Laura Joszt, MA

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The results of a patient experience survey highlighted the need for healthcare providers to offer convenient communication options and user-friendly healthcare technology to improve experience and satisfaction.

The survey was conducted by Updox, a complete healthcare communication platform for in-person and virtual care. It was conducted online from August 31 to September 2, 2021, with responses from 2076 US adults ages 18 and older.

According to the survey, 53% of respondents said they would prefer to update or provide information such as health conditions, new prescriptions, or test results, digitally using online forms that can be accessed securely by phone, email, or patient portal.

In addition, 55% said convenient communications were among the most important factors when it comes to a good patient experience. User-friendly technology, such as an easy-to-use health portal or telehealth app, was the second-most important factor (51%), followed by secure information sharing (50%), and increased health safety (47%).

It’s clear that COVID-19 has impacted and even accelerated the expectations and preferences of patients and the ways they prefer to engage with and receive care from their healthcare provider,” Zach Zettler, president of Updox, said in a statement. “It is critical for practices to adjust to these needs to better connect with patients where they are - on their phones. When it comes to technology solutions that consumers believe are important for a healthcare provider to offer, it’s all digital.”

Common technology solutions patients expect to be offered included:

Patient reminders by phone call, email or text (65%)

However, 3% said no new technology solutions were important for healthcare providers to offer to patients.

The survey also evaluated new expectations of healthcare providers as a result of the pandemic. Requiring that masks be worn by both patients and providers during in-office visits was most expected (58%) followed by socially distanced waiting rooms (52%) and an option for online paperwork (42%). Only 41% and 39% expected telehealth appointment option and communications conducted virtually, respectively. Furthermore, 12% said their expectations of healthcare providers hadn’t changed as a result of the pandemic.

“Communication can truly be a huge barrier in getting healthcare services, which is why it’s so important for today’s providers to focus first on establishing relationships,” said Sherie Garrison, RN, Luke Project 52 Clinic. “At my clinic, Updox really is the glue we use to build trust with our patients. Texting with them isn’t always medically related — it’s a way to show we care about them, and we’re connected to them.”

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Patients expect more convenient communication options and user-friendly technology from healthcare providers now.

Patients Expect Providers to Offer Convenient Communication, User-Friendly Technologies

Telehealth isn't the only enduring technology that was implemented during the COVID-19 pandemic; artificial intelligence (AI) was being used more than ever across Moffitt Cancer Center, said Edmondo Robinson, MD, MBA, MS, FACP, senior vice president and chief digital officer at Moffitt Cancer Center.

What new technologies or services did Moffitt implement during the pandemic that you think have good applications after the pandemic is under control?

A couple of things that come to mind in terms of response to the pandemic in order to make sure that we were still driving our mission to prevent and cure cancer. So one — and this is common, you hear this theme for everyone who responds to the pandemic — which is telehealth, telehealth, telehealth. Right? And so, you know, we pivoted very quickly. We had a 7,500% increase in our telehealth visits. That's come down since the height of the pandemic, but not all the way. So, there's some middle ground in there between where we were before, and where we were at the height of the pandemic. You know, virtual visits are just gonna be a standard channel through which to deliver care. 

And so you know, that there's a whole suite of activity that has to go with that. All the workflows, you know, the technical components, as well as just making sure patients are ready for that. There's a concept of digital health, in terms of literacy, right? So we think about literacy, and then there's health literacy, and then there's digital health literacy, right? And so, we have to actually pay attention to that. 

But in parallel to really, one, getting getting a lot of our employees to work from home, and then doing the virtual visits, something else that happened in parallel and actually continued to accelerate during the pandemic is the leveraging of artificial intelligence throughout the enterprise, though. So, everywhere from predictions of outcomes, like sepsis, to driving our business operations, leveraging robotic process automation, for example, but layering in artificial intelligence so that with AI, the bots are  not just automating, the AI is finding the next opportunity to automate or the AI is fixing the bot if it breaks on its own. Those kinds of concepts.

So again, leveraging AI everywhere from business operations to clinical operations, is another thing that we actually accelerated during the pandemic.

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Dr. Edmondo Robinson Highlights the Growing Use of AI

Although a slightly higher percentage of patients with cancer prefer telemedicine to in-person visits, satisfaction scores were equally high for both, according to a study from Memorial Sloan Kettering (MSK) Cancer Center researchers. The findings were 

JNCCN—Journal of the National Comprehensive Cancer Network

The researchers assessed satisfaction and preference from 1,077 survey responses from radiation oncology patients. The patients received care at MSK’s main campus and six regional locations in New York and New Jersey. They were evaluating office and telemedicine visits that took place between December 2019 and June 2020.

A total of 726 of the patients were seen in office for prepandemic visit and 351 patients had telemedicine visits during the pandemic. The median age of patients with telemedicine visits was 65 years (66 years for office visits).

Satisfaction was largely the same. For level of concern by the physician, 92% of patients with a telemedicine visit compared with 93% of patients in office selected the top score. Similarly, 94% chose the top score for telemedicine and 94% for in office when evaluating the friendliness of their physician.

When rating the quality of their physician’s explanations, there was a slight advantage to telemedicine with 91% of those patients selecting the top score compared with 84% of patients who had an in-office visit.

“These findings provide some evidence that there is a role for telemedicine beyond the COVID-19 pandemic and that it can be a particularly useful tool for certain patients—especially those who may have challenges coming on-site for an appointment,” co-lead author Narek Shaverdian, MD, MSK Department of Radiation Oncology, 

. “Giving patients flexibility and options by being able to see them both in-person and through telemedicine can improve access to care.”

According to the survey results, 45% of patients preferred telemedicine, 34% preferred in-office visits, and 21% had no preference for their visit type. Patients who were married or had a partner and who had better performance status were more likely to prefer in-person office visits.

Patients who had a telemedicine visit that included video conferencing were more satisfied. In comparison, patients who had a telephone-only appointment were more likely to say they would benefit from an in-person visit. Shaverdian noted that voice-only encounters with new patients are particularly challenging and telemedicine is really a benefit for patients who have and can use video capabilities.

“Digital tools like telemedicine have the unfortunate potential consequence of paradoxically increasing disparities in access to care,” said co-lead author Erin F. Gillespie, MD, MSK Department of Radiation Oncology. “But the counter to that is there will be some disadvantaged patients that would not have accessed the system at all, either due to technologic barriers or travel time, and now can connect at least by phone, which is an important and positive change.”

While one-third (34%) of patients who completed the telemedicine survey agreed with the statement that “cancer care will be negatively impacted” by the COVID-19 pandemic, only 8% were concerned their own cancer would not be treated successfully because of the pandemic.

Delays in diagnosis and treatment of cancer

 have been well documented and are expected to cause tens to hundreds of thousands of excess cancer deaths. 

, screening and treatments for breast, colon, prostate, and lung cancers saw a particularly harsh decline, according to a study from Avalere Health and the Community Oncology Alliance.

“Telemedicine maintained patient confidence in the physician and treatment, but efforts to increase access to audiovisual technologies must be prioritized to improve patient– physician communication,” the authors concluded. “These data should help inform efforts to maintain access to telemedicine for patients with cancer beyond the pandemic, while highlighting the importance of equitable access to audiovisual technologies to support the most vulnerable patients.”

Patients receiving care at Memorial Sloan Kettering preferred telemedicine visits over in-office visits with similar satisfaction scores.

Patients With Cancer Prefer Telemedicine to In-Person Visits; Satisfaction Is the Same

Hospitals and health systems are largely not equipped to handle all the patient data they could receive and turn it into actionable information, explained Edmondo Robinson, MD, MBA, MS, FACP, senior vice president and chief digital officer at Moffitt Cancer Center.

Oh, absolutely not they have they don't know what to do with those data. Especially we start talking about wearables, right? So, you think about it, a patient says, "Hey, I, I'm averaging 10 more steps this week than I was last week." What does that mean? You know, other than saying, "Yes, keep going. That's wonderful," it's hard to know what that means.

And so I think there's a process around structuring your approach to understanding, in this case, remote patient monitoring, wearable types of data, to say, are there criteria whereby a certain change — because it because some of those data are even continuous, right, continuous monitoring — so are the criteria whereby a change would trigger an intervention of some sort? Are there summaries? You know, a weekly summary, a monthly summary, whereby understanding those data at that level across over time is important for many intervention perspective. It depends by the data. And that's not even including all the research you want to do, which is going to ask the questions differently and attack them differently, depending on the  hypothesis being built in that particular research study.

So, you know, it could be everything from "I have a patient on a particular chemotherapeutic intervention; they're now at home after getting their infusion in the infusion center, and I want to monitor adverse drug reactions or events." Well, I could use wearables for that. But what does it mean, if the heart rate went up a little bit? Or if the heart rate went down a little bit? Is that a 88 [heart rate]? Or is that just normal variation in a heart rate?

You've got to set those parameters and you've got to understand what it means to have those data; but just looking at it constantly, it's not gonna be helpful. So, again, you really got to be disciplined about your approach to those data.

Will health systems and hospitals need to implement things they don't currently have, like artificial intelligence (AI) or different algorithms?

It could. That could absolutely accelerate your ability to sift through those data and get to...separate the signal from the noise, right? You absolutely could leverage machine learning to do that. You need a ton of data to train those models really well. But, ultimately, I think that's where it's going to go, whereby what happens is, the AI surfaces up, "hey, this, look at that, that's important."

But even short of that, you can just set some hard parameters around some of these things, right? Where, you know, they're not always perfect, but they at least signal that you should pay attention. So, for example, if your heart rates over 100 [bpm], I'm going to pay attention. Now, it could just be that you were out for a run — not a big deal. Or it could be that you are having some kind of reaction. And I'm thinking about even for patients who are on the inpatient side. It could be that I caused that high heart rate or I know the reason for their high heart rate. Or it could be that I don't know the reason. And I better go figure out what the reason is, right? So though that's just a hard, it's not even AI driven. That's just a hard line, that 100 right. So, there's some of that.

The reason why machine learning might be really critical is often it can pull signal from noise that we can't see normally. Right? And it might do it sooner. And that's actually really important.

Laura Joszt, MA

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Patients Expect Providers to Offer Convenient Communication, User-Friendly Technologies

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Patients With Cancer Prefer Telemedicine to In-Person Visits; Satisfaction Is the Same

Dr. Edmondo Robinson Outlines Hospital Readiness to Receive Large Amounts of Patient Data