At the end of an emergency room visit, a provider goes over an patient's discharge instructions -- appointments to make, symptoms to watch out for, potential complications, when to come back -- in the span of a hurried few minutes. Even in the best of conditions, a patient and his / her family is presented with a wealth of information in a short period of time: information overload. Ultimately, this results in missed follow-up appointments, poor home care, and poor healthcare resource utilization.
Currently at Penn, we are experimenting with an online tool that allows clinicians to customize their own sequence of messages and triggers (e.g. at time of discharge, at time of scheduled appointment, etc) for specific diagnoses and cases. With this tool, we propose improving post-discharge understanding and compliance by breaking up the discharge instructions into digestible chunks and re-presenting this information to the patient when most relevant.
For example, after an I&D, it may be most helpful for patients to receive wound care instructions immediately after leaving the emergency department, as they might have to change the dressing over the next few days. A few days later, it will be more important to re-educate the patient on how the incision should be healing, and it is at this point in the patient journey that the patient would be most receptive to watching educational content that teaches the patient what they should be on the lookout for.
This same sequence could be generalized to any type of procedure and for those procedures scheduled in advance, can include crucial pre-procedure instructions to increase the likelihood that patient is adequately prepared for surgery.
Furthermore, with many patients lost to follow-up, a customized sequence of messages can be used to automate regular communications with the patient to ensure that subsequent appointments are scheduled in a timely manner.
Most important to the success of the sequenced messages is the ability of the staff / provider to iterate in response to real-time analytics. Built into the platform is a dashboard that reports patient usage and message success rates to help physicians better analyze how their interventions are performing.