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Utilizing Emerging Technologies to Promote more Efficient Face-to-face Patient Clinician Communication Jelena Mirkovic

Hello,

My name is Jelena Mirkovic, and I am coming from Norway.

I am working at Oslo University Hospital at the Center for Shared Decision Making and Colaborative Care Research. I finished my PhD studies in april this year and now I am working as PostDoc.

Picture of parts of Oslo University Hospital, and view over Oslo.1

My interests

My research interests are development of mobile applications and services for patients and their integration with HIS. In this context I am specially interested in issues related to security, usability and user-friendliness, and mobility over different terminals and contexts.

As I saw through my work on the thesis these issues are highly correlated and they must be addressed in relation to each other, rather than in isolation.

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Relation to SOFTec topicsDifferent research shows that effective communication between patients and clinicians is one of the key factors influencing good outcomes of patient care and compliance to treatment.

So, my perspective I want to discuss in this workshop is how utilization of emerging technologies can promote more efficient and effective patient-clinician communication.3

Issues - patientsLimitation of face-to-face communication (Munksgaard et al, J Headache Pain 2011)Less personal hospital visits (Silverman and Kinnersley, Br J Gen Pract 2010)

The limitation of face-to-face communication is the main concern for patient when considering use of new technologies in healthcare management.

Also, research shows that some patients think that use of computers can result in les personal hospital visits.

4Issues - cliniciansAdditional work (Boonstra, A. and Broekhuis, BMC Health Serv Res 2010; Park et al, Int J Med Inform 2012)Learn how to use new technologyAdditional dataMore communication skills

On the other side clinicians often show negative opinions regarding adoption of new and advanced technologies in clinical practice since they see them as additional work.

they have to learn how to use new technologyprocess additional dataimprove communication skills5

How to overcome these issues?

So, the main challenge when designing and developing ICT systems for healthcare is to make sure they do not limit and negatively influence existing patient-clinician communication, but to fit in the existing context and enhance communication flow.

I will now describe couple of systems developed in our research center with the goal to support collaboration and information sharing between and among patients and care providers.

6CHOICE system

The Choice is a touchpad tablet PC application designed to help cancer patients in preparation for a consultation with a clinician to communicate their symptoms, problems and concerns.

The application enable patients to select, prioritize and rank their problems according to need for symptom management support before meeting with clinician. 7

CHOICE systemWhen patient finish assessment, the system creates an assessment summary document. This document clinician use for providing individually targeted symptom management support.

8CHIOICE systemResults (Ruland et al, JAMIA 2010; Heyn et al, Psychooncology 2013)Significantly more symptoms addressed Symptom distress decreased Patients more active participantsPatients understood better their condition and have more controlSystem usefulness

The goal of the Choice tool is to provide support for more patient-centered, illness-related consultations and help clinicians to better address a patients individual symptoms and concerns.

That was also proved by the results from performed clinical trial that showed significantly more symptoms addressed during consultations and better user activation and sattisfaction.

The Choice is used today by some of the departments in the hospital.

9Connect system

The other system is Connect. Connect system is a patient portal that integrates a suite of Internet-based tools designed to support cancer patients in illness management.

The system provide numerous features designed to support patient-provider communication, collaboration and shared decision making in different online and offline environments (hospital, outpatient clinic, and patients home).

10Connect system

Using the system patients can monitor their symptoms, obtain individually tailored evidence-based self-management support, ask questions to a clinical nurse specialist, communicate with other patients in a forum, and use a diary.

The access to the system is enabled over both web and mobile application, enabling access to the healthcare information over different contexts (e.g. home, hospital).

11Connect system

Results from initial trial (Ruland et al, Cancer Nurs. 2013)Less symptom of distress and depressionBetter self-efficacy and health-related quality of lifeBy providing patients with around the clock access to important health information, the goal of the Connect system is to help patients better understand and manage their illness, become more engaged in their own health care, and improve communication with care provider.

Couple of initial trial studies proved the potential of the system, and further studies that will investigate system effectives of the systems is planned or in progress.12

Contact: Jelena.Mirkovic@rr-research.noWeb address: http://www.communicaretools.org/ Thank you for your attention!

These are just some of the projects from our research center.

Through this examples I wanted to show some of the research work that support patients in coping with health-related challenges and provide the means for better interaction with health providers.

More information about this and other research projects you can find on our web page. Thank you for your attention!13