Health Care Communication: Billions Lost and Just as Much Potential

In healthcare, financing and cost containment are two of the key metrics to follow and examine closely. However, the road to actually reducing the cost of care has been a long and arduous one, mainly because a lot of wasteful care is still disguised as, and looks a lot like, valuable care.

A recently published article JAMA article looked at how we can re-imagine a very central aspect of healthcare: How we communicate. Every year, errors in communication are believed to cost us billions of dollars.

A lot of our institutions and providers still rely heavily on pagers, which when compared to the possible alternatives brought on by smartphones, seems very antiquated.

Of note is the mention of an interesting observation described by MIT's Erik Brynjolfsson as the "productivity paradox" where technological advancements did not result in improved efficiency until the next generation of leaders re-examined the nature and process of the work.

Stated in a different manner, this can and should be viewed as a call to action to rethink the nature of how we work. The technology has advanced tremendously. However, it continues to burden the work flow and thus be viewed as much a problem as it is the solution.

Communication is at the Core of healthcare, but how we are communicating is placing barriers where there once was freedom to cultivate rapport.

It begs the question why do we continue to keep adding more machines, laptops, and personnel into patient rooms? Shouldn't we be doing the exact opposite?

If we have smartphones, smart cars, and smart homes, when will it be time to adopt, for instance, smart Rooms? ....Smart (fill in the blank, there are many in healthcare)?

• Rooms that are simple in design and maximize interactions.
• Rooms that can recognize when the provider has entered and confirm that the patient is on the exam table via sensors.
• Rooms that once the door is closed are essentially sound proofed, allowing for the preservation of this central core aspect, that is communication and preserve physician - patient rapport.
• Rooms that are acoustically designed with voice recognition that would have the capability to transcribe a visit into the EMR during real time.
• This voice recognition could apply to the patient as much as to the physician and be incorporated as part of the personalization of care that we are reaching for.

As this quest for reaching and ultimately exceeding our potential marches on, it will be prudent to adopt stringent benchmarks that will help guide the re-examination of the nature of our work.

After all, the utmost trust and integrity in preserving patient confidentiality is part of the reason we have been slow to re-imagine the nature of our work, and for good reason.

One framework to borrow from arguably one of the most sensitive areas in our health is the Center for Disease Controls's ACCE Framework. In evaluations of genetic methods that hope to personalize health and ultimately reduce cost, the CDC employs the ACCE framework. The name is an Acronym for Analytic validity, clinical validity, clinical utility and associated ethical, legal and social implications.

• Analytic validity
• Clinical validity
• Clinical utility
• and Associated Ethical, Legal, and Social Implications.

As long as the re-imagined modalities for the future of healthcare communication can pass muster in all of the aforementioned categories and simplify the current process, they will have tremendous potential to improve how we communicate.

How have you re-imaged the way you work?

Follow @ChiwesheMD

Sources:

Center for Disease ControlJournal of the American Medical AssociationMIT.edu