Build Trust Through Patient Engagement Technology: A Children’s Hospital Case Study

Editor’s Note: This article is based on the 2022 Healthcare Analytics Summit session entitled, Innovative Communication and Digitally Integrated Solutions Significantly Increase Patient Engagement. The panel consisted of Emily Webber, MD, FAAP FAMIA, Vice President and Chief Medical Information Officer at Indiana University Health and Riley Children’s Health, and Angela E. Cromlich, MSN, RN-BC, Clinical Analyst, Clinical Interoperability Team, Indiana University of Health.

Having a child in the Neonatal Intensive Care Unit (NICU) can be a stressful and overwhelming experience for caregivers. In addition to worrying about their baby’s health, they may struggle with navigating the complex medical system and understanding the various procedures and treatments being administered. Effective communication between caregivers and healthcare providers can help alleviate some of this stress and improve caregiver and patient engagement.

As we reflect on the significance of Independence Day, it’s worth considering how the values that underpin our country’s founding principles translate into healthcare. Effective communication and patient engagement are vital aspects that enable individuals and their caregivers to actively participate in care decisions and take charge of their health journeys, even when the unexpected happens.

Despite its importance, health systems find it challenging to facilitate communications between caregivers, patients, and providers. This often hampers efforts to engage people in their care, and this is no less true with the most vulnerable of patients, those in the NICU, and their caregivers. The need to bridge this gap has become even more critical in recent times when healthcare systems face unprecedented challenges. The integration of data-driven technology solutions is a promising approach to bridging this gap, however. These tools have effectively revolutionized patient engagement by overcoming communication and care delivery barriers.

With more accessible modes of communication, patients and their caregivers are empowered to connect and entrust care to providers. Patient engagement solutions also give healthcare practitioners insights into care and access obstacles, allowing for proactive interventions and targeted support.

Patient Engagement Tool Tackles Intricate Communication Needs

A children’s hospital provides a compelling case study illustrating the impact of effective digital patient engagement technology. Riley Children’s Health acknowledged a need for a user-friendly interface and universal accessibility to engage the parents and guardians they encounter through their NICU.

“A lot of our industry tools are not always designed for kids and adolescents, which means we have to address gaps in functionality, particularly with patient-facing communication,” said Emily Webber, MD, FAAP FAMIA, vice president & chief medical information officer at Indiana University Health (IU Health) and Riley Children’s Health. Webber was a featured speaker at the 2022 Healthcare Analytics Summit held in Salt Lake City, Utah.

Webber’s work uses quality improvement methods and elements of a high-reliability culture and systems-applied informatics for safe and effective data exchange and patient experiences. She is also a practicing physician who understands first-hand the complex terrain patients and caregivers must traverse when admitted to the hospital.

Health systems, she said, must account for multiple variables when addressing communications and patient engagement strategies, such as a patient or caregiver’s hospital access, geography, and patient acuity. Most importantly, any solution must be equipped to ensure caregivers are involved in “every step of the child’s NICU journey,” she added, especially since admittance to the NICU is usually unplanned and unexpected.

Key Tenets of Patient Engagement for NICU Clinical Staff

Caring for babies in the NICU involves a large and complex medical team, and it’s often stress-inducing for caregivers, she said. When designing their patient engagement strategy and solution, therefore, they focused on the following key tenets:

• Allow clinical staff to automate key messages to guardians and reduce time to complete discharge steps
• Allow multiple caregivers other than biological parent(s) access to baby upon admission
• Obtain non-medical consent for visitation and camera monitoring used in the NICU
• Provide a visual tracker of individual patient progress

They also designed their technological patient engagement solution to support culturally competent care, which meant not making assumptions about caregivers. “That part of effective care means understanding how your values, beliefs, and behaviors impact your patients,” Webber said. “That sounds really simple, but in healthcare, we assume everyone has two working cars or has two parents who can drop everything and come in for [NICU] training. If we designed a solution just for those families, we would be excluding a lot of our patients.”

Guiding principles for Designing a Patient Engagement Solution

Ultimately, Riley Children’s Health adopted and designed a technological solution that allowed them to communicate with caregivers via mobile devices, explained Angela E. Cromlich, MSN, RN-BC, a clinical analyst on the clinical interoperability team at the Indiana University of Health. If a patient doesn’t have a mobile device, though rare, clinical staff can manually print the same content. Identical content is also accessible via web browser and email, she noted.

The patient engagement solution sends caregivers automated evidence-based educational content in written and video form. It encompasses comprehensive education on topics such as prematurity, safe sleep, car seat installation, and orientation to the logistics and daily experiences within the NICU. The solution also permits clinical teams to view caregiver information and determine who has read messages, with a single click on the baby’s name, she noted.

Cromlich, who was a co-panelist with Webber at the summit, concluded her remarks by sharing their guiding principles for the design process, which included: 

• Accessibility: Meet patients where they are, providing information in various formats, multiple languages, and with convenience in mind.
• Security and Privacy: Maintain confidentiality and ensure all communication remains HIPAA compliant.
• Standardized Care: Streamline and automate messages when possible so clinical teams can focus on patient care.
• Health Literacy: Repurpose existing content and ensure support teams working on the backend are aligned with strategic goals such as health literacy and branding.

With little time to orient caregivers to the NICU, educating, sharing pertinent information, and coordinating visitation can quickly burden clinical staff and caregivers. Although, with the right patient engagement tool, ongoing education can be provided seamlessly throughout their stay to support infants and their families who are in the NICU for extended periods. Additional educational topics can be assigned within the solution to equip caregivers for a safe and timely discharge.

Ensure Caregivers, Patients Have Ongoing Supports After NICU Discharge

With little time to orient caregivers to the NICU, educating, sharing pertinent information, and coordinating visitation can quickly burden clinical staff and caregivers. Although, with the right patient engagement tool, ongoing education can be provided seamlessly throughout their stay to support infants and their families who are in the NICU for extended periods. Additional educational topics can be assigned within the solution to equip caregivers for a safe and timely discharge.

“They’re doing this while they’re trying to bond with their baby, and it’s extremely emotional,” Cromlich said. “Our goal is to ultimately prepare those families to discharge and feel confident and safe in caring for their baby at home without that care team and all of that equipment.”

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