Dr. Megan L. Ranney’s recent research study found that patients in urban emergency rooms prefer a technology-based intervention, irrespective of age, sex, income, race and ethnicity, to address behaviors that put them at a high risk for poor health, such as cigarette smoking, alcohol use, and being a victim of violence.
Ranney, an emergency room physician and researcher at Rhode Island Hospital, talked with Providence Business News about how the prospects of technology-driven apps will change the delivery of services for patients seen by ER physicians.
PBN: How exactly will technology-based interventions change the delivery of health care services in an emergency room?
RANNEY: In the emergency department, we want to provide more services to patients than we necessarily have to time to do, particularly with public health or behavioral interventions, addressing risky behaviors, such as drinking, smoking and stress.
These are worthwhile tasks, but they are difficult to accomplish in an emergency room setting.
We are interested in the potential of technology to deliver behavioral interventions, in the way same that there are devices, gadgets and apps and smart phones that can provide you with [real-time feedback], we’re trying to develop similar technology for emergency department populations.
PBN: Did you find that there was a generational divide between younger patients and older patients in terms of technology acceptance?
RANNEY: No. We were expecting that young people would be more interested in technology-based interventions, based on data from the Centers for Medicare and Medicaid Services about wireless use among the young and the poor. We found that age really didn’t predict interest in technology.
We were thrilled to find out that patients across all ages were texting – the oldest patient was 95. We were very happy with the high percentages of use [only 36 out of 973 patients preferred a paper questionnaire to filling out the survey on an iPad].
My sense is that among older physicians, they may need to be sold on this approach. In general, physicians are unlikely to recommend treatments unless there is proof that they work.
PBN: Does Lifespan have the technology infrastructure in place today to do the kind of interventions your study suggests can be done?
RANNEY: Lifespan does not currently have the technology-based tools necessary. A few of us are working to develop the text messaging interventions and Internet-based interventions. It’s something that is ripe for development.
PBN: How will such technology interventions improve care and reduce costs in the emergency room?
RANNEY: With the rise of the Affordable Care Act, it has placed an increasing demand on policy makers as well as hospitals to increase value for the patients and decrease the number of emergency room visits, to invest in better preventive care.
By investing in technology interventions to help patients change risky behaviors, you can meet those goals. Once you develop the technology, it’s relatively low cost. You don’t have to pay for an extra social worker 24 hours a day.
PBN: How will your role change as an emergency room physician with such technology interventions?
RANNEY: Given the potential and ability to refer people to education or intervention services through technology, I can include greater weight to screening patients for risky behavior.
We have a huge lack of services in the state for people with alcoholic disorders. If you’re not well insured, there’s not a lot out there for risky drinkers. They often end up at the emergency room. In my role as an emergency room physician, I would like to do more to help these folks.
As a result, patients will come in to an emergency room and we can be more helpful in diagnosis and treatment.
