Patient Education.  The words bring to mind tri-fold brochures with muted colors and line drawings.  How can healthcare providers engage, retain and ultimately teach today’s healthcare consumers when most materials remain in a style far from the stimuli that confront the public at every turn?

Granted, health is in essence the responsibility of the individual. More and more often consumers turn to the internet to learn about medical issues.  Yet clinicians remain a trusted source for the reliable information needed to maintain good health and make smart treatment decisions – not to mention the positive effect that understanding has on compliance.

Therefore providers should consider the ‘how’ in addition to the ‘what‘ of patient ed, and look for materials that bring excitement to the discovery of accurate and useful information.  A move to engaging, interactive materials may also help a practice achieve “stickiness” (patients remain with and refer friends to doctors they trust) and find new revenue (education can add reimbursement opportunities) while fostering patient understanding and compliance.

A Vital Role

Primary care providers serve consumers not only through diagnosis and treatment but also through counseling and the coordination of care beyond their practice walls.

In 7 Ways to Save Primary Care, Ken Zonies reflects, “when a patient comes in, they determine if the patient is ill or “worried-well. The worried-well are treated with compassion and advice. In those with illness, the doctor determines the severity of the disease and the need for intervention. The affected organ system is determined. The doctor then either treats the disease or refers the patient for testing or a subspecialty opinion. In the hands of a well-trained, experienced primary care doctor these complex decisions can be made accurately and seamlessly. The primary care doctor is the conductor of the health care symphony. His job is to coordinate the specialists, tests and procedures. Then he guides the patient through the dangers that medical interventions sometimes produce” (Zonies).

Patient education is a necessary component of these efforts, especially when a provider wishes to involve patients in their own care. However, much as the EMR is an important tool for documentation but can in no way replace the physician’s diagnostic capabilities, patient education tools should be used as an adjunct to the provider’s expertise. “The Internet and linked databases will only find their true benefits when the information extracted from them by doctors is recognized as being more valuable than the data“, Zonies concludes. (Zonies)

Moreover, the use of multimedia patient education tools in conjunction with an EMR can bring about the most value for patients and their providers.  This is especially true when an educational module can be directly linked to and initiated from the provider’s Plan of Care and in the way of follow-up through printed or emailed Patient Instructions.  A practice might also capture more revenue by documenting education provided during counseling and coordination where was the time spent) and even in lower level visits with a nurse or physician assistant.      

Effective patient education materials:

  • Engage – appeal and communicate to multiple learning styles, allow interaction
  • Compel – users to comply with provider and medication instructions
  • Teach – foster a natural progression of interest (topics), help pts raise the right questions
  • Retain – interaction at point of care, later alone, at home with family, to keep up to date
  • Reassure – solid information that can be accbessed in privacy or with provider and family

Educational Goals

It goes without saying that patient education materials should be accurate, but in order to be effective, educational resources should also have qualities that make patients want to learn. Afterall, providers want their patients to receive messages that can help bring about positive outcomes. In addition, providers strive to maintain their status as a primary source of medical knowledge in order to tie the information to the provision of medical services. This allows for revenue both in patient retention and by billing for educational counseling sessions, which with the appropriate tool can be nurse-directed thus avoiding loss of physician productivity.

In order to accomplish these goals, effective education materials should engage, compel, retain, and reassure patients while teaching them the information needed to make smart decisions about their health and treatment options.

Engage.  Whether we are 12 or 72, members of our society have begun to expect light, sound, color and a certain level of interaction from most any learning experience. Be it online college coursework, continuing education, or simply searching for a new recipe or movie listing – we look to interactive media for information. Even advertisements increasingly attempt to use multi-media “education” to compel their audiences. Amid this world of excessive stimulation, a learning tool must catch us from the get-go to keep our attention.

Goal – interest people in their own health

Compel.  Compliance with provider and prescription instructions is naturally facilitated by a level of understanding, a fact that has been well documented in regard to adherence to instructions for prescription medications (Haynes, Ellis, Jackevicius, Benner).

While a decline in health may stimulate someone to seek knowledge (Dunbar), the same level of interest should also apply to the prevention and maintenance of good health (Roter).  Prevention programs that employ interactive tools are more effective. For example, an education program employing an interactive tobacco cessation CD-ROM was strongly related to increases in tobacco cessation knowledge, attitudes, and beliefs (Gordon).

Similarly a recent investigation examined the effect of a web-based interactive multimedia education program on health outcomes of 228 children with asthma.  The study showed that supplementing conventional asthma care with interactive multimedia can significantly improve asthma knowledge and reduce the burden of childhood asthma (Krishna).

Whether in relation to prevention or treatment choices the goal of empowerment through education should be discussed with every patient, according to his/her own situation and life priorities (Aujoulat).

Goal – empower patients to effect their own health outcomes

Teach. Videos, animations, rotating 3D models and the ability to interact with media not only bring a “cool” factor to learning tools, but allow providers to customize the learning experience by appealing to and communicating with patients who respond to varied learning styles. (Kaur, Souza, Hamilton).

Patient education materials should also provide a breadth of information that fosters a natural progression of interest from the causation of disease or mechanism of injury, through treatments and procedures and on to other interrelated topics. For example, an aging woman with a recent fall might want to learn about fractures and treatment options and then extend her search to bone health, osteoporosis, and even hormone therapy.

Goal – give patients the tools they need express themselves and ask questions pertinent to treatment and lifestyle decision-making

Retain. Another benefit of tools with multimedia and interactive capabilities is increased retention, both in the sense of remembering what is learned and in developing a role as a trusted source to which patients will return repeatedly. 

As mentioned, learning tools should not only allow patients to “get their hands on” their own medical issues, to look at a situation from all sides and move easily from topic to topic, but should also allow for interaction with providers at the point of care and later at home alone or when sharing information with family members.

Integration of patient education materials with an EMR allows providers to maximize the learning experience at the point of care.  For example, smoking cessation can be linked to test results and family history. This is especially powerful when facilitated by an Application Service Provider model that allows for viewing of the same materials in the doctor’s office and then later at home, in the library, or at work as well as measurement of the success of various prevention and education programs through data reporting.

Granted some consumers cannot easily access the internet or use multi-media materials outside of their experience in the clinic.  Therefore it is important for providers to maximize the patient’s experience at the point of care, fully utilizing multimedia, multi-dimensional and interactive capabilities, before sending patients off with resources that allow an extension of the in-office education at home.

In fact, the feasibility of using an interactive laptop program in the emergency department to prevent alcohol misuse among adolescents was examined in 2003. Even in the ED setting, the use of an interactive program was not only feasible, but showed promise of effectiveness in reducing alcohol-related behaviors among adolescents (Gregor).

Goal – lifelong learning and ability to communicate about medical issues with others

Reassure.  While the ability to share information is important, a patient must be assured that the information they choose to access is private. The ability to view and interact with patient education resources outside of the medical office where a patient can take their own time in their own comfort zone is essential. The information itself should also bring reassurance in that it provides the knowledge that empowers decision making.

Goal – help patients feel comfortable

In Summary

Healthcare providers by nature want to impart their patients with accurate, up-to-date medical knowledge in order to help them make decisions that render positive clinical outcomes.  However, they must also consider the mechanism of delivery of that information.  In fact, providers should be enabled with learning tools that allow them to provide the same level of quality of visual information as seen in the animations and models pharmaceutical companies use in their advertisements.  This is how patients expect to learn, and helps maintain the role of the physician as trusted source of information and medical service provider, much like the similar visual aids improve the “stickiness” of a website.

In fact, interactive, multimedia patient education is not only good for patient health. These tools may also stimulate the financial health of a practice by providing an underused revenue stream in the way of counseling and coordination of care with a physician as well as during lower level visits with nurses or PAs. In fact, some payors reimburse for group educational sessions for specific disease states such as diabetes or prevention programs for lifestyle modification.  Therefore, patient education initiated at the point of care and documented within an EMR may provide the most benefit for the practice and the health care consumers they serve.

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Kristin H. Norton, PhD
VP of Business Development
PracticeIT

Kristin Norton’s article is published in EHR Scope Spring 2008 Volume 5 publication.  To view her article and references, please visit www.ehrscope.com/magazine