Erica Rubinstein, Vice President of Service Excellence and Patient Experience, Mount Sinai Health System
Technological advances in healthcare are on the rise and the innovations have been life changing for patients. While these changes have been beneficial and exciting, they also have the potential to be overwhelming.
It is the challenge of healthcare organizations to ensure that patients are at the center of these advances and that the care remains personalized and engaging for patients and their families as well as for the staff that are providing care.
Several years ago, a patient sent us a letter that began with him thanking the hospital for curing him of his disease. From a medical perspective, his story was a great success. However, he was left feeling emotionally depleted from a perceived lack of empathy and connection while receiving care. He described feeling as though he was “just a number” and the staff assigned to him did not seem to know who he was as a person.
It was clear to me after reading his letter that providing great clinical care is simply not enough. We have to place more emphasis on connecting with patients in a meaningful way that goes beyond their illnesses.
While more technology can lead to the experience feeling less personalized (a physician who is focused on the computer rather than the patient during a visit), at the Mount Sinai Health System (MSHS) our efforts have been to use technology to make the patient experience more engaging and comfortable.
The quality of communication and access to information are common themes of the patient feedback we receive when asked about the overall experience. Patients feel better cared for when we are keeping them more informed. Knowing this information helps us to design interventions that will foster a more meaningful relationship between patient/ family member and caregiver.
Our growing number of patients and families who are Limited English Proficiency (LEP) are at greater risk of not feeling as connected or engaged in their care due to having a language barrier.
One of the ways we have been able to personalize care and help LEP patients connect with their providers is through Video Remote Interpreting (VRI). This technology has allowed patients and staff to have a more interactive alternative to the over the phone method of interpreting. The response from staff is that VRI is easier to use due to the convenience of it as well as the reassuring presence of an interpreter that can see and hear both the patient and the hospital personnel which lends itself to better engagement and a more meaningful interaction. It also helps solve the problem of not having an in person interpreter available when needed (usually during nighttime hours or when there is an unexpected need such as an emergency room visit). Being able to access an interpreter they can see within minutes is both reassuring and can lead to a higher quality of care overall.
Not surprisingly, clinicians also prefer VRI to over the phone and it has resulted in increased compliance and usage of services. We recently launched a smartphone application as well which puts the VRI capabilities literally in the palm of the provider’s hand.
A few patients and family members shared comments about using VRI:
“Awesome idea because I feel that providers hear me better than with the phone as we try to develop a care plan for my daughter. With the phone, doctors interrupt the interpreter, but if they have to see the interpreter, they let them finish. I would especially recommend this for the ER.”
“Video is good because you can see them during the teaching process (how to use my wheelchair). [I am] proud of Mount Sinai, the doctors and the Wheelchair Clinic.”
As we continue to innovate and bring new technological advances to our patients the challenge is to avoid the potential risk of providing more care in a less caring way. Making sure we are partnering with our patients in delivering the care is going to benefit our patients, our caregivers and the overall institution.
Another way that we are working to partner with our patients in a meaningful way is through a program called Open Notes.
Open notes allows patients to access their outpatient provider’s progress notes in their patient portal.
Research shows that when patients engage with their own notes it helps them recall the conversation with their physician and can lead to an improved understanding of their health condition, including the appropriate way to take their medications, along with any treatment decisions that were made.
Patients who use Open Notes often feel an increased sense of ownership of their health information, more of a sense of participation in their own care, and a stronger sense of open communication with and trust in their own providers.
We were fortunate to be one of the first to offer Open Notes to both Spanish and English speaking patients with the use of Bilingual Navigators. This new program has been received very positively within the community.
One patient who used Open Notes stated, “During this difficult time for immigrants, this is such a wonderful way to show that Mount Sinai really does care about us!”
As we continue to innovate and bring new technological advances to our patients it is imperative that we not lose sight of the emotional needs of our patients and their loved ones; that we remember what is most important. In the words of Maya Angelou:
“People will forget what you did, they will forget what you said, but they will never forget how you made them feel.”