Improving patient-to-physician communication with technology
STORIES OF COURAGE: Kenzie's story
Teenagers more likely to share critical information with doctors using Health eTouch
Like many patients at Nationwide Children's Hospital, 16-year-old Kenzie Davis is asked many questions about her health. But now, researchers at Nationwide Children's Hospital have developed a device that lets her fingers to do the talking.
The Health eTouch is a wireless computer tablet that allows doctors to gather vital health information in a private, high-tech fashion. It's a communication style most teens have spent years mastering. "It's easier to answer the questions truthfully," said Kenzie. "I don't want my parents hearing some of the things I tell doctors. I don't want to worry them."
The secure Web tablets ask questions that vary based on the user's age and reported behaviors and lets physicians know instantly if there are high-risk behaviors that need to be treated immediately. "Physicians are doing the best they can during the brief office visits," explained Kelly Kelleher, M.D., a principal investigator for the Center for Innovation in Pediatric Practices in The Research Institute at Nationwide Children's. "There is so much information that has to be collected from patients in a short period of time and it's extremely difficult to do so without the use of technology." Kenzie added, "It seems more personal. The conversation is between just you and your doctor instead of you, your parents and your doctor."
Studies have shown that adolescents are more likely to answer questions truthfully on a tablet or a computer rather than face-to-face with a physician. For young people like Kenzie, that can make a big difference in the quality of health care they receive, because the more a physician knows about his patient, the better care he is able to provide.
PEDIATRIC ADVANCEMENTS: Waiting room gadget may prove to be a life-saver
In order to better understand the ways in which Health eTouch is improving communication between physicians and patients, researchers at the Center for Innovation in Pediatric Practices in The Research Institute at Nationwide Children's Hospital conducted a study of the system, published in the June issue of Pediatrics.
The study compared the results of nearly 900 primary care patients, ages 11 to 20, who took part in Health eTouch screening in the waiting rooms of urban clinics. These clinics were randomly assigned to have pediatricians either receive screening results just prior to face-to-face encounters with patients, or two to three business days later. When provided with the screening results, pediatricians were able to view a summary of patient responses to screening questions, as well as a list of flagged responses thought to indicate high-risk behaviors.
After participating in Health eTouch, 59 percent of adolescents screened positive for at least one of the following behavioral concerns: injury risk behaviors, significant depressive symptoms or substance use. Of those youths who screened positive and whose results were provided to pediatricians just prior to their consultation, 68 percent were identified by their pediatrician as having a problem. However, only 52 percent of youths whose results were delayed until after their visit with their pediatrician were identified as having a problem by their pediatrician.
"Our research has found that advances in information technology, such as the Health eTouch system, may help overcome barriers to behavioral screening," said Kelly Kelleher, MD, a co-author of the study.
Adolescent health experts recommend parents regularly engage in conversation with their children about social pressures and high-risk behaviors. Avoid the "third-degree" style of direct questioning and instead ask your adolescents how they feel about these issues in general. This approach can open the door for more direct and personal conversations down the road.
Questions for parents to ask their adolescents:
- Do you think it's okay for people your age to drink alcohol at parties?
- When do you think it's okay for two people to have sex as a part of their relationship?
- If you ever felt really sad or depressed, would you feel comfortable telling me about it?
- Why do you think some teenagers use drugs and some don't?
- Do you feel safe when you are at school?
- Is there anything I can do to help you?