Tackle the Patient Cultural Divide With These Technologies


Using EHRs and other technologies can enhance care coordination, patient engagement.



Understanding patients’ beliefs, practices, cultural and linguistic needs lead to better care coordination and better patient engagement over time. For healthcare organizations that don’t prioritize cultural respect with patients the fallout can lead to patients disappearing from the healthcare system.

“Patients may not continue to go to organizations and thus there is a financial impact when the interaction is not positive or respectful to them as an individual,” says Jon Walter McKeeby, DSc, MBA, CPHIMS, CPHI, chief information officer for the National Institute of Health (NIH) Clinical Center.

NIH has promoted cultural respect as a part of its Clear Communication initiative that includes plain language health information and health literacy for specific populations.

“Having an awareness of certain demographics is important for medical professionals when communicating to patients,” McKeeby says. Demographics may include age, sex, gender identity, race, ethnicity, nationality, citizenship, language, education level, and desired methods of communicating information such as phone, email, or patient portal.

NIH leaders say that using EHRs, patient portals and other technology can prepare providers to have a better understanding of patient’s cultural and language needs when treating them.

“When medical care is required, patients often feel vulnerable and stressed,” McKeeby says. “Often, knowing certain demographic characteristics of a patient can help medical professionals better communicate with each other and can positively impact how patients perceive that communication.”

What complete EHR records include

A study published in the Spring 2018 Perspectives in Health Information Management, a peer-reviewed research journal of the AHIMA Foundation, found that many master patient index records, which records both demographic and visit-specific information are incorrect or incomplete. All of the providers surveyed said that the lack of consistency in records is due to demographic information from patients that are constantly changing. Others point to lack of data points that address all of the demographic fields that providers need to capture.

McKeeby says that data collection should include robust demographic information that prepares providers in communicating with patients.

“An understanding or awareness of individual patient’s demographics can assist with all of the following communication components through the patient care process: how to address the patient, the language spoken and need for a translator, the way in which care providers communicate to the patient and the patient’s family, the reading level and understanding of patient education materials, and the way in which a medical team reviews discharge education with the patient,” McKeeby says.

Making sure gender and language fields are current in EHRs is an important part of patient care, McKeeby says.

“Identifying the patient’s gender identity within the electronic health record helps staff members and clinicians provide appropriate patient care services in the best manner possible,” McKeeby says. “Patients’ health concerns and treatments also differ by gender identity. Knowing a patient’s gender identity assists in treating patients with respect and allows the care team to understand how the patient prefers to be addressed.”

McKeeby says health records that include language can ensure that translators are available prior to a patient’s appointment.

“The reading level and preferred language in the EHR can be used during the discharge process to ensure the educational material meets the needs of the patient,” McKeeby says.

Patient-facing technology

Patient portals give healthcare organizations the opportunity to use not just multiple languages, but images and reading levels to communicate with patients, says Patricia Coffey, RHIA, CPHIMSS, CPHI, health information management director for the NIH Clinical Center.

“Having the results, clinical documentation and educational materials available in multiple languages in the appropriate manner allow the patient to understand the meaning of the information provided,” Coffey says. “This reduces anxiety, concerns and provides a more satisfying patient experience and can help ensure patients follow instructions regarding medications or therapies prescribed post-discharge or visit.”

Coffey says that it is important that patient-facing communications are accessible on multiple devices based off of how patients receive information.

“Understanding age and devices patients have will affect whether the organization focuses on phone alerts, email notifications, a web-based patient portal, or a smart-phone application patient portal to communicate results and upcoming appointments to patients,” McKeeby says.

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