Outsourcing empathy – Is technology what the doctor ordered?More posts
With rapidly amalgamating digital and physical worlds, technology is becoming an increasingly indispensable tool that has the potential to deliver real value in our daily lives. People bank online, shop online, broadcast their lives online, book appointments online and can locate anything they need at any point in their day as long as they are connected. Digital experiences have become as natural and as comfortable as any physical exchange. Digital innovation has changed the way people think and behave, in predictable and measurable ways. It has happened slowly without anyone noticing because it has been organic and felt natural. We are living in a digital world. But what happens when we are sick, in pain and anxious? Can digital experiences be an effective substitute for face-to-face interactions when patients need empathetic understanding and personalised support?
There’s an app for that
Digital innovation provides a unique opportunity to help shape the way people interact with brands. With more than 70 per cent of consumers expecting a personalised interaction with brands today (Epsilon 2018), why should Healthcare be any different? For doctors and healthcare professionals, technology presents an opportunity to extend interactions with patients beyond the consulting room and into an unlimited digital context. Doctors can outsource the emotional and practical support they don’t have the time or capacity to offer otherwise. If digital experiences truly reflect patient’s emotional and practical needs, they can also be an important tool in helping to affect the behaviour change doctors need to see in patients who do not adhere to treatment or who are in denial about their health. But success is by no means guaranteed. Technology poses as many risks to brands as it does opportunities. When agencies obsess over technology and the client more than they obsess over the patient, the opportunity to achieve a rewarding outcome is at risk of being lost and the result may be an expensive emotional disconnect that is difficult to correct.
Defining the empathy gap
When brands and their agencies talk about behaviour change in the context of healthcare and healthcare professionals, they often talk about how they want doctors to be more empathetic, to understand their patients on an emotional level so that they can appreciate and accommodate patients’ challenges and needs to ensure rewarding outcomes. It seems doctors want the same thing. Natasha Abadilla, a researcher and medical student at Stanford writes “One simple truth in healthcare is that patients want doctors to be more present. Doctors want to be more present too, because without that human connection their professional life offers little meaning”. But there is an emotional empathy gap between healthcare professionals and patients. The gap is natural and born out of the fact that doctors can’t help but be desensitised to patients’ emotional needs by repeated exposure to illness and distress and external influencers like time-pressure, frustration and fatigue. That’s not to say empathy doesn’t exist, but it’s cognitive, not emotional, empathy. This is where digital innovation can step into the breach. Increasingly healthcare professionals rely on digital solutions to provide patients with the emotional support, the hand-holding and guidance they need and might not be able to get from their face-to-face interactions.
Can digital really be an effective substitute for physical contact between a doctor and a patient? Before we can answer that question, we have to look at what patients want from doctors and what they feel is missing.
What do patients really want?
PwC’s 2018 Health Research Institute surveyed over a thousand patients to find out what they look for in their physician. The results are as follows:
–Trust – Their wellbeing is their doctor’s priority
–Partnership – More engagement with their own care
–Convenience – Round the clock service
–Customer Service – Attentive and personalised care
–Good Communication – Clear and simple explanations and instructions
–Time – Dedicated attention and care
–Access – Better access and flexibility
–Empathy – Compassion and commitment
Technology is an obvious solution to most of these needs. Websites, apps and interactive experiences can offer patients more time, unlimited access, better communication, convenience, more care partnership opportunities and as a result, deliver a better patient experience. The two elements that are not quite as obvious when we think about digital as a solution, are empathy and trust. If doctors demonstrate genuine empathy, trust will follow. Is it possible to digitise empathy? Before we can answer the question it’s important to define what we mean by empathy.
Cognitive vs. emotional empathy
The cognitive dimension of empathy centres on an understanding of others’ behaviour and emotion. Most doctors have cognitive empathy or compassion and plenty of it. But the emotional dimension of empathy refers to an ability to experience and feel others’ emotional state and that’s where it becomes difficult.
Research tells us that doctors who feel a patient’s struggles and anxieties deeply, tend to resort to withdrawal as a coping strategy. Most doctors manage not to fall into negative behaviour traps by building cognitive empathy which is controlled and leads to measured responses. Cognitive empathy is aided by the desensitising effect of repeated exposure to challenging conditions. It is well documented that exposure produces emotional and physiological desensitisation resulting in diminished emotional distress. If we expect HCPs to be emotionally connected to their patients, we run the risk that they will become emotionally overextended. So, in healthcare professionals, cognitive empathy tends to override emotional empathy and that’s not a bad thing. Here’s why:
In their study, examining how doctors’ emotions in face-to-face interactions impacted their patients, Joana Vilela da Silva, MD and Irene Carvalho, PhD have determined that doctors’ emotions do have a lasting impact on patients. When news is good and the answers are clear it’s easy for doctors to express positive emotions and have healthy interactions with their patients. But if external stressors like time, pressure, difficult outcomes, or frustration are too keenly felt and the doctor becomes distant, the negative impact on a patient can be felt long after the interaction. So, empathy and compassion are important but a controlled cognitive view of the patient is better than a raw, emotional one. But how does this affect the patient?
To a patient, it’s always personal
As much as we might like to have a pragmatic view of our own health, an illness can be the most emotive aspect of anyone’s life. The impact of an illness on not only our physical wellbeing but also our psyche is significant. So, having our emotional needs met can be as important as addressing the illness itself. Patients don’t just want to know what course of treatment they need, they want to know:
-What to expect
-What to look out for
-What progress looks like
-When they will know if they are not responding to treatment
-If they aren’t responding to treatment how concerned they should be
-And the list of anxieties goes on…
On top of all of the uncertainty, some patients are coping with persistent physical or emotional discomfort and sometimes acute pain or dexterity challenges. All of these factors make it difficult for patients to make logical, pragmatic decisions about their treatment. This is why we see irrational behaviours like non-adherence, denial and avoidance. Patients need to be understood on an emotional level not just on a pragmatic one. They need help both with treatment and overcoming the irrational behavioural barriers standing in the way of progress. Doctors do not have the time or the capacity to meet the demands of every patient.
Is it possible to give patients the ‘human’ connection and reassuring guidance they are looking for in a digital context? The answer is yes, but only if we truly understand the patient and their journey.
The trap that most brands and even digital agencies fall into, is a tendency to fall in love with technology or a solution before we have the patient figured out. Rewarding outcomes depend on how well we truly understand the patient and their entire journey from recognising a problem, to treatment and management. Not just from a pragmatic but also an emotional point of view. Understanding and answering the emotional needs will significantly improve the chances or arriving at a rewarding outcome for the patient and their doctor.
Here are two examples that show how technology can offer valuable support and constant reassurance beyond the doctor’s office in every aspect of a patient’s life:
Pfizer Oncology have embarked on a mission to redefine life with cancer. Importantly developing breakthrough treatments is only one part of Pfizer’s mission. The other key component is supporting cancer patients as they move through treatment. After extensive research to clearly understand a cancer patient’s journey from diagnosis to remission, Pfizer has designed and developed a connected experience called ‘LivingWith’ that serves as a constant companion for patients by providing relevant personalised support at every step throughout a cancer patient’s journey.
-Here patients can find help that better prepares them to navigate their hospital appointments.
-Patients can find healthy eating plans, coping strategies for difficult moments and guides on how to have tough conversations with those closest them.
-Patients will find guidance on how to ask for and accept help and can send articles to their support network that offer guidance on how best to offer help and comfort a patient.
Content can be tailored by cancer type and stage. Resources are available at any time and patients can update their experience by updating their personal profile.
Brain in Hand is an app for people on the Autistic spectrum and those who suffer with anxiety and other neuro disabilities that cause difficulties in living independently. The app provides access to personalised support on-the-go, putting the individual more in control of their own support.
-Brain in Hand includes a diary and reminders to ensure important parts of the user’s day or obligations aren’t missed.
-The app offers quick access to tailored coping strategies for many of the problems people with Autism, mental illness or brain injuries might face.
-Using the app, users can plan conversations they know they need to have in advance and can save prompts like “remember to make eye contact” or “remember to listen to what the other person is saying” to help them navigate difficult interactions.
-It also offers a traffic light system to monitor their anxieties and can request additional help from a trained professional if needed.
Users have reported that Brain in Hand is a valuable safety net, giving them the comfort of knowing someone is there to help if they need it. HCPs say it provides them with greater visibility of how their patient is feeling. They also accredit a marked improvement in patient engagement, communication skills and self-confidence to the Brain in Hand app.
These examples demonstrate clearly that it is possible to provide empathetic understanding and effective support in a digital context. There are more examples like them, but not nearly enough. Too many patients feel unsupported and too many doctors wish they had more time and better resources to support them.
Technology improves the day
Empathy is the critical ingredient to a fruitful relationship between a doctor and patient. When patients believe their physical and emotional challenges are understood and met, they feel greater emotional comfort. If a patient feels emotionally supported, face-to-face interactions with their doctor can be driven by cognitive and not emotional empathy.
The consistent and ever-present practical and emotional support needed to help influence patients’ behaviours and improve control and compliance is too big a burden for time-poor healthcare professionals. This dynamic creates the ideal opportunity for innovative technology to step into the breach. But digital experiences can only succeed if they truly reflect the needs of the human beings they serve. They have to be programmed and designed to intuit what the patient needs and when they need it. The burden on the architects of the digital solution is great because they have to understand every nuance and every possible scenario the experience must accommodate. There will never be a perfect substitute for human interactions but in the healthcare sector, brands and their agencies have an obligation to do everything they can to understand what an extended interaction should look like, what support it should offer, by who and when, and then replicate that as best we can for effortless consumption. Hive’s philosophy of putting patients at the heart of every experience reflects a belief that we owe it to patients to never leave them feeling disconnected and alone. We owe it to over-stretched doctors and carers to provide peace of mind in knowing patients are getting the personalised support they need to enhance comprehension and compliance.
This is an interesting topic, I am a clinical psychologist and also studying marketing now, so have been on both sides of the fence. I have commissioned digital interventions within services I have run, mostly focussed on long term condition management or CBT for anxiety and depression. Some have been very good and others not. Some patients choose to use digital interventions because they do not feel well understood by their health care professional, or for the privacy that digital gives. I think those that work well involve patients strongly in co-creation of the product, and how it evolves. Inclusion of peer support elements certainly helps too. I completely agree you need to really understand the ‘customer’ and their needs before you can create digital programmes which in any way feel empathetic. Experiencing a digital programme which shows knowledge of the patient and their journey can feel very empathetic, but an app or programme which is not based in such knowledge can be very distressing and invalidating. I have not been involved in the development of digital interventions, only selecting them for use in the patient pathway, or marketing them. But involving patients, and knowing the relevant literature right from the outset seems very important. When developed in this way digital has much to offer patients to compliment medical or psychological care, or for those who are largely able to self manage conditions.
To add, I do not feel the digital for most people will, or should, replace the need for real human connection. I think we have to be careful when resources are limited not to over rely on it