Collaborative communication typically works out better than one-way communication — even in a hospital.
A new study literally put the power in patients’ hands by allowing them to type their agenda into the EHR before their appointment.
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The results? Seventy-four percent of providers and 79 percent of patients said they believe the process helped improve communication between the parties.
The study, which was recently published in the Annals of Family Medicine, is what the authors call “the first OpenNotes study of cogeneration of clinic notes.”
The study occurred between June 9 and July 22, 2015, at the Adult Medicine Clinic at Harborview Medical Center, a Seattle, Washington-based safety net hospital. Approximately 101 eligible patients and their 28 clinicians partook in the study.
Approximately 101 eligible patients and their 28 primary care physicians partook in the study. Participating patients, who were recruited via telephone the night before their appointment, arrived at the medical center 30 minutes prior to their scheduled appointment. While in the waiting room, they typed their agenda directly into the EHR.
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On average, it didn’t take patients long to type in their agenda. Forty percent of patients took less than five minutes to type, and 43 percent of patients took between five and nine minutes. Their agendas varied in length, with 21 percent of patients typing less than 15 words and another 21 percent typing 60 or more words.
When the physician arrived, he or she evaluated the patient’s agenda either before the appointment began or upon entering the patient’s room. The patient’s agenda was kept in the EHR, next to the physician’s note.
After the appointment, both the patients and the physicians were surveyed about their experiences. In their survey, patients were asked to self-report their demographics, health and impressions of the experience. Physicians were asked if the agenda was helpful and if it aided them in understanding their patient’s concerns.
Overall, responses from both parties were positive. “Doctor and I on same page,” one patient wrote in the follow-up survey. Another wrote, “Made me think about reasons for visit before seeing doctor.” In the follow-up survey, one physician wrote, “Engaged patient to participate more in the visit, he felt ‘heard.'”
Additionally, the survey results showed 82 percent of clinicians and 84 percent of patients believe the method helped prioritize the visit. And both parties seem eager to use the method again in the future — 82 percent of clinicians and 73 percent of patients said so.
This method not only sheds light on the importance of communicating with patients, but also reframes a well-known concept: patient engagement. Perhaps the future of primary care starts with letting patients set the agenda.
Photo: Buero Monaco, Getty Images
