Digital Health Training – Response from Brenda Riley (TAG)

As a member of the Perfect Patient Pathway Test Bed Advisory Group (TAG), I am regularly asked for my thoughts, opinions and experiences about using technology for managing my health.

At a recent TAG meeting, we talked about the Digital Health Champion project in collaboration with the Good Things Foundation and reflected on the role for patients in future training for health professionals. Most of us seemed surprised and disappointed that the project did not involve patients in this training of the clinicians. However, on reflection, perhaps this would have been over-ambitious at this stage. It may be only the initial training with further training envisaged.

The Digital Health Champion training has focused on how health professionals can be made aware of patients’/participants’ emotional attitude to new technology and strategies for helping patients along the 5 progressive stages.

This is particularly difficult for new health technology, as patients probably start with varying levels of commitment as to whether or not to take on the new technology (their choice).

They also probably start with varying competences with technology, which cannot be assumed from their age, gender or medical conditions.

They may also have other co-morbidities which affect their manual dexterity or their memory.

Alternatively, the patients may be very technology savvy and may even be more knowledgeable than the health professionals, particularly regarding the medical purposes, options and implications of the technology. They may even have read the manual!

Another issue may be the parallel journey that health professionals go through. They may also have varying emotional commitment, technological skill and confidence to guide patients, rather than just to demonstrate the product. Many technologies claim that they will save clinicians’ time but I suspect that in the early stages they may result in increased workloads on already pressured clinicians and unfortunately, this may result in rushed attempts to teach participants how to use the technology.

From my own experience of learning to use new technology I have found that it is necessary to actually use it in the presence of the clinician, rather than just have it demonstrated. ‘You don’t learn to drive in the passenger seat!’

This allows any problems to be resolved there and then and any personal notes to be made by the patient. When the patient can demonstrate use of all the relevant functions of the product, this confidence itself will increase their emotional stage of commitment. It may be useful to get the patient to demonstrate its use again (with reference to documentation or notes if necessary) just prior to the end of the session, to ensure that it has been remembered (and for ‘overlearning’).

The patient’s competent use of the product would also give positive feedback to the clinician about their own ability to teach the technology, which increases their emotional commitment and confidence with future patients.
One way of assessing a patient’s general technological knowledge and confidence might be to ask them if they know how to change the date and time on the product (with the documentation where required). I find that assumptions are often made in manuals and documentation, but this skill can to some extent be generalised. Also, most products will need to have the date and time correct before use and will also need to be changed by the patient at various times in the future.

When training / learning how to start these conversations with patients, one ‘ice-breaker’ exercise is to ask participants to describe and demonstrate how to tie a shoelace, and then ask a colleague to follow the instructions exactly. This is not as easy as it might sound! (lace-up shoes needed of course….)

This could be followed by health professionals from different health technology projects teaching their colleagues how to use their product, and then getting them to demonstrate using it. This peer-learning approach also has the serendipitous effect of engagement / dissemination of information.

So, innovators and improvement teams take note – when teaching techniques relating to specific health technology products, I would willingly participate as the ‘patient’ for this, either based on my own (low) technical skills regarding smart phones, or role-playing an even less able patient. And if asked, maybe other patients would like to be involved too!

I think that the Good Things Foundation involvement in the Test Bed is very important, as is the contribution of the clinicians to the success of these projects.

Brenda Riley, PPP Test Bed TAG

 

Following publication of our report last week, Matt Moxon (Good Things Foundation) has written a blog about “What about the digital skills of health professionals?” You can read the blog here