Becker's Hospital Review

38 Executive Briefing: Preserving the Physician-Patient Relationship Patients are changing the physician-patient dynamic by taking control of the limited time they have with their physician. Sixty- eight percent come to their appointments with a list of questions for their physician, according to the patient survey, and 39 percent have checked WebMD or an online source before their visit. An- other 20 percent said they bring data from personal monitoring devices to share with physicians during their appointments. Outside of the appointment, patients are becoming active con- sumers and personal advocates for their own health outcomes: About 80 percent of respondents say they feel engaged in man- aging their own health. This means patients are expecting physi- cians to step up to the plate and engage with them in the limited time they have together. "I prefer/require my doctors to be open and happy to discuss my conditions with me, including any uncertainties or problems in my care management and treatment. If a physician is not willing to be open with me, I change physicians," explained one survey re- spondent. Digitizing the patient experience Emerging technologies present new challenges and opportunities for physician-patient communication. While many physicians may be wary of EHRs, most patients do not feel the same way, accord- ing to the survey. "I perceive technology [in the exam room], if done right, as a posi- tive," one respondent wrote. "It raises efficiency and improves data access and communication between physicians." "I can see my medical record on my general practitioner's com- puter screen, including X-rays. This allows him to explain things more clearly," wrote another. According to the survey, 69 percent of patients noted a difference in the amount of technology used by their physician in the last five years and 97 percent are comfortable with it, especially with the use of desktop or laptop computers. German patients were slightly more comfortable with computer usage (91 percent) than respondents from the U.S. and the U.K. combined (77 percent), but the majority of both groups said they feel comfortable with this standard piece of equipment. Survey respondents felt less comfortable with the less common technologies , such as mobile devices, telemedicine tools, and interactive wearables such as Glass or smartwatches. Of respon- dents from the U.S. and the U.K., 27 percent said they felt com- fortable with physicians using mobile devices during their exam, 18 percent felt comfortable with telemedicine tools and just 2.5 percent were comfortable with interactive wearables. And while most patients — 58 percent — say they feel technology positively impacts their overall health experience, a small seg- ment of respondents — just 3 percent — echo the concerns of physicians who are worried screens are negatively impacting the overall healthcare experience. "While concentrating on filling out all the little spaces on the com- puter screen some valuable interactions and conversation gets lost," said one survey respondent. Preserving the art of medicine Technology will continue to be an increasingly significant compo- nent of care as adoption of various devices in the exam room con- tinues to increase. While this may pull physicians in two directions at once as they juggle EHR requirements and limited appointment times, it will be even more critical for them to establish good com- munication techniques. Health IT should support the physician- patient relationship, not supplant it. "Sitting side-by-side with my patients, I pull up the health record on my laptop and we review our notes," said Dr. Steven Schiff, MD, medical director of the Cardiac Catheterization Laboratory and CMIO of Orange Coast Memorial Medical Center in Fountain Valley, Calif. "I know they leave with a thorough understanding of their health status." While patients appreciate the benefits of technology, they con- tinue to value time for discussion, advice and recommendations, privacy and engagement during their physician visits. Maintaining a focus on these tenets of the physician-patient relationship will help physicians connect better with patients and more effectively improve health outcomes. "Capturing the complete patient story while remaining focused on the human life at hand is what the art of medicine is all about," said William Kapp, III, MD, CEO and chairman of Landmark Hos- pitals and Technomad. n Nuance is the market leader in creating clinical understanding solutions that drive smart, efficient decisions across healthcare. Nuance provides solutions and services that improve the entire clinical documentation process — from the capture of the complete patient record to clinical documentation improvement, coding, compliance and appropriate reimbursement. More than 500,000 clinicians and 10,000 healthcare facilities worldwide leverage Nuance's award-winning solutions to improve patient care and support the physician in any clinical workflow and on any device. www.nuance.com/healthcare The average in-office appointment is just 12 minutes long. In this short span of time, patients may experience some of their most monumental life moments, good and bad.

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