Monday, July 24, 2006

Patients use iPods to get information on surgery

Patients use iPods to get information on surgery
By Michael Schroeder
The Journal Gazette

What’s on your iPod?

The latest from rapper 50 Cent, rocker John Mellencamp’s greatest hits or maybe – just maybe – information about your upcoming surgery.

A pilot program through Indianapolis-based Clarian Health Partners is providing iPods to bariatric patients as part of its ongoing efforts in education. “HealthPod” is the first program in the nation to use the popular pint-sized devices as support mechanisms for bariatric patients, Clarian said when it announced the program this month.

It’s the latest wrinkle in the effort to keep patients informed about all aspects of their care – a far cry from yesteryear, when it was assumed it was better that only the doctor knew what was going on. Medical officials say keeping patients in-the-know helps to allay fears – even if some details may be difficult to bear at first – and increases the likelihood that they will take initiative in their care.

If all goes well with the pilot program, Clarian hopes to use iPod technology to support patients going through cancer, transplant and women’s health programs.

No immediate plans have been announced locally for iPod patient education, although health care providers use Internet and video tools to help educate their patients.

Technological advances like the iPod are a complement to ongoing education but not a replacement for one-on-one interaction, health care officials say. In the same way, many people turn to the Internet to research their options before setting foot in a doctor’s office or hospital.

“Having all that (information) real time is a huge benefit,” said Terri Hohlt, administrator for the Clarian Bariatric Program.

HealthPod allows patients to review audio and video clips about the bariatric program, their procedure, the pre-operative preparation and post operation follow-up at their own pace and review the information as often as needed. The first iPod was dispatched July 11.

Bariatric surgery is a weight-loss procedure for patients who are morbidly obese – typically 100 pounds or more above their ideal weight. Several procedures exist that either reduce stomach size, decrease the body’s ability to absorb calories and nutrients or both – as is the case with the most common bariatric procedure, Roux-en-Y gastric bypass surgery.

Like all weight-loss measures, success requires a personal commitment to be made to eat properly and exercise.

Patients who participate in the HealthPod program get ready access to patient testimonials, surgeons answering frequently asked questions, a virtual tour of the facilities and specifics about their surgical procedure. They also get access to diet and grocery shopping tips, recipes, exercise routines, motivational messages and, after it’s all said and done, an iPod that is theirs to keep.

Clarian invested about $120,000 in a studio, video equipment, IT infrastructure development, program maintenance and distribution of the iPods, each of which costs $299, minus the health system’s 10 percent corporate discount. Clarian spent about $8,000 on the iPods and set aside $30,000 more for program expansion.

Hohlt stressed that HealthPod is just one component of an educational effort that includes regular face-to-face consultation. Still, the pilot program affords patients an opportunity to share health information with family members at home, she said.

Hohlt knows how hard it can be for patients to swallow the realities of surgery, especially in a sterile environment. She’s had patients walk out of bariatric program classes crying, saying they are scared, after hearing about the particulars of surgery.

“You need your family support to make it through,” Hohlt said.

A colleague at Clarian concurred.

“For increased chances of a successful preparation for and recovery from bariatric surgery … patients need to be steadfast,” Cindy DeBord, registered nurse and clinical resource manager of technology solutions and education for Clarian, said in a statement. “In order to be steadfast, bariatric surgery patients need to be educated with accurate information and motivated by the emotional support of loved ones. An informed patient is less likely to have return visits.”

That sentiment is echoed by others in the medical community.

Like numerous other local health care facilities, Parkview Regional Cancer Center provides patients with on-site Internet access. Staff members provide guidance on useful Web sites – such as the American Cancer Society’s site – and patients can surf on their own. A small one-room library also provides pertinent books, videos, pamphlets and other materials.

But the crux of patient education revolves around personal consultation. Nurses typically spend about 45 minutes to an hour talking with newly diagnosed patients, discussing their condition, laying out treatment options and answering questions. Patients are encouraged to ask as many questions as they wish – even if they have already been answered, said Lynn Gerig, cancer center care coordinator.

“They’re going to know much more about cancer than they ever wanted to know,” Gerig said.

It can be overwhelming given the gravity of the situation and technical nature of the information, she said.

But ultimately education decreases patients’ fear by illuminating the unknown, decreases their potential for side effects (as patients learn how to properly prepare for treatment and what steps to take – such as rest – to recover) and improves their follow-through, said Gerig, who is a registered nurse.

When patients know all their options, “it gives them control … in a very frightening situation,” she said.

The more patients know about their cancer and treatment, the more equipped they are to monitor their health and take necessary precautions. After treatment, that could mean the difference between making a preventive visit to the doctor’s office when symptoms first arise and landing in the emergency room in dire condition, she said.

Like others in her profession, Gerig couldn’t think of any good reason to withhold information from patients, even if some details are sometimes hard to stomach. She joked that she knows enough is enough when a patients’ eyes glaze over, but she expressed serious concern about the well-being of those who prefer to remain in the dark.

“There always are individuals who say, you know, ‘I don’t want this (information) … just do what you have to do,’?” Gerig said. She accepts that this is how some patients cope but worries that it inhibits optimal care.

Many of these patients experience a high level of anxiety about treatment – even to the point where some may not be able to hold still during a procedure – and they may find it hard to trust their doctors, leave out useful personal medical information and lack proper follow through, she said.

Luckily, Gerig said most people don’t defer education on their condition and treatment options.

Kim Harris, director of clinic services at Fort Wayne Orthopedics, agreed. She said the average patient is more knowledgeable – in large part – because of the Internet.

Harris points patients to the company’s own Web site and partner WANE-TV, Channel 15’s Web site. The latter includes a tool called “Interactive Human Atlas” which provides 3-D video clips on topics such as ACL (or anterior cruciate ligament) tears.

Once in the office, a patient’s education entails personal consultation and literature, mainstays in the field. Whether patients just want the basics or want more in-depth information – as most seem to – that’s what they get, she said.

“We try to tailor the education to what they are looking for,” Harris said. She’s quick to add that there’s a pay-off for patients who take advantage of Internet resources, like the Web sites, before they come in. “I think they get more out of their visit.”

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