Online Marketing Tool May Improve Patient Centered Care

SciWorks Radio is a production of 88.5 WFDD and SciWorks, the Science Center and Environmental Park of Forsyth County, located in Winston-Salem.

We've all been to see the doctor. Frequently, there is a short window of time available for the doctor to see and diagnose you, often based upon what you tell them at that time. This makes it difficult at best to provide a good patient-centered care model. That can be frustrating to both you and your doctor.

I may see you in a 30-minute or a 15-minute clinic slot, and I don't have a year to get to know you and then factor in all those nuances about your life.

That's Dr. Matthew Corriere, Associate Professor of Surgery at the Wake Forest University School of Medicine. He specializes in peripheral arterial disease, an often painful condition dealing with blockages to the arteries in the patient's legs. There are several possible treatment options, each with varying potential risks, treatments, and outcomes.

If we're sitting across from each other in the clinic and I ask you “tell me what's important to you about your peripheral arterial disease treatment,” you can't articulate that, and you might not even be able to be consciously aware of it.

Dr. Corriere is developing a novel solution to help patients participate in their own healthcare decisions. One that many internet shoppers can relate to.

I know I like rock music, and if you ask me, “Why do you like Bruce Springsteen but you don't like Miley Cyrus,” I might not be able to really put my finger on the essence of that. But whoever's watching what I look at and buy can put songs in front of me that they know I would like based on my shopping habits. I'm really interested in applying that to treatment choices, where we treat the treatments like competing products and let the consumer show us, even though they can't tell us, what's really important to them. So what we have done is borrowed technology like Amazon or iTunes uses where we give the patient a bunch of different treatment choices and, even though they can't tell me their value system, I can let them shop for a little bit between treatments and I can deduce from that what's important to them.

The questions are delivered on an iPad through an app that is being developed for this purpose.

We basically show the patient, through the app, about a dozen choices between two treatments where we have different levels of these attributes, and we watch how they choose between that. What that does is force trade-offs between these things. And through that we can deduce the underlying value system that they would use to make a choice, even though they might not be consciously aware of it or able to tell us what it is. We really frame it up more in terms of the treatment attributes for example, the type of treatment, how much better are their symptoms going to get, what are the odds of the treatment being successful or working at all, how risky is it, and how durable is it? Where we got that information was from the patients themselves. We actually had a series of focus groups where we brought a bunch of patients with P.A.D. together, and it turned out there was a whole universe of issues that the patients really care about a lot that are nowhere to be seen in our treatment guidelines. The most fascinating thing is the patients actually develop self-awareness running through the treatment choices, and actually say going through it, “I didn't realize before I did this, but by the time I was on that third choice, I could tell that risk of the procedure or the treatment was really what was most important to me, and I found myself looking for that every time.”

This process is being developed in terms of treating peripheral arterial disease. If it's successful, it could be used in other areas of medicine, building a full and nuanced profile of patient data, values, and lifestyle choices. This could help you and your doctor discover treatment options in the same way Amazon has been showing me some pretty sweet recording gear lately.

There're a lot of other factors that go into the decision-making that the patient might be oblivious to. What I'm trying to do is bring the patient into that conversation, and I think it gets harder to ignore what the patient wants when we can represent it in a quantifiable way. The thing that makes this the coolest thing I've ever worked on is that I have patients thank me for doing the work I'm doing. It has resonated with basically everybody I've shown it to. That's been really rewarding.

This Time Round, the theme music for SciWorks Radio, appears as a generous contribution by the band Storyman and courtesy of UFOmusic.com.