6 Ways Emerging Technology Improves Patient Engagement

Endocrine-based digital and mobile health adjuncts

Getting patients to participate in self-care is indeed a challenge. Key behaviors such as keeping up with appointments and follow-up visits, failing to take medications or implementing steps advised to improve their health, such as monitoring their blood sugar levels or practicing at-home exercise.

Fortunately, the burgeoning online tools and digital medical devices are already meeting a critical healthcare need and have begun to transform clinical care by bridging the gap between clinical recommendations and patient actions.

Employing medical devices and technological innovations enhances patient-physician communication.Use of tablets (iPads) makes medical data easily accessible, facilitating immediate responsiveness with patients. Photo: 123rf

Six strategies for employing health technology have been identified for clinicians to employ to enhance patient-physical interactions, and when implemented may lead to significant improvement in disease-related outcomes.

1. Stimulating Engagement Leads to Adoption

Incorporating emergent technologies into clinical practice may act to bridge the gaps between patients' behavior change and healthcare practices.1-4 The innovations in technology, such as wearable devices, mobile apps, smartphones, and iPads, are helping to improve engagement between healthcare professionals and patients.

For example, leveraging the use of tablets and laptops that are mounted to mobile desks facilitates healthcare discussions that in turn foster delivery of immediate responsiveness to patients where ever the patient may be in the medical facility (ie, the clinic, radiology, examination room, physician’s office).3,4

Tablets have proven to increase patient adherence given their portability and ease of recordkeeping. This task enables patients to organize and manage their medications both on the go and at home as compared to stationary computers or the piece of paper that gets left on the counter.

In a study published in JMIR Research Protocols,3 the research findings revealed that patient engagement increased with regard to better medication management, and improved for clinicians who were able to view medications and access test results when assisted by a personal health record (PHR) accessed using a tablet.

Another advantage to the mobile tables is permitting immediate access and referral to health information (eg, lab results, pathology, imaging, medical history, medications) permits the clinician to respond to patients’ questions in the moment.

Even more impactful, patient adoption of new technologies such as wearable devices have been shown to increase patient engagement by measuring health parameters (eg, steps, blood pressure, glucose) and providing immediate feedback on patients' health.4 For example, the Freestyle Libre Flash (Abbott) has simplified the process required for patients with diabetes to monitor their blood glucose levels by bypassing the need for finger pricks.

As patient engagement has risen with the aid of health technology, the goal remains to drive adoption,4 and these actions are starting to transform clinical care beyond blood glucose checks. Wearable devices are also helping patients measure key vital signs with smart clothing that tracks heart and brain health through the application of electrocardiogram (ECG) and electroencephalogram (EEG) sensors.

2. eHealth Is Every Where All the Time

The inability to access healthcare records from one medical practice to another has arisen as a major obstacle to seamless care, particularly for patients who see multiple specialists in a variety of medical settings.

The introduction of eHealth solutions has begun to streamline patient management by facilitating improved communication between practices and facilities so that test results, diagnoses, and treatments, including prescribed medications, are shared, which supports better overall coordination of care and patient satisfaction.

For example, clinicians have the opportunity to leverage multiple technologies that will facilitate treatment in the office setting, including the use of platforms, such as the Fitbit and Apple Health app, that connect to electronic health records (EHR) by automatically downloading patient data from wearable devices, computer-based programs, and online counseling sessions.

The major advantage to clinical care in the age of data-capture devices is an ability to share real-time results, be it heart rate, blood pressure, blood sugar, activity level, or sleep. Even more valuable, the introduction of chatbots has introduced a new form of motivational communication that delivers one-on-one responsiveness without placing an untenable burden on office staff.5

Results gathered by the Juniper survey highlights the efficiency of chatbots,5 including their ability to save healthcare industry businesses time and money from answering patient questions and predicts this will save as much as $0.70 per interaction or four minutes per inquiry.

The chatbot capability employs artificial intelligence (AI) and provides patients with personalized answers to non-emergency questions and timely prompts that free up staff to deal with more emergent issues as well as to offer feedback when the office is closed or between appointments. Messaging might include reminders to keep appointments, take medication, drink water, and get up and walk.

3. Employing Virtual Reality to Improve Daily Life

When patients are able to visualize a process with the aid of a  diagram or other visual aid, they are more likely to increase their understanding of at-home therapy exercises and to follow prescribed best practices aim to improve specific health parameters. 

Virtual reality (VR) has introduced a means of helping patients remember their care plan and to follow through with actions such as physical rehabilitation with innovations, such as the VRPhysio line of VR programs that track at-home exercise effectiveness and provide therapists with data in real time.

Another benefit of VR technology is in advancing healthcare professionals' knowledge via VR training programs. In these situations, doctors and patients are brought together to foster effective strategies to manage the patient's medical condition.6

This was demonstrated in a study published in Front Public Health,6 which found that VR was particularly beneficial as a training tool for physicians. Patient avatars were employed to simulate a typical 15-minute patient consultation session that led to an increase in physician self-awareness of prescribing habits. In this case, antibiotics were given in response to patient demands rather than as recommended in the treatment standards of care to illustrate the need for clinician preparedness in managing patient demands and expectations when they counter standards of care practices.

Similarly, VR training has proven advantageous in the field of endocrinology. For example, endocrinologists would be able to leverage this virtual treatment approach in determining the ideal management plan when discussing obesity treatment, diabetes care, or thyroid replacement therapy,7-9 for example, with patients in a virtual environment to anticipate common issues and questions concerning patients' health.

4. Telemedicine Extends Clinical Expertise to Everyone

About 60 million Americans live in rural areas across the United States where healthcare access is often scarce in these remote regions.10 Employing telemedicine technology, endocrinologists have been able to bring their specialty—be it diabetes or thyroid cancer—to patients who were unable to travel or live too far to receive needed multi-disciplinary management, thereby extending care door-to-door.7-9

The utility of telemedicine has been growing, particularly as a significant enhancement in care for patients located in rural regions, including blood glucose monitoring and thyroid cancer diagnosis and treatment. 

In one study,7 researchers confirmed the efficacy of delivering telemedicine care for women who were being followed for gestational diabetes; these patients achieved significantly lower their blood glucose levels in comparison to the control group. In findings from another study, published in the Journal of Medical Internet Research,11 the researched found that home telemonitoring lead to decreased patient mortality by as much as 6.5%.

When using a telemedicine platform, clinicians gain the ability to connect to platforms that integrate with EHR systems to support immediate access to the patient's health history in order to assist in remote patient care.

In this way, the potential for telemedicine to improve healthcare access and enhance patient participation is just beginning to reach its full potential.

5. Online Emotional Support

Evidence in support of the emotional gains achieved by patients when participating in online communities has been growing. This online resource has become a way for patients to share their experiences, offer treatment insights, and to find answers when their physician is unavailable has facilitated the healing process across many chronic conditions.

Participating in online communities may benefit clinicians as well since this forum introduces a setting for physicians to learn about common patient concerns and gain insights while offering accurate medical information that may dispell myths and treatment misunderstandings commonly being shared.

Results of this assessment looking at the benefits gained from online support groups was shared in an article in the Journal of Health Communications.12  They reported that these patients experienced favorable emotional support when friending and blogging features are used. This opportunity may serve as an important tool for medical practitioners to connect with patients, expending the patient-physician communication model.

When clinicians participate in an online community, there is an opportunity to increase patient engagement, ultimately bringing patients and practices closer together—building bonds and fostering greater trust in their clinical care. Physicians might consider connecting with their own patients through online communities, through social media, or even by text.

In a study conducted by a team at the University of Cincinnati College of Medicine,13 the researchers assessed a closed Facebook group for liver transplant patients and healthcare providers. They found that 95% of participants responding to the survey reported a positive impact on their patient care.

Much of their improved outlook was attributed to the level of support the patients perceived they gained from their online clinical participation.13 This reinforces the opportunity that social media represents as a communications channel for clinicians to introduce valuable educational content that has the potential to improve medical understanding, adherence, and ultimately outcomes through posts that offer healthcare tips and recommendations.

6. Approachable Mental Health Interventions

Most patients living with a chronic disease are at risk for depression and anxiety at some point during their continuum of care. Yet, the majority of these individuals are unlikely to connect with a therapist or mental health counselor because they may not be able to afford one, they do not realize they need such support or may consider the process of finding a therapist too daunting.

The problem remains—Hitting a dark patch when alone can be particularly difficult. Enter the myriad apps available extend to mental health to individuals in the privacy of their own homes and in their daily lives. With the accessibility of support through the growing number of mental health apps that can be retrieved on a smartphone, therapeutic support has become readily available, portable, and affordable to nearly everyone.15,16

Whatever the circumstance, by giving these patients an avenue to gain coping skills and develop self-care strategies, they will become more adept at managing their responses when faced with a crisis. Having concrete steps when faced with perceived crises will go a long way in enhancing their ability to respond to their treatment plans, leading to better disease outcomes.

For example, two such services, Talkspace and BetterHelp, may be recommended to appropriate and interested patients to connect them with a mental health counselor on demand. A growing industry of therapeutic practices who are able to reach patients via platforms that employ texting and instant messaging to provide personalized coping interventions.

A review of the top 25 most popular mental health apps is available at www.psycom.net/25-best-mental-health-apps.

In sharing these resources with your patients in the office as well as online, clinicians will be connecting more fully and efficiently with patients and introducing more convenient health management strategies that may lead to better health outcomes for many patients.

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