We spoke with Dr. Eve-Lynn Nelson, the Principal Investigator on the project entitled Development of an eHealth Provider-Patient Communication Measure housed at the Center for Telemedicine and Telehealth at Kansas University Medical Center in Kansas City, KS.

Q: What is unique and/or innovative about your study?
Telehealth offers much potential to improve health across geographic barriers and socio-economic conditions through increased access to quality care. To date, telemedicine research suggests that the technology generally works well and that providers and patients are generally satisfied. The next logical step in telemedicine communication research is systematic analysis of provider-patient interactions using well-validated measures. The study is innovative in looking at what stays the same and what changes in the relationship between telemedicine providers and their patients. It adapts an existing patient-provider communication coding system for the eHealth context. The measure will open the door to more thoroughly addressing research questions about communication within telehealth practice.

Q: How is your project progressing so far?
The project has completed Phase 1, the review of the measure by a panel of telehealth experts. The panelists provided insight into adapting the measure for the interactive televideo setting and for adapting the coding system. The project has progressed to Phase 2, the collection of taped interactions across telehealth clinics and the coding of provider-patient interactions.

Q: What prompted you to explore this research?
When we approach clinicians at the Medical Center about seeing patients over interactive televideo (ITV), they often have strong opinion about how technology will affect the provider-patient relationship. The study will validate a measure to research relationship factors over ITV. It will provide a systematic way to look at advantages and disadvantages of communication in the eHealth context.

Q: How would a typical end-user utilize the final product/results of your research?
The study’s goal is to modify the Roter Interaction Analysis System for coding interactive televideo consultations. This measure, the main product/result, could be used in future telehealth research to address central questions about patient, provider, and system attributes related to telehealth outcomes, just as in the traditional clinic setting. Patient-provider communication is likely a key mediating variable in technology adoption/diffusion, patient/provider satisfaction, interview disclosure patterns and diagnostic accuracy, knowledge acquisition, adherence to treatment recommendations, psychological well-being, and, ultimately, health outcomes. Future research with the measure will allow more in-depth analysis of provider-patient interaction components that influence chronic illness management over ITV.

Q: What are the greatest challenges in eHealth and more specifically, your project?
In terms of the interactive televideo system, the technology itself is not a great challenge. It is generally reliable, easy to use, and becoming more affordable. In addition, providers and patients have been overwhelmingly satisfied with using the eHealth system as compared with driving across Kansas for services or waiting months for consultation. The greatest challenge has been negotiating telemedicine time with providers who already have clinics scheduled months in advance. Similarly, the greatest challenge to the current project has been working with rural staff to manage data gathering with their many responsibilities.

Q: In what ways would you like to see eHealth evolve?
eHealth is evolving rapidly in Kansas with a number of state and federal initiatives to expand affordable, high-speed technologies to rural areas. I would like to see eHealth evolve as a tool to reach overarching quality of care goals, including access to the best possible, patient-centered care. Ongoing eHealth measurement is key to making sure interactive televideo and other technologies support evidence-based care. In my own area of child mental health, the last decade brought significant advances in psychotherapy and psychopharmacological treatments, but access to such treatments lags behind. eHealth offers many exciting solutions to expand access to treatment, educate parents, provide distance education/training for rural professionals, etc.

Q: How do you stay informed of advances and innovations in eHealth?
The collegial support from the Health e-Technologies Initiative has been helpful in staying up-to-date about research advances in eHealth, particularly across the diverse technologies and latest bells-and-whistles. Other areas that I’ve found helpful are updates from professional organizations such as the American Telemedicine Association, talking with other telemedicine programs, and interacting with national and state groups focused on rural health.

Eve-Lynn, thank you for the update.

In our March edition of Meet the Grantees, we will hear from Dr. Susan Fussell at Carnegie Mellon University.