Prescribing Information for Better Health

Video Transcript

Tracey Welson-Rossman: Hey, and we're live. Good afternoon from Philadelphia and good morning to anyone, any viewers who are not on my time zone. My name is Tracey Welson-Rossman founder of Journal My Health, which is a digital platform to help those with chronic conditions better tell their health stories. Joining me is my partner in crime, Joyce Griggs, who is the founder of United States of Healthcare. And I think this is our third or fourth livestream that we're doing? Third. Thank you. And our goal on these live streams is our ability to help patients and their caregivers with better information about how they can take a little bit more control of their healthcare journey. Joining us today, well actually, I want to turn this over to Joyce, and she's going to introduce our topic.

Joyce Griggs: Thanks, Tracey. And hi everyone. So, joining us today, I'm so happy to say is Geri Baumblatt and Eran Kabakov who are here from Dócola and they are going to be talking to us today about the importance of our healthcare providers prescribing information, not just medications or or other things like that. And they're also going to be talking about how we can be better, informed about our health with in-between-visit communication. So prescribing information and in-between-visit communication and how those two things together can work so that we can help to be part of improving our healthcare. So Geri and Eran I'm going to let you two introduce yourselves to our audience and Geri, let's start with you.

Geri Baumblatt: Sure, I'm Geri Baumblatt. And I've actually been working in health literacy, patient education, digital health, and patient provider communication, and for over 20 years. So I'm happy to join you.

Eran Kabakov: I'm Eran Kabakov. I'm the co-founder and CEO of Dócola which, as mentioned, is a platform to help healthcare providers share information with patients. And really, the reason why it came to be is because of my background. I've been a healthcare provider for over 30 years, the majority of as a physical therapist and I really appreciate being here as well.

Tracey: Well, I think, what's really interesting is this idea of prescribing information. So when we talk to our healthcare providers, what does prescribing information, what do you mean by that? And how can we ask our healthcare providers for this additional information?

Eran: That’s a, that's a great question. So the the term prescribing information is something that came about as we have been developing the technology. For me as a clinician, it is absolutely clear that what I share with the patient, any information that I share, even where where they should park when they come to see me, it's part of their treatment, right? It reduces anxiety. It improves understanding of what is happening and so, communication seems put aside in healthcare, where really it should take a center stage as part, and collaborate with a procedure or a medicine. And so prescribing information is what we see is the future of healthcare, where we get the right information when we need it to help us take active part in our, in our recovery. And I think that is is as far as how do we ask providers for that? That's a tricky question because some providers are sensitive about it. They say, well, I'm already giving you information or they're simply, and the truth is, most of them are just overworked. So it's very difficult to provide information. And that's why we see technology as as helpful in that.

Geri: Yeah. And I, it, and it doesn't have to just be technology. It's really anytime the provider says, Here's the right information for you, use this website, and avoid these websites, or, you know, look at this book or this pamphlet and don't look at this stuff from this organization because it's biased or or confusing or out of date. And so it's anytime that the clinician is really saying this is the appropriate information for you at this point in time. And I think that there's a lot of ways to do that, like I often say things like, you know, I've looked some things up but I'd rather you tell me what are the best sites to use? Because I'm trying to make sure I look at good, up-to-date information. But even when I've worked with hospitals, creating patient education, sometimes they've said, where did you get that information from? That's not correct. And I'm like, from your website. And they're like, oh interesting. We didn't know that that was on there. So even the hospital's own website might not be what the doctor or the clinician wants you to see. And, you know, I think a few years ago, there were even mugs that some clinicians had that were basically like disparaging Dr. Google. And the thing is, people want to know what to do. They want to get their questions answered. If you don't want them to go off on a tangent, make sure you're meeting their information needs. And years ago, Don Berwick actually called this "information therapy" because it's just so important that we answer people's questions and concerns and really otherwise they're going to feel scared and unsure or even embarrassed to ask us some of these questions.

Joyce: That is that those are such, those are such great points because I have seen in my own work there have been websites that have been put up that have been anti-a-therapy or anti-something. And they look very plausible. And they look like the National Association of Etc, you know, fill in the blank. And so it's easy to be fooled, even if you are a very discerning, you know, viewer of information. So I think that's really important. Can you restate who that was you were just mentioning, Geri? You mentioned someone that had given a great quote. Said his name was Don.

Geri: Don Berwick, Dr. Don Berwick. And he became really interested in this field when his own wife was in the hospital and he found just how difficult it was to get information. And in fact, it's even reliable websites, right? Because I might be diagnosed with Crohn's disease or breast cancer, and I might go to a really reliable website, but I might be confused and unclear about my diagnosis. And if I look at correct information, but it's not right for me, then I'm still going to come in and be confused. And have the wrong questions or the wrong concerns about something. And I could really freak myself out, and probably upset my doctor, so the way to avoid that whole problem is to say, you tell me what's right for me so that I make sure I'm not going to the right website, but, the right, looking at the right information on that website for me at this point in time.

Joyce: Excellent clarification there. So when it comes to getting the right information, you know, what strategies are there for asking open-ended questions? Like, we know that asking questions, there's data, right?, that show patients who ask questions get a better result at the end of the day. Many of us though are not asking questions because of whatever the reasons are, we know that there are many reasons for that, but how do we better understand the stakes, right, of our condition and how to manage our health? And maybe sometimes we just don't know what the exact question we should ask is. Are there a couple of, like, go-to open-ended questions that we can put out there that, you know, we can just put in our arsenal to help us when we're a little nervous. And okay, at least I know I can ask that one question.

Geri: Yeah, it kind, of it kind of depends a little bit what you're talking about, because are you talking about an upcoming procedure or a new diagnosis, but some of the things I really try and go to are, you know, just in a way, what does, what does this mean for me? And that's kind of a two-way street, right? So I want to understand not just, what is my diagnosis? But what is my prognosis? And I need to tell my doctor like, hey, I like to play tennis. I like to travel. You know, I try and do these things and I work part-time or full-time, or I'm caring for somebody else. And so, how is that going to affect my life? And putting that in context, asking for that context can be a huge help because then, they can say they can say, oh, well don't worry. You're still going to be able to play tennis and do this and do that. But you are going to have to like change your diet and it might limit, you know, the types of places you can eat or or things like that. And so I feel like that really helps put things in context and help me start to think of what are my other questions about how this is going to affect me.

Eran: From a, from my clinician point-of-view, I can tell you that I think that if you put a frame around the question, so if I'm the patient and I'm talking to the provider and I can say, I think I understand what's going on. I'm concerned about this subject, right? This specific subject. How should I, you know, what does that mean to me in regards to this subject? One of the difficult part as a clinician is that while we know our area of experience, we have expertise in a specific area. We cannot give all patients the right information at the right time. Some patients will come up with a question that that we don't have an answer to. And so I often say, it's a great question. Let me get back to you. I think the patients have the same leeway in saying, I gotta be honest, I'm kind of shocked right now. I know I'm going to have some questions. What is the best way for me to to and who is the person in the practice here to to ask those questions? And I think if you put that, that way to the clinician and really say, oh, well, absolutely. You can call and talk to John or Jane or or me at this specific times, I'll be available, but you're setting the stage as a active participant and have equal equal say in the relationship between the clinician and the patient. As a clinician, I would so appreciate that.

Geri: Another way I try to organize my questions, are this framework that Jessie Gruman came up for patient engagement where you ask, Why is this important? So both like, why are you asking me to change my diet or take this medication or get this procedure? Just, what is, what is the why? And then try and think of my own why, like why do I want to feel better or have this procedure. And then what makes it possible? Like, oh well you need me to to start walking everyday? I don't feel safe walking in my neighborhood. So how, how is that going to be possible and safe for me to do that? And safe if is actually the third one. So even if you're saying, oh, I need you to, you have heart failure. I need you to weigh yourself everyday. Well, A, why am I weighing myself? People don't like doing that. So if you tell me oh, it's because you're we're looking for really small weight changes because that means your heart's not pumping fluid out of your body well. That's different than, oh, you're gaining weight and I need you to step on a scale every day. And then possible, do I even have a scale? Can I read the scale clearly if I stand on it? Is it a good accurate scale? And then is it safe? Can I balance on the scale and not fall? Or in the case of my dad, he was in a wheelchair. So, we're like, how, we got home and we realized, oh, we have a scale but he can't stand on it safely and we don't have something that accommodates weighing him in a wheelchair. So those are the types of things that can be really be helpful when you're trying to think through, because I know I always get home and my husband will be like, well did you ask this and this and this? And that's the other reason why prescribed information is so helpful. Because then he and I or me and my mom or whoever it is, we can look at it together and then come up with our questions and have a better conversation next time we go in and really be prepared.

Tracey: So Geri I think you bring up a good theme which is okay, you're in the doctor's office and it sounds all great, great and perfect. And then you get home and you realize I don't have all this all the ingredients. So one of the things that we discussed was the idea of asynchronous communication. So whether it's through texting, depending on if they have a portal, what do you feel are the benefits of that type of communication in between and I'm going to add a little extra to that. Is how do we, how do clinicians help their patients understand? Because I'm having this issue with my mother right now who just had a hip replacement. Thank goodness, everything went well, but why am I calling my doctor in between? Why am I communicating with them? You know, is, so how do how do clinicians give permission for that communication in between appointments.

Eran: I’ll give you. I'll take a stab at that to start with. So, I think, I think if we define first, you know, let's define communication and how it happens, right? We have the, we have the face-to-face communication, or I mean face-to-face can be by phone or by the live communication, like we are doing right now, and that happens on a regular basis, and we all familiar with that. But as you mentioned, it has quite a few downfalls when it comes to retention of what is being said and understanding of it and actually being able to put it into action. So, the technical term for what we're doing is synchronous communication, we are currently talking one-to-one. Asynchronous communication would be the second type of information sharing, which is basically in between, when we're not face-to-face. In healthcare as clinicians and I, and I'm taking and I'm putting the hat of the clinician, we have an opportunity to look at our care continuum for diagnosis or patient per persona and we can really see if we sit down and we put it on paper we can very quickly recognize that there's an 80% of information that somebody can view and interact with not face-to-face that will fill in the gaps that you're mentioning. Like, why am I calling about this question? I mean, am I the first patient that this surgery is being done on? No I mean you've done thousands, so you must have received this question so many times before. And why am I, why am I asking it? So I think that that's that's where it's synchronous, but you know, if I take a step for, step back for a second and we take it outside of healthcare, let's take it, let's take the patient is being a car and the clinician is a is a mechanic. And if I take my car to the mechanic and the mechanic tells me, Oh listen, your carburetor needs cleaning. Here's how you do it. Super simple and they go about giving me a 15-minute description of how to clean my carburetor and put it back in the, what are the chances of me taking the car home and successfully doing that? It's like zero. Now when we talk about car mechanics, it's simple. But when we talk about healthcare, we don't think that way. And when somebody is diagnosed with diabetes it's way more complicated than dealing with a carburetor and a car. Right? So we have to provide and I'm putting the onus on me as a clinician, "we" as a clearly, me as a clinician, we as my team, my colleagues and I the onus is on us to come up to the times and say, okay, how can we do this better? I'm obviously here because I believe technology is a great empower empowerment in this, but that's the that that's where I think a asynchronous versus synchronous comes into play.

Geri: And we know that a lot of people I mean, no matter how lovely your clinician is, when you're sitting there as a patient, you're you're in a role and there's a, there's a dynamic, right? And you might be embarrassed to ask a question. I've heard people say, well, I'm having surgery but I thought it was vane to ask what my scar is going to look like and so they won't ask that. Let alone questions about hemorrhoids or sex or any of these other things that are huge. I mean, a lot of people who are having hip replacements one of their big concerns is, their hip is causing pain during sex, but that's not really often discussed during the visit. Now, if you give somebody information like a video or something that they can watch beforehand, that can proactively answer a lot of those questions and it can normalize the fact that if they do have other questions, it's okay to ask them because, oh, if it's in this information that goes out to everybody, that means it's not just me. There must be other people who have those questions, but then the other thing is, especially if you can give people a way like if your doctor says well, you can email me or you can text me your questions before your visit and my, my staff will print it out and get that ready for me. It gives you a chance to formulate them and it gives you a chance to ask those questions without sitting in that dynamic in that moment and summoning up the bravery to ask that question, you can just submit it to them, they can see it. They're not responding in a moment of like, oh, that's a strange question. A doctor even said to somebody wants, oh, nobody's ever asked me that before. And I was like, well, I don't think it's because they don't want to know, they're just embarrassed to ask it. So that's another great thing is, it lets you think about your questions, put them in writing and then send them, but the information clinicians give you before and after visits can really help address those questions as well.

Tracey: I love the idea of the video and just getting back to the experience we've recently just had with my mom and I'm sure this was years and years and years. The hip replacement everyone was asking, will she go into rehab and I'm like, no, they gave her a book with her rehab stint and it's 10 weeks and this is it's exactly, it's a calendar, it's like, all this information, and they gave it to her after she set up her surgery, so that if she did have questions. So, I, you know, I didn't really think about that Geri, just, in terms of, like, she would have had time to review it and then ask the questions before the surgery to clarify, but they're really looking for the patient to take a lot more responsibility. Which I thought was good.

Geri: And it's it's a lot, too. I mean, when you get a whole binder, you know, especially if you're not feeling well, it's really hard to go through that and we know that videos are better for learning, people make those connections in their brain between what they're seeing and what they're listening to. A lot of people also have lots of challenges reading, not just small print, but just literacy challenges and then how well is it written? And so that can be a lot to try and pick something up and read through whole binder or booklet when you're not feeling well, or if you're being discharged from the hospital. That's just a lot to put on people and it's harder to share, too, like with a video, you could send it to other people in your family and share it as well so that they're in the loop on what's going on. But they're probably not also going to sit down and read through the whole binder. Even if you do.

Tracey: Right. Good points. Worked for us, though.

Joyce: These are really great points. Now, I know we're at 21 after. Should we keep going? Or shall we?

Tracey: Do you want to ask that last question?

Joyce: Yeah, I'd love to. Just before we wrap up, can you you know, Eran, just tell us a little bit about Dócola and how we can, how can it help us to inform our, how we can inform our healthcare providers. Right? Because it is for healthcare providers. How can we as patients, let our healthcare providers know about Dócola?

Eran: Sure. So, so Dócola is, and I didn't mention before, but it is a completely free service for clinicians to be utilizing. It really enables them to to mix and match so they can bring in the binder information from the binder and they can create videos and put it together. I think that the best way to get the word out is just simply ask your, tell your clinician, Hey there's this platform that you could have given me all this information on www.doco.la and, and it's free. And that's, that's, that's all that's necessary. And we definitely would appreciate any clinicians who are viewing this or anybody else. If you have questions reach out to us, we are available, and Geri and I are on LinkedIn. We're always happy to have a conversation.

Joyce: Awesome. Thank you so much.

Eran: Thank you for having us.

Joyce: Yeah.

Tracey: So if you have any questions, post. You can always, we're going to post the video up on our Facebook. So if you're watching this post-live. Oh, we have a question here: is Dócola available in Canada?

Eran: That’s excellent question. It absolutely is, yes. And we already are, we already have clinicians who are utilizing us there. Yes.

Tracey: Thank you for that question. But if you do have a question, post our livestream, please, you know, put it in our Facebook chat and we will send the questions over to Geri and Eran and we will, you know, get those answered for you. And hopefully, you can join us for our next Facebook Live in probably a couple, couple weeks and thanks Brenda for for watching. Thanks everyone. Have a good rest of your full week if you're in the United States.