LK 120How to instantiate digital empathy
Empathy is when you can put yourself in someone else’s shoes and feel what they feel. Carl Rogers, an influential American psychologist said, “When empathy is extended, it satisfies our needs and wish for intimacy, it rescues us from our feelings of aloneness.” Can empathy be extended through digital health in a meaningful way? Can it extend and scale the reach of the physician outside of the four walls, and meet people where they are?
To understand empathy, we must acknowledge that the most basic of emotions such as fear and aggression are under the influence of the ‘reptilian brain.’ No one wants to need health care. Instead, it is a conscious or subconscious fear thats drives much of our behavior related to health care; fear of pain, of an undesired outcome, of isolation. In this context, we should appreciate that patients are not ‘consumers.’ A consumer is a person with choice and freewill, interested in trading a resource for a ‘good.’ A patient, on the other hand, is someone with tethered-will, carrying fear about trading a resource for a ‘bad.’ A patient is someone faced with a decision that he or she would rather not make at all. Unlike a consumer for whom the choice may be optional, for a patient, a choice is not optional. Even no choice is a decision. And when a health care decision is involved, empathy from a health care provider can have wonderful effects.
By way of example, HealthLoop is a digital patient engagement platform that facilitates automated virtual check-ins between the physician and patient between visits, around an episode of care such as a surgical procedure. Through automated emails coming from the physician, patients at home, both pre- and post-procedure, are solicited to complete digital check-ins containing guidance and questions served up in small pieces at the time that they matter most. When the messages honor concerns about pain, recovery, and uncertainty, then patient engagement, even with automated messages, can achieve unprecedented results.
HealthLoop patients have a sustained engagement of 72%. A byproduct is that 82% report feeling empowered in their own care, 64% of patients who might not have remembered to stay compliant are guided back on track, they enjoy a 25.5% reduction in 30-day hospital readmissions, and over 88% are satisfied or extremely satisfied with their care. And when patients perceive empathy from their physicians through ongoing outreach, they prove to be very willing to give back. Practices can learn that while 52% of their patients feel that their expectations for the episode of care are set accurately, and expectations of 40% are “in the ballpark,” 8% report that their expectations are not set well. Such insights provide practices with new ways of identifying opportunities for continuous process improvement. And empathy also proves that the digital relationship can yield durable benefits. At 1-year post-procedure, over 62% of patients continue to submit digital patient reported outcomes back to the practice.
We are entering a new era of digitally-enabled health care. While digital dialogues can enable more frequent touch points between patients and physicians, it would be easy for them to be clinically factual, losing the human touch. However, when crafted with empathy at their core, they can transform the patient experience. As a recent piece on CNN.com reported, “Automated empathy allows doctors to check on patients daily,” and a new era in medicine, one in which empathy and follow up are becoming best practice, is beginning to unfold.
Dr. Rosner is a 10-year veteran of healthcare innovation, a practicing hospital-based physician, the holder of
two engineering degrees, and multiple patents. As CMIO of HealthLoop, he is leading the way in redesigning
healthcare delivery in the digitally connected era. He is actively involved in research and clinical trials, and has
a publication track record in the peer reviewed literature. A practicing Hospitalist at Kaiser Permanente, Dr.
Rosner brings hands-on expertise to innovation in Health IT, health policy, patient engagement, and payment
reform. Previously a Medical Director for Archimedes Inc., a nationally renowned healthcare modeling
company, Dr. Rosner has worked with Washington D.C. policy makers, national thought leaders in voluntary
health organizations, leading researchers at academic medical centers, and both major and minor healthcare
systems. He often presents at venues on technology in healthcare, and has been an invited speaker on
national platforms including the Centers for Disease Control, Kaiser Permanente’s Innovation Center,
FutureMed, and digital health conferences. Dr. Rosner specializes in bringing technology and insights from the
fields of engineering and mathematics to medical care and patient engagement. He also has a long standing
background in ethnobotany, and has served at Kaiser Permanente on the Complimentary and Alternative