The way we receive healthcare has changed dramatically—but what hasn’t changed is our desire to feel understood and cared for. That need for empathetic care is at the heart of being human, especially during times of illness, pain and vulnerability.
In the new world of telehealth, health apps and provider portals, it is easy to lose the personal contact that communicates a sense of caring. But empathy is not just a “nice to have” added extra in healthcare—it has been shown to have strong positive effects on health outcomes and patient satisfaction, along with reducing malpractice litigation and clinician burnout.
With modern advances in technology, expressing empathy is becoming more difficult. There is less inhibition in online communication platforms and a growing sense of disconnection from the people we interact with. So how do we provide empathetic care in a digital world, where we are often not face-to-face with each other?
“If there's something which has really exploded mainly because of COVID-19, it's the fact that we have suddenly jumped into digital modalities to deliver this care,” said Charles Alessi, MD, chief clinical officer at HIMSS. “But empathetic care isn't about COVID-19, this really is about the care we give in the everyday interactions with patients and citizens, in terms of health and care.”
Mazin Alsaidi, MD, is the chief medical officer and consultant general surgeon at the Saudi German Hospital Dubai and shared that empathetic care is important to him and to the patient-centric philosophy at his organization.
“What is the patient experience when he steps into the hospital? It's not only the clinical part, but also the communications, the care, the kindness, the empathy. He can compare two hospitals providing treatment for the same disease, with the same standard, and goes to the hospital that he believes provides an experience that brings kindness to that care,” said Dr. Alsaidi.
Technology that seems neutral—including emails, text messages and video conferences—can maintain and improve the relationship between clinicians and the patients. During the lockdowns and quarantines brought on by COVID-19, these technologies have been a vital link allowing for new ways to provide empathetic care.
“A patient can access apps on his mobile phone to speak to the doctors, or to make an appointment, or raise any queries about his management. Accessing doctors through all these platforms has made the bond and the connection to the doctors rapid and with easy access, becoming the communication between the doctor and the patient,” said Dr. Alsaidi.
In a recent discussion with HIMSS Davies Award of Excellence recipients Nebraska Medicine, Atrium Health and Truman Medical Center, Jonathan French, CPHIMS, SHIMSS, senior director of thought advisory and the Davies Award program at HIMSS, was struck by an observation regarding the importance of empathy when delivering digital care. “When the pandemic hit, these health systems all rolled out a variety of virtual platforms to allow patients to self-screen or have a virtual encounter for COVID-19,” said French. “Despite the availability of these entry points into the system, call banks were still overwhelmed. Patients were scared, and wanted that human interaction when seeking information.”
“I've been in nursing for about 30 years, but the subject of empathy is pretty much what I live with every day, and it's pretty much the essence of what we do as nurses,” shared Kathy Sienko, OBE, the chief nurse at King Faisal Specialist Hospital and Research Center, a Davies-recognized organization.
She believes clinicians have had to think differently when delivering healthcare beyond hospital walls in telehealth modalities, with empathy and compassion that goes beyond the “up close and personal” exchange with a patient. “We need to make ourselves available to them in ways that are perhaps sometimes not always possible when we're in the hospital setting. Giving them access to information, incorporating online information and other sources of data into the way that we deliver care, in ways that we have not been able to do before, or haven't been motivated to do before.”
Sienko shared a quote by Maya Angelou, “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel,” to help express her belief that the patient experience is deeply affected by creating a sense of empathetic care. “That's the risk when we're using technology, to hide behind the screen,” said Sienko. “We have had to be very thoughtful about how we delivery really personalized, compassionate, empathetic person-centered care.”
From a phone consultation, a portal giving access to health data, or a group chat for sharing information with patients – technology creates connections. Sharing information during times of illness and uncertainty can be a powerful experience of empathy for patients and their families.
Sienko has seen this many times over in her work as a nurse. “Human beings are made for connection and relationship. Technology has allowed us to create connection. The fact that somebody could ring to ask when they were worried about something is, of course, demonstrating compassion. The fact that we were able to create video consults for neonates, whose parents were not able to come into the [neonatal intensive care unit] to see their babies was another way of us really ministering to the worries and concerns. We were able to create video conferencing for relatives to be able to see their moms and dads and sisters and brothers in the [intensive care unit]. It was another way of us really understanding that what people needed was that kind of connection.”
Sam Hanna, MBA, CISA, professor and associate dean at American University, believes patient engagement is about making patients part of the healthcare ecosystem through continuous touchpoints. When patients contribute data and information, their providers can begin tailoring offerings to their needs and wants.
“As a physician, for example, you want to be able to provide [care] when the patient needs it. At the same time, that patient has to be able to provide data and information back to that clinician in terms of their sleep habits, in terms of their diet, in terms of their whole life experience,” explained Hanna. “Together, that creates that feedback loop between the two. The technology enables that. Technology is not the solution—it’s one piece of the solution.”
As healthcare moves beyond the hospital and closer to the community via new technologies, it becomes more important than ever that medical staff not lose sight of the patients receiving care—even when they are at a distance.
Tim Morris is the commercial portfolio and partnerships director at Elsevier, a company that delivers information and technology to hospitals around the globe. As a trained emergency department nurse and with parents living with health problems, he has seen the impact COVID-19 has had patient treatment and limitations on access to care. “I recognize that in the future I'm going to be a patient as well. I'm looking into the future to see how technology, information, and our systems are going to improve my care going forward, to ensure that I receive the same quality of care no matter where I go on the globe—and that I may be able to receive empathetic care from people who are able to understand my needs as well.”
Morris believes these skills in empathy can be taught to nurses and doctors, with new ways of communicating that add more to the overall care of a patient. And others agree, including Kathy Sienko. “I know there is a lot of debate in nursing about whether people are born compassionate and empathetic or whether we teach students and nurses-in-training empathy and compassion. My experience has been that it can be taught. In the right clinical environment, with the right nurses as role models, people can learn to be compassionate.”
Technology helps train the skills that improve empathetic care. For example, virtual reality and augmented reality tools help nurses who are finishing their training but have not yet had the experience of working directly with a patient in certain situations. Hospitals are also using augmented reality scenarios to teach how to handle difficult conversations and deliver bad news.
Digital training also democratizes the process, allowing all students to speak up and be heard. “When we look at training people in the classroom, you have people who sit in the front engage, those at the back who don't. It's very difficult to determine if they understood what you're trying to communicate,” said Morris. “We were able to implement online training sessions with nurses where they fed back their understanding and engaged. It's not just about watching a scenario in an augmented or virtual reality, it's actually engaging with your preceptor afterward, explaining what you've understood. I think there are some fabulous ways that we can enhance training and engage with people who've never engaged before.”
“When [people] think about empathy in healthcare, they’re still stuck in this notion that empathy is this weird thing that occurs between two people, between a doctor and their patient. We don’t get out of that box,” said Adrienne Boissy, MD, MA, chief experience officer at the Cleveland Clinic. “Empathy can really embody an organization, it can be how [they] operate and design processes.”
Dr. Boissy brought up an example of appointment scheduling and patient access. “If you know what it is like to try to access an appointment after you’ve found a lump in your breast, or lost the use of your legs because they were numb, if you truly immersed yourself in what the patient is going through at that moment, you’d enable an appointment immediately. You wouldn’t sit there on the phone and say a bunch of empathetic things. You’d enable another solution. People want to feel cared about.”
For the past decade, Dr. Boissy and her team have developed a global focus on empathy and the “intersection between empathy and innovation and how they should be deeply intertwined to be maximally effective… the experience of care, what does that need to feel like and how can we redesign things to make people feel cared about, and valued, and known, by an organization?”
Compassion is a two-way street. Patients need it but so do stressed providers giving care at the bedside or via telehealth. Caregiver burden during COVID-19 has been particularly overwhelming.
As a nurse in a leadership role, Sienko is adamant about protecting the nurses who depend on her, making sure that they have the equipment they need and environments that support their ability to care for themselves and their patients. “Making that happen for them, either through myself or through their direct line managers, is one of the ways that we ensure that when they come to work, they can be fully compassionate and fully empathetic. Bearing in mind, of course, that they are also human beings, with the same worries and concerns,” said Sienko.
Digital tools can prevent clinician burnout and protect a nurse or doctor’s ability to provide empathetic care to the patients they serve. “I think the area of communication, the ability to speak to others who are experiencing and having the same challenges is really key,” said Morris. “I love the idea of being able to use communication through journaling, through other tools to actually speak to other nurses, and express how your day has gone. We used to do that as junior nurses, but it's important we continue that.”
The same digital solutions that work for patients often apply to medical staff, with technology tools that increase communication, provide access to wellbeing services and offer ways to connect after-hours to make sure clinicians feel cared for and listened to.
“Clinician burnout is a very frustrating issue,” said Dr. Alsaidi. “When doctors start to be frustrated and anxious, these are signs and symptoms that we need to pick it up early. Communication is very important. You need to talk about that to your managers and find a way to solve it.”
Technology has changed the way providers practice and patients are treated—but still the human touch remains critical in healthcare and in healing. Digital solutions are playing a new role in supporting empathetic care—and that helps patients and caregivers to feel heard, understood, and cared for.
The views and opinions expressed in this content or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.
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