While digital tools enhancing communication between physicians and patients has been proven an effective method for boosting medication adherence for some patients, their use should be approached with caution, according to Esther Choo, an assistant professor at Warren Alpert Medical School in Providence, Rhode Island.
Choo, in a commentary for Quartz, warns that while email and text messaging can be helpful for engaging patients, there are a number of challenges associated with using such tools. Here are three:
- Impersonal relationships: Particularly when it comes to discussing serious or terminal conditions with patients, plans and reassurances primarily should be delivered in person, as opposed to via text message, for example. "[H]ave we arrived at an age when everything--even professional sympathy and support--can be conveyed electronically?" Choo asks.
- Privacy: Despite secure messaging and encryption, security concerns continue to loom in healthcare, Choo says. "If my patient is feeling suicidal or experiencing severe violence, this information has no business sitting unread in an email inbox," she writes. "Yet we have few safeguards in place to ensure that urgent message are not left to languish if I'm on vacation, sleeping or, God forbid, simply behind on my email."
- Work overload: Choo also argues that digital health blurs the line between her work and personal lives. A research letter published in JAMA Pediatrics in January also found that email overload can be costly for doctors and hospitals. "My ED shifts might be 10 hours without food or bathroom breaks, but afterward I used to be able to switch my attention completely to my family," she says. "Now I can pull up medical charts on my laptop and finish my notes on patient care at home for hours after my shift is technically over."
Still, Choo acknowledges that digital health communication tools can be effective when used in moderation.
At last month's College of Healthcare Information Management Executives annual fall forum, Glenn Steele, CEO of Danville, Pennsylvania-based Geisinger Health System, touted the benefits of increased communication and transparency with patients. Via the OpenNotes initiative, he said, error corrections in patient care have been "significant" since 2011.
Additionally, Steele said, medication adherence has improved drastically thanks to the program, which he called "minimally aggravating" to providers.
To learn more:
- read the Quartz article