leverage that is often taken away from them at first glance.

To achieve a successful and sustainable care plan for deaf patients, here is what should be happening:  budget for communication access, create an internal department or find a vendor who can manage your services locally and work with the local deaf community. Also, every deaf patient should have the opportunity to be greeted by a local deaf[1] community advocate. This advocate will guide the deaf patient and medical professionals throughout the healthcare experience.

Every deaf person have different unique preferences to communication access. One deaf person with more moderate hearing loss might communicate using spoken English, but  use an interpreter to effectively receive spoken English. Another deaf person with profound hearing loss might have a PhD in Business Administration, not fluent in spoken English and accesses health care best with an interpreter. A person who was raised in another country who just moved to America may not be fluent in ASL and would rather speech to text technology called CART.

Deaf people have different communication access needs and a lack of system to recognize this diversity leads to a lack of health care access. Health care organizations need to contract with an agency that understand the needs of deaf patients when it comes to access. If they don’t, there is a high risk of liability under federal law. Some hospital administrators choose to contract with national level technology companies to provide Video Relay Interpreting (VRI) services without the consult of the deaf individual which are consistently unreliable, ineffective, unlawful, and cause further oppression of deaf people lead to gross negligence of patient experience and numerous hospitals have been brought to court by the US Department of Justice. If healthcare providers truly value patient experience, we need ask deaf patients what is effective and then implement those services. 

[1] A deaf person needs to be employed in this position or from a trusted locally deaf-centric advocacy organization.  See DEAF GAIN #googleit

Kate O'Regan grew up in Montpelier, VT and is the Founding President of Civic Access. She believes in social entrepreneurship as a form of economic empowerment. She lives in Charlottesville, VA with her three children.

Civic Access, was founded with the philosophy that legally mandated services of communication access can support forward progress for deaf access in the public sector.  

 

Tags:  access  communication  deaf patient experience  interpreter 

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