By: Irfan Husain MS3
A bounceback is a term commonly used in the medical community that refers to a patient that returns to the hospital soon after being discharged.
We typically associate bouncebacks with non-compliant patients, who do not follow their discharge instructions.
In most EDs and urgent care clinics the discharge process involves a quick discussion of findings, diagnosis, treatment, and home instructions with the physician.
This is followed by a discharge summary that includes pages-and-pages of medications, lab and procedure results, and home instructions. In the outpatient clinic setting, patients may only have verbal instructions to rely on.
However, there is another subset of bouncebacks that want to comply with their recommended treatment, but are not able to because of poor health literacy and inability to grasp all the information they need to care for themselves or to explain to their primary caretaker at home. Of course, we cannot forget simple forgetfulness. It is easy to forget one instruction, when five or ten have been told to you.
I had a chance of speaking with Dr. David Mathison, Chief Executive Officer, and Dr. Mohsen Saidinejad, Chief Technology Officer, of healthEworks at this year’s mHealth Summit in Washington, DC. In the video Dr. Mathison provides a quick summary of Video Prescriptions.
healthEworks, NIH-sponsored, was formed by a team of emergency physicians and pediatricians with the goal of “bettering health outcomes by improving medical aftercare, customized for what patients need after a visit”.
healthEworks does this by providing standardized, diagnosis-specific, procedure/surgery-specific or customized patient education videos that can be streamed to the patient’s smart phone, home computer or tablet, detailing aftercare instructions. Currently video prescriptions are being used in several urgent care clinic and emergency departments, such as Children’s National and UCSF. The videos are peer-reviewed by specialists within that content space. The videos are meant to compliment the verbal instructions given by the physician. There are currently over 110 videos available for streaming with a goal of reaching over 150 by early 2014.
Video Specs + Features:
- Streaming compatible on all mobile OS and web browsers
- 720p HD quality
- Multiple views
- Features demonstrations, animations and text
- Available in English and Spanish
- HIPAA compliant
Again, it’s worth mentioning that video prescriptions will likely only benefit those patients with a lower level of health literacy. These patients may need repeated instructions in a different format (visual) to fully understand proper aftercare. It likely will not benefit those patients who are noncompliant.
Another interesting feature of the video prescriptions is that the client is able to monitor the analytics of video use, providing useful data on compliance and video popularity. According to Dr. Mathison, an NIH-funded study shows patients that view the videos have fewer return visits to the ED within 72 hours and overall improved patient satisfaction.