CARING FOR THE REAL PATIENT: IMPROVING PATIENT-CENTERED USE OF TECHNOLOGY (IPACT)
Lolita . Alkureishi,University of Chicago,Chicago,ILLINOIS
Rationale: The ubiquitous presence of technology has altered all of our personal interactions and this includes clinical encounters between patients and doctors. Abraham Verghese has drawn attention to the practice of treating the iPatient, who exists only on the computer screen while ignoring the real patient. Despite rapid adoption of EMRs, smartphones and tablets into medical practice, providers have limited understanding of how technology use impacts the patient-doctor relationship and receive little guidance on issues related to bedside manner or patient confidentiality. While there are known skills and behaviors that can enhance patient-centered use of technology, providers are often not taught these key communication skills. Our workshop will help participants understand how technology use (i.e. EMRs, tablets, etc.) affects the patient-doctor relationship and impacts communication in both the inpatient and outpatient setting. We will provide participants with the tools to teach trainees how to optimize technology use to enhance communication with patients. First we will introduce the literature on how technology misuse can undermine the patient-doctor relationship and present a framework for effective use of technology which was modified from Kaiser Healthcare. Next, participants will discuss their own experiences with integrating technology in a patient-centered manner and share with the large group. We will then review best practices and discuss teaching modalities to address this issue (i.e. OSCE and direct observation). We will also introduce the e-CEX (e-Clinical Evaluation Exercise) tool we developed to rate the trainees performance on patient-centered EMR use. Lastly, we will share our tips for implementing a Improving Patient-Centered use of Technology (iPaCT) use curriculum. All participants will receive a toolkit to implement the iPaCT curriculum at their home institutions.
Objectives: By the end of the workshop, participants will: 1. Understand the impact of modern technology use in healthcare on the patient-doctor relationship. 2. Identify best practices to utilize technology in a patient-centered manner to enhance patient-doctor communication. 3. Adapt best practices and key lessons learned into a communication skills curriculum to teach trainees to promote respectful, engaging and compassionate technology use.
Methods and Content: 0-5min: Introduce faculty & participants: Participants state what they wish to learn. 5-15min: Screen video of technology misuse during patient interview: Participants will use a checklist to take notes on the impact of technology use on communication, identify barriers and ways to improve the interaction. Debrief with large group. 15-20min: Background: We will review the literature on how technology misuse can undermine the patient-doctor relationship and discuss patient perspectives of physician technology use. We will break up into small groups for remainder of workshop. 20-40min: Small group 1: Climate and Barriers: Participants will share their experiences with integrating technology (i.e. EMR, mobile devices) in inpatient and outpatient settings and the effect on patient-doctor communication. They will identify systems, cultural and technical barriers to effective patient-centered communication. Debrief with large group. 40-65min: Small group 2: Identify Best Practices: Participants will brainstorm how to use technology to enhance patient-physician communication. They will discuss the important elements of effective technology integration (i.e. non-verbal communication, patient engagement). Debrief with large group. 65-80min: Small group 3: Resident Education: Participants will brainstorm effective methods to educate residents on patient-centered technology use. They will identify teachable moments in inpatient and outpatient settings and discuss how faculty supervision can enhance patient perception of technology use. Debrief with large group. 80-90min: Wrap-up: We will present a framework for effective use of technology, review our tips to improve patient-centered technology use and introduce teaching modalities we developed (i.e. OSCE and direct observation). We will introduce the e-CEX (e-Clinical Evaluation Exercise) tool we developed to rate the trainees performance on patient-centered technology use. We will open the floor to questions. All participants will receive a toolkit which includes: teaching video, checklist, e-CEX, pocket-cards summarizing best practices, and other tools to implement the iPaCT curriculum at their home institutions. Setup: "A/V Equipment needs: Laser pointer, Powerpoint, Computer with audio to play video at a sufficient volume for the room, projector and screen. 1 paper easel or white boards with markers.