Over 12 months, I rebuilt my practice workflow to solve the problem of inefficient knowledge transfer between me and my patients. Now with a new system incorporating a library of leveraged digital assets I’m saving time and improving patient experience. Here’s how it happened:
“Hey, Picasso! That patient wants to keep your drawing to show her family!”
My secretary shouted down the hall to my office. An elderly patient asked to keep a pen and paper drawing I made while explaining lung cancer radiation therapy. When she got home, she knew her kids and grandkids would ask what the doctor said. She thought the illustration I’d created on the exam table paper would be a good primer to jog her memory.
Patient knowledge retention from in-person doctor explanations is not great, as low as 20 percent just one week after the encounter. This is understandable – patients are anxious about their diagnosis, and a single live event is not conducive to processing complex information. Doctors know this, and we see it manifest as post-visit phone calls from patients and their family and noncompliance with instructions and medications.
The current paradigm of live-only knowledge transfer isn’t working well for doctors either. Repetitive (almost robotic) explanations are corrosive to MD morale and compound with other daily grievances to drive up burnout. Many of us will explain the same complex disease and treatment thousands of times in a career. Outsourcing explanations to nurses or other support staff works to a point, but can backfire in a variety of ways.
After some brutally honest introspection, I could see there were days where my live explanation performances varied in quality. I did not like the trajectory ahead and I needed a better way.
To learn more about the landscape of doctor-patient knowledge transfer, I interviewed about 40 doctors. Few did verbal only. Most docs incorporated small hacks to enhance and streamline patient explanations – hand-drawn images with pen and paper, 3D models, maybe even a brief whiteboard illustration. But while each little hack added incremental value to the live encounter, none of them scale.
I used the mental model of leverage to clarify my thoughts. All the typical strategies to enhance patient knowledge retention – drawings, 3D models, and the like – are low leverage because effort inputs are 1:1 with result outputs. With this paradigm, the only way to improve knowledge transfer was to spend more time with patients. That’s terrific, but adding time to the schedule is not an option in a busy clinic.
I’d seen enough. I got an iPad, pencil, digital whiteboard app, and a good microphone. Over the course of six months, I created 35 short two to three-minute videos at a fifth-grade education level – digitized answers to the most common explanations I give in my practice. The content wasn’t pixel-perfect, but my patients valued the personal touch and authenticity of a video made by their own doctor for them.
I jury-rigged a vehicle to deliver videos to my patients by posting on YouTube and emailing links to patients. They could review on-demand and share content with family. Having a digital version of my explanation relieved patients’ burden of memorizing the details of our live encounter and solved my recurring problem of parroting back to family of forgetful patients what I’d said in the office. The new system streamlined my clinic workflow and previous sticking points in my day disappeared.
Compared to the old paradigm, this new system was highly leveraged. I was able to educate my patients and their families asynchronously with unlimited on-demand repetition and zero additional input effort from me. In this sense, my effort inputs (about one focused hour per video) were highly scalable and had unlimited output upside.
But there were deal-breaker level issues with my content delivery system. Sending links via my email opened a 2-way communication, which came with the risk of misuse and liability exposure. My patients are wonderful, but nobody wants emails about constipation on a non-call weekend. Also, hosting content on YouTube – while the path of least resistance – is perceived as unprofessional. Over time, trolls and quack remedies filled the comments section, confusing and disturbing my patients.
I hired software developers to build a scalable solution so any doctor who wants to convert their knowledge into digital assets can securely send content to their patients via a one-way HIPAA secure link. Since many interested docs didn’t know where to start, I’m helping them by adding simple digital images to their dictated verbal explanations. Together we’re creating ready-to-ship video content for patients.
As of this writing, early patient engagement data are flowing in and the results are shocking – 75 percent email open rate and 91 percent video view rate among those who opened an educational content link from their doctor. This blows paper educational handouts and glossy med device fliers out of the water. Patients view their doctor’s videos 1.6 times on average, which means either they come back to watch again or they share with family.
Instead of trading up for a faster horse by drawing in the exam room, it felt like I’d just built a motor car.
I created a new workflow around my digital assets. When patients checked in for a clinic visit, I scanned the chart for their visit diagnosis and fired off a content link with the relevant videos. My MA roomed the patient and they watched content while I completed other tasks. When I enter the room, their questions are more targeted, insightful and our visits are faster and more satisfying.
Doctors are unique in that our knowledge and experience are incredibly valuable, but distributed scarcely via single episode live events. When we convert our knowledge into digital assets that can be consumed at scale, we earn time, efficiency and carve space to do only the things we can do.
Image credit: Shutterstock.com