Use of technology opens opportunities for improved patient education
Use of technology opens opportunities for improved patient education
Choose projects to meet both patients' and clinicians' needs based on assessment
Many of the technological advances being made provide opportunities to improve patient education. They often are a wonderful addition to traditional education methods, such as one-on-one teaching, written materials, and videos.
"We see the patient education program very holistically. Technology is used as a complement to all the other things we do. Not everything done face-to-face can be done online with the use of technology or vice versa, but they are used in tandem. Very rarely do we have a service online that does not exist face-to-face," explains David Wiljer, PhD, director of Knowledge Management and Innovation in the Oncology Education/ Radiation Medicine Program at Princess Margaret Hospital in Toronto.
A whole range of technology is available, from the very basic to the complex. A very simple use of technology at Princess Margaret Hospital is providing access on the web site to brochures that are generally given out by clinicians to support teaching.
Patients lose documents or may want to share the information with a family member, so they are made available online, explains Audrey Friedman, MRT, MSW, director of Oncology Patient Education and Survivorship at Princess Margaret Hospital.
"There are a few brochures that may not be available, but that would only be limited by input from a nurse that says the information in the document requires an intervention or a teacher. In most cases, all the documents we develop are downloadable 8X10 sheets," says Friedman.
A more complex use of technology at Princess Margaret Hospital is the patient portal. Patients have online access to their health record through the portal, and they receive tailored educational messages. For example, they are able to click on their protocol for chemotherapy for a breakdown of what to expect each week. There is information about the drugs they will receive with the possible side effects and who to contact if they have an adverse reaction.
One of the services available through the portal is the ability to ask a librarian a specific question and get an answer. This service is offered face-to-face, and the team working on this project decided to offer it online, as well.
The portal is a pilot project for some breast cancer patients, diabetes patients, and chronic kidney disease patients. In their department, Wiljer and Friedman work on the portals for breast cancer patients.
"We really see this as a platform of the future and a way to engage patients," says Wiljer.
Patients receive access to their lab results and diagnostic reports that can include trending results and information on what action to take based on the results.
A web portal also is available to patients at M.D. Anderson Cancer Center in Houston. It gives patients a way to communicate with their health care team on non-urgent matters and to receive responses in a 24-hour turnaround time. The patient's web site also provides access to information on the procedures he or she is undergoing, as well as coping and self-management information and disease and treatment information, says Nita D. Pyle, MSN, RN, associate director of the patient education office at the cancer center.
Patients have a place to journal so they can track symptoms they can send to their health care provider and they have access to their medical record. A section covering frequently asked questions, such as the definition of hemoglobin, reduces the number of repetitive questions to health care teams.
Soon patients will have their lab results posted on the portal following a seven-day lag time to give physicians time to discuss the results first.
"Our hope is that patients will be able to click on education documents that explain the information found in lab results, such as blood counts," says Pyle.
Many beneficial aspects
There are many reasons for using technology to deliver patient education. Accommodating a variety of learning styles is one reason, says Pyle. Also, it helps to provide a consistent message on a topic.
"Patients don't have to be onsite to communicate with us. They can access information in video, e-learning, print and even download information to an iPod," she adds.
Technology provides a format for a timely exchange between patients and clinicians.
Yet there are several aspects to consider before developing a project that makes use of technology. Friedman says Princess Margaret Hospital serves more than 150 cultural communities, so language is always an issue.
Although unsuccessful in reaching every community, staff have identified the most prevalent patient groups served by the hospital and tried to respond by developing many of its technologies in multiple languages.
For example, virtual tour technology based on self-navigated video is on the institution's web site, so patients can tour the health care facility clicking on objects, such as the information desk, or a map when more details are needed. The interactive tour, created to help reduce patient anxiety before hospitalization, is available in seven languages.
"We try to use our technology to help people find the right information based on who they are including in their language preference and information preference. Some of our tools you can choose to navigate using a lot of images and video, but you can choose to navigate the same or similar information using text and more clinical information," says Friedman.
Before new technology is implemented, a thorough needs assessment must be completed. This includes talking to patients and often conducting a survey. It is important to understand the patients you are trying to reach with a particular technology, says Wiljer.
For example, when setting up Caring Voices, a social networking web site, the team learned when assessing potential users that most of the people in the target audience would not have a lot of experience on social networking sites, so they couldn't rely on the standards of Facebook. Instead, they needed to make the site very simple and easy to use.
"It is a combination of understanding your audience, understanding the technology options, and understanding how it is going to be implemented," says Wiljer.
In addition to patients, the needs of other stakeholders must be assessed, such as the clinicians involved. In preparation, the technology must be thoroughly researched, including evidence found in scientific literature.
The team working on a technology project should include clinical experts, education experts, technology experts, and a project manager for oversight. Patients need to be included, as well, says Wiljer.
Once a technology project is ready to be implemented, a clinical champion is identified to help with the adoption phase, and - finally - an evaluation is completed to determine if project goals have been met.
Once implemented, the technology project is promoted to users. Frequently, it is difficult to get busy clinicians to initiate the use of a new technology. For example, the virtual tour would support patients coming to Princess Margaret Hospital for treatment, but staff at primary care facilities must make them aware of it. The projects that can be marketed to patients directly, such as the Caring Voices web site, are the most successful, says Friedman.
Technology projects are started only when it is determined they will be useful and that they can be implemented and sustained from a cost perspective and human resource perspective, she adds.
SOURCES
For more information about the use of technology for patient education, contact:
Audrey Friedman, MRT, MSW, Director, Oncology Patient Education and Survivorship, Princess Margaret Hospital, University Health Network Provincial Head Patient Education, Cancer Care Ontario, 610 University Ave. 5-319, Toronto, Ontario M5G 2M9. Telephone: (416) 946-4501 ext. 5340. E-mail: audrey.friedman@ uhn.on.ca.
Nita D. Pyle, MSN, RN, Associate Director, Patient Education Office, U.T.M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 21, Houston, TX 77030. Telephone: (713) 792-7128. E-mail: ndpyle@md anderson.org.
David Wiljer, PhD, Director, Knowledge Management and Innovation Oncology Education/Radiation medicine Program, Princess Margaret Hospital/University Health Network, Assistant Professor, Department of Radiation Oncology, University of Toronto, 610 University Ave., 5-973, Toronto, Ontario, M5G 2M9. Telephone: (416) 946-4501 ext. 4703. E-mail: [email protected].
Many of the technological advances being made provide opportunities to improve patient education. They often are a wonderful addition to traditional education methods, such as one-on-one teaching, written materials, and videos.Subscribe Now for Access
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