Patient/provider solidarity: rethinking the patient questionnaires
Patients have critical information that healthcare professionals need to deliver the best care. So, how can we improve the communication of this information?
Shift Health, a full service health IT company based in Toronto, Canada, envisions the patient-experience movement as an opportunity to address patient/provider communication – a fundamental interaction to the provision of effective care – by targeting a ubiquitous health care tool: the patient questionnaire.
Traditional clinical questionnaires reinforce inequality in therapeutic relationships. They are not designed to engage patients and are seriously limited by poor uptake, survey fatigue and complexity. This dynamic leads to a communication breakdown: patients remain passive subjects in their care, critical patient information is missed, providers are hampered in their ability to deliver focused care and patient experience ultimately suffers.
Shift Health has built “TickiT,” a digital questionnaire platform that invites patients to be active participants in their care. Borrowing from the worlds of design, popular culture, participatory medicine and building on the Triple Aim framework, TickiT features intuitive graphics and simple language that come together to create safe and engaging questionnaires. With TickiT, patient-entered data is organized instantly and sent to providers’ computers as flagged reports that highlight critical information. Client feedback revealed that this feature cuts appointment time in half.
TickiT is designed to resonate with high-risk populations and low-literacy patients, whose medical information is subject to misrepresentation. Drawing from the expertise in empathetic survey design of Shift Health co-founder and CEO, Dr. Sandy Whitehouse, a Vancouver paediatrician and academic researcher, TickiT questionnaires are designed from the patient’s perspective. Patients are eased into their clinical visit because questions are presented one at time, using a maximum word count and an eighth grade literacy level. One study has revealed that 83% of over 900 patients surveyed felt more prepared for their appointment with TickiT.
TickiT questionnaires eliminate judgment and aggression making them powerful in assessing stigmatized issues such as sexual health and obesity. For instance, with TickiT, “can you afford to buy healthy food?” is re-framed as “I can afford to buy healthy food.” The latter opens up many possibilities for patient responses and allows for answers that account for the complexity of each patient’s situation. A study published in JMIR found that a TickiT questionnaire focused on eating, drugs, depression and sex was associated with a 99% uptake in adolescent patients and that 92% of adolescents surveyed found TickiT easy to use and easy to understand.
TickiT is currently used by approximately 3,000 patients in 15 clinics, such as Boston Children's Hospital and The Hospital for Sick Kids in Toronto. TickiT’s presence continues to grow in 2015 with scheduled to roll outs with San Francisco Public Health and Vancouver Coastal Health.Shift Health has a growing knowledge of how to recreate patient questionnaires that embody the ethos of participatory medicine and re-think the communication structures that are embedded in medical spaces. We understand how targeting patient/provider communication will transform health care and would relish the opportunity to share this wisdom with the like-minded MedX community.