Authors: Bruce Runyon Lavinia Mitroi
Publish Date: 2015/09/22
Volume: 60, Issue: 12, Pages: 3502-3503
Abstract
Even though the traditional adage “everyone needs a good listening to” is doubly true within the patient–physician relationship patients often have difficulty reaching their physician once they exit the examination room with the patient front desk and the physician playing “telephone tag” rather than effectively communicating tragically culminating at times with a visit to the emergency department for patients suffering from more serious conditionsIn assessing core qualities that influence patient satisfaction communication issues appear to influence low physician ratings even in the presence of other positive qualities 1 Furthermore even though part of the movement toward “patientcentered care” includes timely communication with a physician’s office in practice automated answering systems and message taking contribute to largely negative patient perceptions 2 despite the data supporting the use of technology including automated telephone systems standard telephone calls emails and faxes as facilitating the management of multiple chronic conditions 3Modern technology has opened multiple channels of communication between patients and their physicians whether through telephone calls secure messaging systems or Bluetoothenabled technology such as “smart scales” all of which can serve to prevent unnecessary emergency department visits It is vital however to consider the preferences and familiarity of the patient population with these technologies prior to implementation of a novel communication method Elderly patients usually prefer to receive personal assistance from a human operator whereas younger patients typically feel more comfortable with a “robocall” texting or emailIn this issue of Digestive Diseases and Sciences Thomson et al 4 describe and validate the use of an automated telephone monitoring system with interactive voice response IVR in the prediction of readmission for patients with cirrhosis Despite patient dissatisfaction with automated telephone systems cited by other studies this pilot study reported a high level of compliance with 70 of patients completing over 80 of their IVR assessments particularly among patients with cirrhosis who are frequently noncompliant Furthermore the responses provided by this population enabled the authors to successfully predict which subjects would be hospitalized while increasing the value of facetoface encounters with the treating physicians through the provision of additional information 4IVR monitoring has the potential to improve the efficiency and effectiveness of hepatology care by predicting which patients are stable enough to require less frequent communication versus patients who demand additional interventions Nevertheless since responses collected from automated telephone systems are largely dichotomous yes/no or ordinal limited to a Likert scale rating of how the patient is feeling these types of data are not conducive to immediate intervention As the authors note although scheduled calls with a member of the patient’s care team between office visits could provide more detailed data for informing management decisions these calls are resource intensive
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