Overcoming Patient Barriers During Doctor Visits

by Holly Shoemaker

I previously discussed simple ways doctors may enhance patient awareness by choosing the most appropriate method of communication. Along with that, are important considerations and barriers that may affect how patients communicate and take in information.

Barriers that Affect Patients

• Bedside Manner – How a doctor projects him or herself affects how patients communicate. Just like a physician needs to take into consideration how patients learn, patients need to understand how a doctor communications and listens.
• Fear of Speaking Out – If patients become insecure or their personalities clash with a doctor's bedside manner, they speak less. Patients may feel they lack the ability to challenge what a doctor says. Because a doctor may be viewed as an authority figure, patients may become timid. Some patients may fear lack of follow-up care if they challenge what a doctor says.
• Multiple Providers – Patients who see multiple provides have different levels of trust with physicians. With those different levels of trust, comes varying degrees of openness. Patients may confuse how they communicates with one doctor, especially those who see multiple ones.
• Insecurity – There are many reasons patients may not open up to a doctor, and insecurity may stem from many of them. If patients perceive a doctor is not listening, or a patient does not understand the information communicated, they will not ask follow-up questions. Patients then take on less of a role in their own care. Anytime a patient perceives negative treatment from a medical professional, it affects treatment.

Information Changes Medical Care

Because the internet, apps and other technologies provide so much information, patients have more material available to them to research concerns and conditions. Armed with research, patients may be more willing to become involved in making decisions about their own care. However, too much information may cause an unwillingness to listen to what a doctor says. 

Concluding Thoughts

A willingness to listen and demonstrate patience on both sides will help patient awareness. When patients take steps to ensure they have knowledge and understand how barriers affect them, they then become the catalysts needed to change doctor-patient relationships.

How Medical Professionals Use Texting and Still Comply with PHI

by Holly Shoemaker

In a previous blog I recapped how text messaging had become a preferred method of communication for those working in the emergency room (ER). Now, some medical professionals have looked at texting as a means of sending information regarding patient follow ups.

Study at a Glance and HIPAA

A recent study published in the American Journal of Public Health (AJPH) looked at using text messaging to follow up with lower-income parents whose children had received a flu shot and needed follow-up visits.

The participants determined they wanted to send targeted messages, which were to include the child’s name and a reference to a “second flu shot.”

That seemed like an easy and effective way to remind parents about a follow-up visit, and texting provides an easy way to communicate with a majority of patients. However, there were problems with the language. The message contained Patient Health Information (PHI) as defined by the Health Insurance Portability and Accountability Act (HIPAA). Under HIPAA, all communication must protect patient information. In this case, the message had the patient’s name and implied he/she had already received a flu shot. Those two pieces of information violated patient privacy.

Text messaging is also not considered a secure form of electronic communication. Even when sent by secured means, there is no way to guarantee the intended recipient receives the message.

The study team found away to protect PHI. It eliminated names and made the language generic. Instead of saying that a child needed a second flu shot, the team send a reminder that some children may need a second one. The message ended by prompting the recipient to call for an appointment.

Concluding Thoughts

The study serves as a good reminder for those medical professionals who prefer texting. It is a feasible means to communicate as long as the messages keep patient information private. The study also sets a standard on how to comply with HIPAA and PHI.

Medical Mobile App Clearance Times Decrease

by Holly Shoemaker

The Emergo Group, a medical device consulting firm, has provided updated information that shows the time it takes for apps that undergo the 510(k) process has decreased.

Numbers at a Glance

The study shows that medical mobile apps that undergo the 510(k) process takes about 138 days to receive clearance from the Federal Food and Drug Administration (FDA) in 2011, which was down from 146 days in 2010.

The data analysis took submissions through the end of 2011 to look at a 12-month data set. The analysis showed that 95 to 97 percent of all 510(k) applications received FDA clearance within one year of submission.

What is 510(k)?

The 510(k) status is a pre-market submission made to the FDA to show that a device may be marketed as safe and effective. Introducing a new device or changing the usage are some reasons for needing this clearance. The FDA publishes further guidelines here.

Good News for Developers 

One of the hurdles for developers designing medical mobile apps was the time needed for clearance. Any additional delay meant using more time, money and other resources. What the study found was that many medical mobile apps have a shorter wait time for clearance when compared to other devices.

Another study by MobiHealth News found 76 cleared apps in the FDA’s 510(k) database, and the average clearance time was less than the time reported by Emergo Group. This study found the clearance time was 25 days shorter between 1997 and 2012, with an average time of 110 days.

Outstanding Issue

Developers continue to debate what the time for clearance actually means. The FDA’s data defines the dates as when the agency receives the 510(k) application and the official “decision date.” Some developers and companies say the wait for clearance is longer because discussions occur before the actual filing of the application.

While medical mobile apps requiring FDA clearance takes more planning, developers have many tools to assist them. I still recommend using Happtique guidelines to assist, as that app store dedicates itself to just health apps.

Concluding Thoughts

No matter which study patients believe has more validity, both show progress when it comes to medical mobile apps clearance. That is untimely good news for patients too because they gain access to better quality information. Once approved, the device is deemed safe and effective, which helps marketing efforts and branding.

Simple Communication Steps to Enhance Patient Awareness

by Holly Shoemaker

While healthcare changes are on the horizon, doctors and medical professionals still face challenges regarding the best ways to keep patients informed. Before deciding on the tool used to communicate information, physicians and medical professionals need to ensure they choose the most appropriate way of communicating with patients.

Simple Steps to Follow

• Make Information Available in Many Ways – Simply put, people learn in different ways. Some are auditory learners, others learn by reading, some are kinesthetic learners and others need a variety of approaches. Doctors should consider these methods when communicating with patients and understand how patients best process information. Verbally mentioning information is not always enough to truly communicate. Providing information in a written form, or along with a visual, reinforces points and helps patient remember information related to their own care or conditions of family members and friends.
• Jargon – While patients need access to healthcare information in multiple forms, verbal communication will remain a primary way to communicate with a doctor. Many medical terms may be out the realm of a lay person’s vocabulary. Doctors should ensure they tailor their speech and communicate in terms that reach all patients.
• A Word Is Not Always Enough – Do not always assume that a patient may take a medical professional at his/her word. Use of current research will reinforce suggestions and may serve as a way to open up further dialog, or make a patient feel they may ask questions to better process information.

Concluding Thoughts

By first ascertaining the ways patients take in information, doctors and medical professionals may then decide on the proper channels of communication. The technology itself only becomes effective after the medical community first learns how patients take in information to stay informed.