EPtalk by Dr. Jayne 10/19/23

Clinical informaticists are often asked to help their organizations with strategies to combat health misinformation, whether it’s through implementing patient education solutions, providing input for patient-facing websites, consulting on social media campaigns, or creating content for distribution through mixed channels.

The Kaiser Family Foundation recently released results of a health misinformation tracking poll pilot with the goal of following health-related misinformation in the US, especially in communities where misinformation can gave the greatest negative impact. This round of tracking looked at important topics: COVID-19/vaccines, reproductive health, and firearm violence. Plans are in place to investigate other health topics in coming months. A Health Misinformation Monitor report will be distributed to those who are working to fight health-related misinformation.

Those of us seeing patients on the frontlines spend a good chunk of our time counseling against misinformation. It’s challenging because we would often rather use that time to talk about other important topics like dietary changes, lifestyle adjustments, and cancer screenings. We’re still seeing patients that are falsely convinced that COVID vaccines are killing healthy patients, that sex ed causes promiscuity, and the increased rates of firearms deaths “aren’t a thing.” In addition to taking time away from other health topics, having these conversations over and over is exhausting, so I’m excited to see what this new resource makes available for clinicians.

I’m onboarding a new consulting client and a significant amount of time is slated to help the organization improve productivity. We’re going to work to streamline its meetings, improve communication, and get some process guardrails in place. As I met with several high-ranking members of the company this week, it was obvious that one of them was multitasking on his phone the entire time we were meeting. I’m no stranger to the fact that conflicts come up, but what I experienced was not only rude, but also wasted the resources of the others who were on the call. I’m still figuring out all the dynamics in this organization, but at least one person who wasn’t on that particular call also mentioned the behavior as “habitual” for this leader. True leadership is being willing to reschedule meetings, to step out when you have a conflict or distraction, or to delegate meetings to others who can cover them.

In the worst case when one has to field text messages during a call, can I offer a pro tip: install the relevant texting app on your laptop so that you can manage your phone’s messages without actually having to touch your phone (let alone have it visible to others on the call). The solution won’t necessarily help with inattentiveness, but it will reduce the obviousness of undesired behavior.

Speaking of communications and productivity, one of the biggest time wasters I see among the large organizations I work with is trying to use too many “pull” communications and not enough “push” communications. Pull refers to materials that someone has to go to in order to get information, such as visiting a page on the company intranet or going to a reporting dashboard. They require effort on the part of the end user, who may need to remember that they need the information and also may need to remember where they need to go to get it. Push communications put the information in the hands of the user without a hunt. This method can be great for distribution of data that’s episodic, like a weekly census report.

I just had a conversation with one of my clients this week about using the right method for the right data. They were using a compound push/pull method. They pushed a link out to the audience on a daily basis, but then the users had to click the link, log in to a dashboard, and reset a filter to today’s date to see the daily data. A simple stopwatch exercise showed that this took about 30 seconds for the recipient to get to the right data, assuming they didn’t get distracted by another task along the way.

I asked the sender what the purpose of the email was and was told that it was to distribute end-of-day metrics that are finalized during a 2 a.m. reporting package. That sounded reasonable, but the need for users to log in and adjust filters to see the data didn’t. I talked to a couple of data consumers, who agreed the process was annoying. They are required to look at the data daily, but said that greater than 95% of the time they don’t need to do any further digging, so a snapshot would be fine.

I multiplied the daily review of data times the number of people looking at it times the average hourly rate of the end users. The company is spending $7,500 annually for employees to click links and adjust filters. In comparison, automated distribution of each day’s static data can be added to the reporting package for about $120 in work effort. I’m not surprised that no one thought of this before. It’s magic moments like this that make consulting fun as well as beneficial to the client. I’m hoping that they take this as an a-ha moment and look at some of their other communications to see what kind of savings they can generate.

It’s also a good exercise for organizations to examine how well their communications are reaching the target audience. If you’re maintaining a website for people to visit to get information, how many unique visitors is it getting and at what frequency? If you’re sending emails, what is your open rate? If you’re throwing things out in a Teams or Slack channel, are you measuring whether the materials actually make it to the audience? It’s important to understand too that different people consume information differently, and for some really important notifications, you may need to send them through multiple channels – email, messaging, intranet/web sites, and more.

People also need reminders when there are deadlines. Simply sending it once and then claiming “well, it was on the Slack channel” doesn’t help with knowledge distribution for most organizations.

From a patient advocacy standpoint, I’m excited for plans to eliminate the reporting of medical debt for consumer credit scoring. The initiative is being handled under the Consumer Financial Protection Bureau, which has rulemaking authority for the Fair Credit Reporting Act. The process involves convening a Small Business Review Panel to identify next steps. Medical debt impacts millions of patients and it can negatively impact their employment prospects, ability to obtain housing, or purchase a vehicle. The rulemaking process doesn’t move at the speed of light, so it will be 2024 before we see how this is going to shape up. Some credit agencies are already excluding paid-off debts and small debts from reporting, but the new initiative will expand consumer protections.

I’m finally able to say “that’s a wrap” to my recent travels. I’ve also caught up with some old friends, made some new friends, and got to learn about both mining and particle physics at the same place, so how can one top that? Now that I’ve been bitten by the travel bug, it’s only a matter of time before I decide where I’m heading next.

If you could go anywhere in the US for vacation, where would you visit? Leave a comment or email me.

Email Dr. Jayne.