I picked up on this fascinating Doctor/Patient video consultation while reading a NPR article by Nancy Shute titled “The Parkinson’s Doctor Will Video Chat With You Now”:
For me it provides a great piece of evidence for a multitude of problems that are typically encountered when Patients and Doctors connect over video in a way that hasn’t been effectively designed.
In this case it’s clear the Doctor is consulting in a very uninformed capacity and as a result of this you can see an enormous proportion of the expensive clinicians time is being wasted as they ask basic questions, wait for answers and document these (presumably into a paper based record).
To highlight the point: In the above 3 minute video (that has been reduced in size by editing of the recording) the Doctor asks and records the patient responses to the following questions:
1. Do you have any questions?
2. Do you think you’ve actually gotten better over the last six months or so?
3. What’s made been involved valuable for you?
4. Is there anything else you want to tell me?
When you realise there is a carer present with the patient (whilst this individual stays out of camera shot you are aware of them because they communicate with the patient during the consult and at one point refocus/move the camera) the very poor design of the system being used becomes apparent.
I cannot for the life of me think why they wouldn’t utilise this patient or their on-site assistant to help this patient document this very basic information before the consultation with the consultant.
There are also several major usability issues highlighted in the video:
> look how little time the consultant spends looking directly at the patient:
Whilst it’s obvious to anyone who has conducted Video calls that the loss of eye contact directly discourages conversation it appears in this situation to result directly from the lack of data collected prior to the consultation and the need for the Doctor to occupy his time documenting what the patient is saying to them.
By designing the service to enable the collection and documentation of this information prior to the consultation you would not only help patients take their time and build on the relationship with their in-person carer/loved one but you would also be able to present this invaluable data alongside the patient image on the clinicians desktop screen – encouraging more eye contact and enabling higher quality communication.
As you can see in the above screenshot, despite the obvious editing of this clip at 1:09 secs it’s quite clear that the patient is uncomfortable (something that has got a very good chance of being missed by a postconsult survey as the patient is so very grateful to be receiving this charitable care).
> The clinician seems to be using what looks like a paper record. An electronic patient history created by the patient would also help bring this medical practice up to date.
[…] Mobile Health blog raises some pertinent issues arising from the interview, although I’m not sure it quite appreciates the fact that this was […]