Clear communication in digital health tools can be more complicated than it seems. In this episode, you’ll learn about:
- a surprising communication roadblock in digital health
- how it can derail a digital health tool
- two things you can do about it.
And for this episode…for the very first time….I have a co-host! (NB We’re talking via Skype so the audio sounds a little different.)
Hi. This is 10 minutes to better patient communication. I’m Dr. Anne Marie Liebel. In today’s episode, you’ll learn about a surprising communication roadblock in digital health.
You know that clear communication between patient and providers is essential. It’s no different for digital health tools, such as apps, patient portals, devices, telehealth, and the most popular digital health tool, websites.
Clear communication in and through digital health tools is complex in its own right. We’re going to take a look at a communication roadblock that you don’t want to derail the digital health tools you and your patients use. And for this episode, I have a co-host!
Anne Marie: Now, I’m excited for this episode because for the first time, I have a co-host. But you have heard him before. He’s the voice you hear at our intro and outro for each episode. He’s also the composer, musician, audio production, and post-production for each episode. So I’m really glad to introduce my ridiculously talented brother Joe.
Joe: Hey Anne Marie. Glad I could be here with you. It’s been a lot of fun working on this project together and today I get to share some perspectives of my day job
Anne Marie: That’s right I’m glad to be on mic with you man, this is nice. And we’re doing this episode together because of the topic. This topic is one that draws on both our professional backgrounds, which are different. You know I’m in literacy and education, lately health literacy and patient and provider education. And Joe you’ve been in health IT for?
Joe: Close to 20 years. In different capacities, most recently as a business analyst, serving clients who are in pharmaceutical and life sciences fields.
AM: Right on man. And we talk a lot– obviously though the course of producing this podcast –about some of the things our fields have in common that we hadn’t really thought of before. Today we’re talking about an issue, Joe, you’d got to thinking about from a health IT perspective, after the episode “When reducing medical jargon, focus on shared meaning.” You brought up some concerns that I hadn’t heard before.
Joe: That’s right, and it was that episode that reminded me how relevant terminology and jargon is in the systems world. because when it comes down to it, when you’re building or configuring a system, your terminology– or for other words your data fields, your attributes, your measures, your metrics– that’s the foundation of the system. and if there’ s not a common understanding of that terminology, if it’s not well defined, then you’re getting off on the wrong foot. And if that problem persists then you can certainly have problems later on in the system as well.
AM: And this is something I hadn’t really stopped and thought of before, and I haven’t really encountered in my reading of the research so much. Obviously, I know why it’s a problem in patient/provider communication. That’s why I think most of the field of health communication and health literacy exist. We’re really focused on getting to shared understandings and eliminating obstacles in people’s communication. But why is it a problem in digital health? in health IT, from your perspective?
Joe: Your terminology it’s your data, and it’s the foundation of a system. Problems can arise when there is a lack of common understanding of the data. You have to keep in mind the other party which is the patient. If they are part of that, a user of that system.
Just take something as straightforward like a date. The visit date, the date the patient was seen by the provider. Well, unless that is really well defined, it could get easily confused with other dates: like the record creation date, update date, the date the record was transmitted to a downstream system date, the date the visit was scheduled on, the follow up date, the prescription fill date. If you’re not aware of all of these dates, going into the specification, it could be a problem to try to accommodate those later on.
AM: That’s interesting because that’s a lot of confusion around a pretty straightforward concept. Like ‘date’ isn’t really a complex concept. But I can imagine that, let’s say, when the concept in question is more complex, there would be even more chance for differences in meaning of a term, or differences in the way that people understand a term.
Joe: Yeah absolutely. Take some of the questions that may be asked of the patients. On things like family structure, gender, race. Certainly diet, there could be things there are a sliding scale, such as maybe alcohol use, there’s not necessarily a binary one there. And then the terminology, the laymen’s term vs. a professional term or a medical term. Would you call it a bursitis, or would you call it grinding your teeth, which one can you relate to better.
AM: Right ok so I like that last example because it’s a health communication issue. And I know from the provider/patient perspective, what can happen if mutual understanding isn’t addressed, all sorts of bad things, outcomes suffer. So from your experience in health IT what happens if these problems of shared understandings don’t get addressed?
Joe: If you don’t have a shared understanding or a common understanding, the data you’re defining, or not maybe defining fully enough, it could be used in the wrong way. When it comes to soliciting that information say from the patient or certainly when it’s used downstream. You’re going to have built a data model and a system that’s embodies these misunderstandings.
For example, if we’re asking the patient questions they don’t understand, or they understand them in a way different than was intended, we’re certainly missing the mark. And those misunderstandings will persist in the system. If we’re not cognizant of the patient’s perspective, this can make patients feel backed into a corner when they’re trying to answer questions that maybe we’ve not been able to accommodate well within the system.
AM: Sure, and that’s kind of bringing me back to your original point about how some of this confusion can happen unintentionally, in communication between the health pros and the IT pros. Because again this is part of why–these kinds of miscommunications and misunderstandings–is part of why the field of health communication exists, right? To address issues like this In the patient encounter, all the face to face communication, the patient education materials, public health campaigns. But what can people do to keep this from happening in a digital context?
Joe: Certainly as part of my role as a business analyst, it’s part of my job to make sure requirements are clearly defined, understood, and properly implemented. We don’t want to lose perspective of the patient along that journey. Stakeholder involvement throughout the process is also key.
For me, being involved in this podcast series it’s made me more aware of health communication and the patient perspective.
AM: That’s funny the NAM had a roundtable discussion on health literacy and consumer facing tools (oops! Sorry, it was a workshop). And it was mentioned, developers don’t necessarily know about health literacy. It’s not their fault but I can see it would kind of be an issue. Because this is where you and I started months ago realizing there was some overlap in our fields that we hadn’t thought about before.
And I am increasingly doing health literacy work for apps and health literacy work for websites for my clients. And it’s from talking with you that I know it involves not just ‘plain language’ right, but these kinds of health communication issues as well – between health pros and IT pros. So.
Joe: You’re absolutely right. I don’t think there is a deep or keen awareness of this in the IT provider space, at least not yet. But we would certainly benefit from that, because obviously it directly impacts the effectiveness and the usability of a system.
AM: Yeah so let’s get on that man, let’s make a podcast about it! That’s what we’re doing!
If your organization needs someone who can be an advocate for the patient from the inception of the project through implementation and user testing, contact me at health communication partners.com. I’ll help you bridge that language gap between health experts, and IT experts, and patients! Because this is about being very clear and ensuring that there are shared meanings.
Now many of our listeners are not folks who are going to be making or designing these tools. And I always like to end with something that folks can do today. So, Joe, do you have any suggestions for our audience? Something to do or to keep in mind when it comes to digital health tools that they might be using?
Joe: Yeah, specific to this topic that we’ve been discussing, keep your eyes open for any terms in an app or a system that could be interpreted in multiple ways. Have the terms been clearly defined, maybe in the help section? Are there resources, like a help request or ticket you could raise, that can help clarify the terms so that the data can be collected and/or used with more confidence and clarity.
AM: That’s cool again getting back to these shared meanings and shared understandings, so that things work the way they’re supposed to work.
Joe: Right, exactly.
AM: Cool. I’ll go ahead and put in from my perspective about being critical consumers of data that are going to result from these tools. Keep in mind that everything else you know about an individual or group. Keep those things in mind and read the data you’re getting in relation to all of this that you know. Remember that because something is quantified doesn’t mean it’s objective.
This has been 10 minutes to better patient communication.