Reflections on the Patient Narrative (returning from Providence)

One of the groups proposing a definition of the patient narrative.

One of the groups proposing a definition of the patient narrative.

This past week I was part of an amazing group of people who assembled in Providence RI for two days to participate in a design studio around the concept of the patient narrative in healthcare.

These people – artists, doctors, software developers, social media experts, policy experts, patient advocates – organized by the able herding of the good folks at the Business Innovation Factory, put their collective experience and a collective 500 hours into articulating both a vision and some concrete steps to take to make the patient narrative a more utilized and powerful aspect of providing healthcare. Look for a playbook to be published that contains the product of this effort.

Coming into the session, I wasn’t completely clear what we could accomplish, or even, frankly, how to define or describe the “patient narrative”. And even today, one day and one full continent removed from the experience, I’m swimming in the ideas and opportunities that were discussed.

To simplify this concept for myself, I would describe the patient narrative as the collection of experiences a patient brings to a healthcare engagement, and the interpretation they and their healthcare provider put on those experiences that guides the diagnosis, treatment, and eventual outcomes for the patient. When valued and used well, sharing and contemplating the patient narrative can lead to extraordinary outcomes – patients who feel like human beings, practitioners who inject empathy into their scientific deliberations, next steps that are more likely to be followed, and more likely to improve quality of life for the patient.

At its most simplistic (but still powerful) level, I’m reminded of the Sir William Osler saying “Listen to your patient, he is telling you the diagnosis.”

So, among the many other interesting and powerful uses of patient narrative, this simple opportunity to re-sensitize the practitioner to listen and appreciate the full story the patient brings is a very exciting one to me. No one can deny that medicine often resembles more a factory floor, where the patients are objects to be analyzed and processed. The introduction of EHR technology has only furthered the distance between patient and doctor – I can’t remember the last time I saw a doctor where she wasn’t looking primarily at a computer screen instead of at me, or my wife, or my child.

Of course, at ReelDx, we believe that we can apply technology in such a way as to reconnect patient and practitioner, and make the patient narrative much more powerful in the provision of healthcare services. Asynchronous video (a terrible, tech-wonky-sounding phrase) holds one key. Allowing patients to capture their story in a medium that can be permanent, shared, integrated into workflow, reviewed multiple times, and stored for future reference promises powerful progress in the effort to deliver more patient-centered care, and to re-empower the patient in the full process.

I’m going to use this space over the next several weeks to articulate a variety of use cases we have imagined – and some we’re already working on – that leverage asynchronous video in powerful ways. And maybe we’ll have a contest to come up with a better phrase than asynchronous video.


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