Patient POV is often missing from medical training. Here's how Wolters Kluwer is addressing that

Patient testimonies have historically been left out of continuing medical education. In recent years, the Accreditation Council for Continuing Medical Education began to include patient perspectives (PDF) in its criteria for CME. Doing so, it argued, could encourage greater sensitivity to patient needs, close knowledge gaps and demonstrate a commitment to inclusivity. 

In 2021, Wolters Kluwer set out to enrich the clinical point of view with the launch of Patient Perspectives, a collection of patient-written stories about their conditions and care journeys as part of its CME.

The company spoke about the importance of incorporating patient perspectives in CME at HIMSS23 in April. 

Patient Perspectives is integrated into Wolters Kluwer’s UpToDate clinical decision support tool, a subscription-based resource with the latest evidence-based medical information for providers and patients. It is used by more than 2 million clinicians globally, including for CME. Before Patient Perspectives, most articles had been written solely by clinicians.

Each patient narrative, part of various Wolters Kluwer databases on specific diseases, is reviewed and edited by physician editors and disease experts to oversee the correct terminology and convey accurate information in a chronological way. But the voice and personal descriptions humanize the experience, Wolters Kluwer argues, and show a side of illness often missing from standard medical training. 

Doctors spend years in medical school and residency absorbing a tremendous amount of information, Jennifer Tirnauer, M.D., senior deputy editor for Wolters Kluwer Health, told Fierce Healthcare. “Patient stories help doctors associate all the facts, understanding and experiences to individual patients that are very memorable,” she said.

In training, students may focus more on symptoms, disease progression and other evidence-based tests, echoed Kelvin Chou, M.D., a professor of neurology from the University of Michigan, who was also on the HIMSS23 panel and has been editing UpToDate articles since 2008.

“All of this is appropriate as a trainee,” Chou told Fierce Healthcare. “The transition to focusing on how the patient experiences the condition sometimes doesn’t come until later.”

As doctors and patients juggle many tasks, their interactions are limited. Compassion is something both parties want, “and it is getting squeezed out by the rest of the tasks,” Tirnauer added. The Patient Perspectives narratives serve as an open line of communication, enabling providers to dive deep into a patient’s world and understand them better.

Because the narratives can be several pages long, they are not meant to be read within a provider's day-to-day workflow, Tirnauer explained. Instead, they are read when a provider has some downtime. The benefit of having the narratives embedded in UpToDate is that providers earn CME credits for reading them.

Physicians who serve as editors solicit patient perspectives from outside their practice, Wolters Kluwer executives say. Because the stories describe what went right and wrong in a care journey, "for the doctor-patient relationship, there is a much greater vulnerability and that is why they need to be separated,” Tirnauer said. 

Even if a doctor becomes a patient navigating the healthcare system, their experience will differ greatly from that of typical patients. Doctors are more familiar with medical terminology and have a sense of what other doctors may know, Tirnauer explained. That may help them communicate in the care setting. 

“But often that’s not the crux of the experience,” Tirnauer said.

Wolters Kluwer has published more than a dozen patient perspectives so far. The company is tracking who is reading them and how much time they spend on the narratives and is soliciting written feedback from providers as part of their CME.