Tag Archives: patient engagement

Goal setting and accountability – health goals update

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I’ve heard it said that when you share your personal goals with others, you are more apt to meet them. Something about accountability. I believe it.

 

About 8 weeks ago, I wrote “New year, new health goals, new tools” describing the excitement in our house about our new Fitbit devices and how we were motivated and ready to up our game in 2022. Happy to report that my husband and I have not lost our motivation and are still comparing our stats most days.

 

I’m averaging close to 13,000 steps or 6 miles a day. I seem to blow past the weekly zone minutes goal by Wednesday most weeks. All good!

 

But I’ve had a lot of ah-ha’s on my sleep patterns. I thought that I slept much better than I do. The sleep tracker data has helped me make some modifications. I love actionable data!

 

We plan to join the YMCA near us to get back doing weights, add more serious cardio than the long hilly walks where we live and to check out the various classes. We dropped our previous gym membership at the start of the pandemic 2 years ago. It’s time to go back.

 

While we have better routines for getting daily exercise, we know we can’t be slaves to our devices. But I admit, there are days when we get the little notification buzz on our wrist at 10 minutes to the hour reminding us that we don’t have 250 steps yet (happens hourly from 9AM – 6PM). We jump up and walk around the house until we hit it. A great reminder to get up and move – especially if I have too many back-to-back calls sitting at my desk. Continue reading →

On the other side of the digital front door – part 3

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Two different procedures. Two different specialties. Two different patient communication approaches. Yet both practices use the same EHR and patient portal.

Prep for surgery instructions. Paper. Branded folder to put the paper in. More paper on next visit. A call from practice confirming specific surgery time and then get transferred to recorded message with specific pre-surgery instructions. Day of surgery sent home with post-op instructions – more paper.

Prep for procedure instructions. Available on the patient portal under letters. Texts and emails sent with specific prep information. Timed texts and emails for each major step along a defined prep timeline. Post procedure summary and instructions given to me on paper and available on the portal.

Practice variation is real. At times, it’s required and makes sense given different specialties. But not always.

So how were these two different experiences from a patient communication perspective? For me, there is a comfort having paper – can easily refer to it when needed. That is, if you know where you put it – hence the branded folder they give you. In the other situation, there was a very prescribed set of timed pre-procedure steps so the texts/emails at specified times telling me what to do was helpful.

What wasn’t such a good patient experience? Continue reading →

New year, new health goals, new tools

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On Tuesday, our new trackers arrived. I’ve used a Fitbit since late 2013 and still had the Fitbit One device. It served its purpose as a very basic step tracker. When it started getting less reliable during our January vacation, I decided it was time to up my game with newer tracking technology. Plus, I realized my device was discontinued a few years ago so forget about just replacing it. My husband, Tom, was ready to start more serious tracking as we focused on new health goals in 2022. He had recently downloaded a free step tracker app to his iPhone, but it was only useful if he always had his phone with him.

We carefully compared the different Fitbit devices reading specs and watching the videos. Doing the comparison shopping together on my laptop had me in tears laughing with him. Tom has never been athletic and hated gym class as a kid. We were doing the main feature compare between the Luxe and the Inspire 2. But we thought we should check out the Charge 5 before we called the question. Part way through the short video for the Charge 5, Tom said, “It’s scaring me, it’s like gym class on your wrist”. I told you, I had tears I laughed so hard at that. We each placed an order for a Luxe and the Premium Membership.

Once we had the devices charged and he downloaded the software for the first time, we quickly figured out the main features and how to navigate. We are constantly comparing our stats. I know that will wear off. But there is a new motivation in our house to get in better shape and get out walking longer distances each day. Continue reading →

On the other side of the digital front door – part 2

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My health journey continues with multiple focuses. And my journey through digital front doors continues as well. I wrote part 1 on this topic in early November when I was in the middle of various health and dental appointments and scheduling more. I also wrote about what I thought was an awesome example of how technology has evolved in “Patient friendly testing – yes, a positive story!” in September.  The end of that story was not so positive. More on that later.

Here are a few anecdotes from my recent experience:

Cataract surgery – I had my initial consultation appointment the end of November and have surgery scheduled for mid-February. Specialized eye drops were prescribed to start taking a few days in advance of the surgery. As soon as I left the doctor’s office, I received a text message that my eye drop prescription from my doctor was pending payment with this special pharmacy – for immediate delivery to my home I should click the link to pay $82.50. I was a little suspicious of a text asking for payment like that and knew I didn’t need to have the eye drops until February, certainly not immediate home delivery. I called the doctor’s office to confirm the text was legitimate and asked how to handle the timing of delivery. I was told I could just text back regarding delivery timing which I did and got a reply that they could do that. I thought great, there’s a person on the other end. But then I received several more automated text reminders to click the link so they could ship right away. Then they called me. I talked through the timing and gave them my payment info. Their proactive communication (and persistence) was a plus, but I was more comfortable with real-time communication to coordinate specific delivery schedule and payment.

Bone health – I had a virtual visit with a Nurse Practitioner from the Bone Health clinic at my primary hospital. This was part of follow-up from my fall and pelvic bone fracture in August. The virtual visit was easy to get into and very thorough. I learned that more and more elders are asking to be seen in person – not this one unless there is a reason to “lay hands on me”. Continue reading →

On the other side of the digital front door

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Being on the other side of health care delivery is always an eye opening experience as to the progress we’ve made with technology and making it easy for our patients, and how far we have yet to go.

Now that I have more flexibility in my work schedule and we’re past the house move, I’m taking time to prioritize my own health. The newest health issue I’m addressing is cataracts in both eyes. I was pleasantly surprised when I saw that the ophthalmic practice in the area who my eye doctor referred me to has a patient portal link on their website. As I waited on the phone to make an appointment, I perused the website. I thought it was odd that the portal had the same name as my health system’s portal. When it was my turn to talk to someone, they told me my new address asking me to confirm it. I had just updated it with my health system on the patient portal last week. So I asked how they, a separate ophthalmic practice knew. They said the patient portal showed it based on my phone number. Turns out it is the very same portal as my health system. I asked if they were part of the system and they said no but they share the portal. Guessing there is more to the story – possibly an Epic Community Connect relationship?

We scheduled the initial consultation appointment at a location reasonably close at the end of November vs one at an even closer location at the end of January. But my positive response to this encounter quickly took a step backwards. As they described my next steps pre-appointment it included writing down two fax numbers. One to give my eye doctor so they could send a report from my last eye exam. And a different one to give my PCP so they could send a referral. When will healthcare finally retire fax machines??

The fact that I can remember my patient portal password means I’ve become a regular user. And that means I’m taking care of my health. Due to my injury in August, I have multiple ortho appointments and now weekly physical therapy visits.

I was late to my first physical therapy appointment due to mistakenly thinking the e-checkin on the portal would be quick. Continue reading →

Knocking on the digital front door

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Health systems are learning many lessons during this pandemic that they will need to carry forward into the recovery and “new normal” phases. One of them may be the need for an integrated digital health strategy, and more specifically a patient focused “digital front door”. The almost overnight shift from in-person ambulatory visits to virtual visits during this pandemic highlighted the need for a more integrated approach for many health systems.

An integrated strategy for a patient centered digital front door has many components including the core website, the patient portal linked to the electronic health record, improved access and scheduling capabilities, call centers, and care delivery through virtual visits. The goal is to meet patients where they are and guide them along the right care pathway with efficient, consistent, and easy processes in the background.

However, these multiple components and functions are often led and directed in an uncoordinated manner by different senior leaders within the organization. The core website is typically owned and directed by Marketing and Communications with technical support from IT. The patient portal is often managed by the ambulatory team in IT partnering with the Chief Medical Information Officer, Ambulatory Services, and Marketing. Improved patient access and scheduling initiatives are often directed by Ambulatory Services or in an academic medical center by the Physician Practice Group leadership. The call center may be managed by Marketing or Ambulatory Services leadership. And telehealth may be provided by a specialized team either connected to or part of IT but be directed by physician leadership.

A successful patient centered digital health strategy needs to involve all these components in a coordinated, comprehensive manner. In some respects, who leads this strategic initiative does not matter. What does matter is that there is buy-in and collaboration from all leaders involved with a common overarching goal to meet patients where they are at and provide an easy, consistent experience to access services. Continue reading →

Partnering for your health

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You go to a conference, hear many great speakers, take some notes, learn about some new firms, make new connections, and catch up with colleagues. There are usually one or two key takeaways. Those btn_epatient_spm (002)stories or presentations that make a significant impression on you.

At the New England HIMSS Chapter Annual Spring Conference this week, that moment came during the session by Dave DeBronkart, known as e-Patient Dave, and Dr. Daniel (Danny) Sands, his primary care physician and faculty member at Beth Israel Deaconess Medical Center. Together they were two of the twelve founders of the Society for Participatory Medicine and the inaugural co-chairs.

Prior to the conference, I knew who e-Patient Dave was and had seen him on social media, but I had never heard his personal story nor met him. Their session demonstrated the power of storytelling at its best. Now I understand why Dave is so passionate about patient engagement.

Their session, “Hot or Not? A Doctor and Patient Role-Play the Archaic and the Modern Way to Engage” was a combination of role play and presentation. Dave started by describing the moment when he was diagnosed with a stage 4 cancer in 2007 following an incidental finding from a shoulder x-ray. He learned early in his journey that the median time left for a patient with his diagnosis was 24 weeks. He thought then that he had at most 6 months to live. That got my attention!

Their role play illustrated what may be the typical patient – physician interaction vs what should be a true patient – physician partnership. They covered communications (email, texting), patients doing their own online research and sharing information with their physician, timely access to results on a patient portal, and disease specific online support groups.

The Society for Participatory Medicine focuses on the power of partnership between patients/families and clinicians. They describe “Participatory Medicine” as a movement in which patients and health professionals actively collaborate and encourage one another as full partners in healthcare. They believe this leads to improved health outcomes, greater satisfaction, and lower costs. Continue reading →

Own your health

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That’s exactly what I did the past 6 months. And this week I graduated. From physical therapy that is. I’ve been cut loose. The next few months is all about me maintaining a daily discipline of stretches and canstockphoto15299929 (1) healthstrengthening exercises.

I first shared this journey in the post “Is there an app for that?” back in June. I also talked then about the importance of patient engagement and personalization.

I’m now around a 2-3 on the pain scale and closer to 2 most of the time. My physical therapist said if in a few months, I’m slipping back or feeling more pain I should get another prescription for more PT sessions from my PCP.

The stretches are much easier to make time for every day. There is short term gain plus a tangible benefit – I actually feel less pain. The strengthening exercises are harder to fit in, especially when I get busy or am travelling. With strengthening, there is no short term gain or tangible benefit – it’s all about the long term. Like going to the gym and doing weights.

The recent Fall ritual of raking leaves, bagging them, then carrying them to the curb led to a lot of pain. When I took care of my 2 ½ year old grandson and his 4-year-old sister recently for almost three days, all the lifting involved set me back. And I know the inevitable snow shoveling that is coming this winter will do so as well. My lower back muscles hurt just from all the coughing I’ve done the past 3 weeks with a bad chest cold.

My physical therapist says be sure to engage my core muscles at all these times and it won’t be so bad. I’m sure she’s right. I will try.

I am well armed with knowledge. I know what I need to do and how to do it. Will I slip backwards or continue to own it? Having lived with this low back and hip pain for years until it got so bad that I finally decided to get help, I know how bad it can be.

It’s now up to me. I need to continue to own it. As with any habit or exercise program, time will tell. Maybe an exercise tracking app or just an old-fashioned paper log is what I need.

Related Post:

Is there an app for that?

Apps aren’t enough

If not now, when?

Is there an app for that?

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Have you ever experienced chronic pain? Did you try to ignore it and push through it? Or did you see your doctor and hope for a resolution?canstockphoto12572942 (002) joints

We expect quick fixes when something goes wrong. Yet chronic pain may mean physical therapy and daily exercises to strengthen certain muscles and address the cause of the pain. Far from a quick fix!

That’s what I’m going through now and at times my patience and discipline are low.  I’m supposed to do a series of focused exercises twice a day. I am trying to take the long view. Just like my shoulder surgery for a torn rotator when I had to do physical therapy for 6 months.

If I think I don’t have time for the exercises or I just don’t want to do them, I tell myself this is what it will take to relieve the back and hip pain I have been living with. No one is just going to fix it for me. Yes, my physical therapist will assess my pain level each visit, ask me how the newest exercises are working out, and determine what to add to my routine. But it’s on me between visits.

I’ve had four visits and try to schedule one once or twice a week. I know the time will come when the time between visits gets longer. And then she will tell me I’m on my own. It will be the true test of whether I own this or not. Will I make the time to do the exercises twice a day? Will I feel my slow progress and realize it’s working?

It’s like flossing your teeth, you need to own it. You can’t just do it for a few days before your teeth cleaning appointment – you have to make it a daily discipline.

I asked my physical therapist about studies on patients not doing their exercises at home. I told her about my experience of owning it after shoulder surgery. She asked me if I was owning this. I said I was getting there – trying to have the long view because I don’t want to live with pain. We need to own our own health. I can’t complain about the pain if I’m not willing to do my part.

We had a good chat. She described how her role is to help patients be successful. She has learned to not give too many exercises, or the patient won’t do them. If the patient hates the exercise, she knows they won’t do it. She has to find an acceptable alternative. And she emphasizes patient education. Continue reading →

Hotels, healthcare and the DMV

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What do these experiences have in common? Customer service – good or bad. I’ve experienced all three in the past two weeks – good and bad.canstockphoto20052265 (002) customer service

It started with the Rhode Island DMV. Rhode Island is a small state of 1,200 square miles and a population of just over 1 million. There is one central DMV. Yes, there are several satellite offices but something as simple as renewing your driver’s license can’t happen at a satellite. And in certain circumstances, online renewal is not an option. That was the case for my husband and I who got our first Rhode Island drivers licenses a year ago. We had to renew in person before our respective birthdays. Not sure why, it’s like we were on probation as Rhode Island residents for a year. Who knows. But rules are rules.

So, we headed over to the central DMV location first thing on a Monday morning to do a simple transaction. We needed to be out in a short time for later commitments later that morning. Silly us.

We arrived just 20 minutes after they opened and found about 150 people ahead of us in the generic “check-in” line. What?? Busier than usual because it was Patriots Day in neighboring Massachusetts, so more Rhode Island people took the day off? Was it the beginning of spring break, so kids were out of school? Or just a typical Monday?

It took us 70 minutes just to get through that check-in line. Then we waited about 45 minutes for our number to be called. Once it was our turn, it was just a 5-7 minute transaction for each of us. Our paperwork was reviewed and updated in their system; we gave them a check. A new photo was taken, and a temporary driver’s license was printed to use until a new one would be sent in the mail. I had hoped for an online task, but it took 3 hours, including the drive there and back.

Tuesday, I had a long overdue doctor appointment. Continue reading →