Using Telemedicine to Improve the Patient Experience (HCAHP Scores)

There are so many valuable uses for telemedicine. You would think that hospitals, knowing how important their HCAHPS scores are would re-evaluate their patient processes and take advantage of the ability of telemedicine to put care team members in front of their patients—at their most mentally vulnerable times: pre and post discharge—in the comfort of their own home.

We tend to shower information on patients (and family members) when they first come into the hospital, we use medical terms throughout their stay and then shower them again with information when it is time to be discharged. For most patients, their thoughts at both these times are full of worry and concern; they are still trying to get their heads around the diagnosis and concern for their family members. Their eyes often glazed over as they take in vast amounts of information only hearing every other sentence. No wonder patients and family members often repeat the same questions.

In the hospital, patients are often spoken to as if they are hard of hearing, especially if they are over 55. This does nothing to help their retention, it only distracts them further. Care teams believe they are doing a good job in their communications with patients yet fail to understand the psychological effect of being recently diagnosed and in a hospital. Patients are having a difficult time processing all the information, they are super-sensitive to anything negative and their thoughts often go off track.

Patients are fearful, many are overwhelmed with their diagnosis, yet they are really trying to understand. Side note: they are also fighting to stay as positive as they can and yet we use terms that sound negative to them and their loved ones (e.g. for LVAD patients we refer to our care team as the patient’s Heart Failure Team). Imagine being a heart patient and hearing “heart failure team” referred to on a daily basis.

When patients are discharged they are again mentally vulnerable. They are trying to figure out how they are going to manage at home, pay the bills, take care of the kids and a hundred other things. Yet, this is when we give them lengthy, critical discharge information (e,g, home care instructions and medication needs), and discuss on-going visits. Again, they only hear a portion of what is communicated.

Our failure to evaluate our patient communications from the patient’s psychological perspective is disheartening.

Why do we not use telemedicine, whenever possible, in the home pre and post discharge? Why not allow them to be in the comfort of their own homes to learn what to expect at the hospital… from admissions to being placed on the floor, seeing a physician, their care team, the procedure, etc.? Other industries and occupations know the value of sharing “what to expect.”  If the patient is an emergency case, providing this service to family members (caretakers) via telemedicine would still be highly valuable.

Why do we not use telemedicine to review discharge instructions, review medications, and answer questions?

I would love to hear that many hospitals ARE doing this, and surely those that have progressive leadership are, but why not ALL? Surely the ROI would be seen in higher HCAHPS scores, and more importantly in the improved patient experience.

P.S. I am going to throw in another tidbit around the patient experience: We cannot disconnect from our patients simply because we are desensitized to the novelty of being a hospital patient.  Nor can we be flippant when patients show discomfort or modesty because we have “done this hundreds of times.”  If the man wants a male nurse, get him a male nurse for Pete’s sake.