Interactive Patient Systems Can Help Activate Patients
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Patient activation has been shown to improve patient experience, outcomes, clinical indicators, adherence, health behavior, and participation in care. Some studies also show a correlation between patient activation and reduced symptoms, readmissions, overnight stays and use of the ER.
Interactive patient systems (IPS) are one of the interventions that have been successfully used to increase patient engagement, which includes activation. Deployed in hospitals via in-room television, these systems have become very sophisticated. A state of the art IPS has numerous features that can engage patients and get them involved in their own care. These range from condition-specific patient education and nursing alerts to the ability to provide feedback on pain and other kinds of symptoms. Some of the more advanced applications can be integrated with hospital information systems, providing bidirectional data to clinicians and patients.
Activating paraplegic and quadriplegic patients can be challenging. At the James A. Haley Veterans Hospital in Tampa, Florida, Veterans with spinal cord injuries access all of the features of an interactive patient system by using an assistive device known as ‘Sip and Puff’. This device provided by QuadJoy enables the paralyzed Veteran to easily navigate the resources on the IPS using their mouth. Through this Sip and Puff technology, Veterans control room lights, adjust their beds, and call nurses. They view education videos, monitor and communicate their pain level, access the Internet, games, movies, and television, and commonly use the IPC to communicate with their care team and provide feedback on their condition.
Interactive patient systems are also used to help patients manage their pain. At Lurie Children’s Hospital of Chicago, for example, a patient’s pain “pathway” starts at admission, when Lurie’s “Partnering in Pain Management” video plays on the bedside TV. Forty-five minutes after pain medication is administered, a pain reassessment prompt appears on-screen and remains there for 15 minutes, allowing the patient to record his or her pain level. These responses are documented in the electronic health record.
The nurse on duty uses this information to help the patient evaluate the effectiveness of treatment. She may also cite it when she discusses pain management options with the patient’s family.
According to Lurie, use of the IPS was associated with an increase in patient satisfaction scores related to pain from 75% to 83%.
“Our approach to care is to keep patients and families at the center of the conversation and actively involved in decision-making. Interactive Patient Care helped us strengthen the clarity and consistency of communications with families, achieving positive gains in satisfaction around pain management,” said Suma Rao-Gupta, MPH, Director of the Pedersen Family Learning Center & Health Sciences Library at Lurie Children’s Hospital of Chicago.
Interactive care plans
The next step in using IPC for patient activation is to engage patients directly in their care plans. That’s what St. Elizabeth Healthcare, a seven-hospital system in northern Kentucky, is doing. The care plan is displayed on an innovative interactive “whiteboard” that serves as a central communications exchange between patients, families and care teams.
The information on the whiteboard is organized into three areas that reflect patients’ three most pressing concerns: My Team (staff profiles, questions for staff), My Day (schedule, discharge information, clinician notes) and About Me (journal, notes, contacts). Care teams can access and update the care plan as needed, and respond in real time to patient questions and feedback.
Patients also receive daily prompts on their TV that alert them to information and educational content they should pay attention to, such as the question of the day, pain assessments, new medication education, and new video notifications.
Seventy-seven percent of patients at St. Elizabeth have engaged with the on-screen system to receive education about their health, and 90 percent of them have received patient safety education. The IPS has also had a positive impact on the organization’s patient satisfaction scores.
“Today, patients and families at St. Elizabeth Healthcare are able to use [the IPS] as a valuable tool to help them better understand their condition, their care plan, new medications and how to prepare for discharge,” said Linda Robinson, manager of Innovation and Process Transformation at St. Elizabeth Healthcare.
Not all interactive patient systems are created equal. Some of them focus mainly on entertainment, which is good for patient satisfaction but doesn’t help patients get well faster. IPS is capable of much more than that. By engaging patients and promoting patient-centered care, a well-designed IPS can encourage patients to comply with their care plans and learn more about their conditions. As a result, they’re likely to have better outcomes and a shorter length of stay.
The inability of many patients to understand discharge instructions and their failure or inability to make a follow-up appointment with their doctor are major factors in readmissions. So by helping patients grasp what they’re supposed to do after discharge, an IPS can decrease the likelihood that they will be readmitted.
In summary, IPS can activate patients to get involved in their own care, and that activation can help them improve their health, leave the hospital sooner, and avoid being readmitted. It’s one case where technology can really make a difference.