Considering the Communication Skills, Tools, and Questions Surrounding Healthcare Screening Assessments
A relatively new and value-based care trend, healthcare screening assessments are helping clinicians understand the social determinants affecting a population’s overall health.
As screening assessments have become increasingly utilized by clinicians, concerns are being raised regarding whether they have the various tools and communication techniques needed to effectively use these assessments.
Due to this trend still being in its infancy, designers are struggling to create effective and efficient tools without a proper model to base their efforts on.
As organizations begin to design and create their strategies for the first time, they will need to consider:
Tools used to deploy their screening
Determinants to observe during screening
How clinicians or providers will speak with patients regarding their screening and privacy matters
Assessing Screener Deployments
Part of designing these assessments will involve the need to determine the best tool(s) to host their screenings on.
These typically fall into two categories:
Digital survey form
Paper form
Digital Survey Form
With a hefty investment, some organizations — such as MHT — are opting to splurge and create screening assessments in digital survey form, with many prioritizing automatic integrations with the physician’s electronic health record (EHR). Automatic EHR integration helps streamline the resulting process and reduce the overall workload for clinicians.
Moreover, because many patients are concerned about privacy issues, there are considerations to be made in providing explanations, such as outlining the clinician’s dedication to digital screening assessments and the purpose they serve. In addition to a thoughtful explanation, designers may want to review an opt-in survey, which can give some patients a sense of autonomy and control over what could seem like a probing or intrusive questionnaire.
With MHT’s cloud-based platform, we integrate with our client’s EHRs using HL7 (negotiable) to securely connect data between the two systems. Our development team works with providers to ensure a secure and fully HIPAA-compliant transmission of all sensitive information.
Paper Form
A low-cost solution, paper form surveys are a good starting point for a doctor’s office to begin slowly incorporating assessments into their practice.
Paper assessments have the option of being mailed out prior to a patient’s appointment, completed in the waiting room, or in the patient room while waiting for their clinician to come in.
With this, healthcare offices will need to troubleshoot a few probable issues before implementation:
Preventing patients from forgetting their assessment at home
Waiting room overflow from patients arriving early to complete their screening assessment
Paperwork management and data filing
A prominent drawback of paper form assessments is determining who is responsible for providing the survey to the patient, as well as the lack of integration into the clinician’s EHR. Without integration, the physician’s office will need to manually input data — risking error — and eating up valuable time.
This may not be a one-size-fits-all approach, however. Some healthcare providers may find that a combination of both digital and paper is the best solution for them. For example, a community that has a largely older population or a mix of multiple languages.
On top of reviewing community demographics, organizations may also want to consider digging into their patient advisory council to guide their implementation, as well.
Determining Assessment Focus and Contents
After determining their preferred deployment method, organizations now need to focus on the content of assessments.
When providers ask probing questions that they do not have an immediate solution to, it may damage the trust between the patient-clinician relationship. Serious consideration of questions is paramount to the success of the entire screening process and retrieving valuable results.
During the determination of content, providers must take into account its community resources and tailor the screening questions around that. For example, if you are asking questions regarding PTSD, there must be a professional within a respectful radius that can help your patient with their PTSD symptoms.
Some assessments can be challenging because even though it impacts their health, patients are oftentimes reluctant to answer questions that don't have a direct correlation. Social determinants, in particular, are a driving force behind mental and physical health. So, you may find that you want to ask questions outside of diagnostic material. However, you must tread carefully and create an assessment that is on that focus only — mixing and matching may come at a detriment to results.
As a few examples, avoid asking questions about:
Transportation without nearby public transportation services
Food and shelter without a local food bank or homeless shelter
Legal matters without a pro bono lawyer available for referral
Patient and Provider Communication
Healthcare providers should make it a priority to hone their communication skills with their patients in order to engender trust and create a comfortable atmosphere to openly talk about what they are feeling.
The reluctance to discuss social determinants is especially prominent in parents or guardians of minors accompanying their child to the pediatrician.
A 2019 study showed that parents do see the correlation between social determinants and their child’s health, however, they are not comfortable answering certain questions because it could bring up discussions regarding their own mental health, domestic issues, or legal problems. In fact, many parents feared that their answers could result in a report being made to child and family services.
In addition to ensuring their patients’ confidentiality throughout their conversation, clinicians must clarify why they ask social determinant questions and make certain their patients understand that they are not being nosy. Instead, they have an answer to any determinant they are inquiring about.
“When we really start thinking through how to start asking patients these questions, being thoughtful about the empathetic inquiry mindset, and knowing that even though we need to know this information, we recognize that although we need to know this information now to better take care of patients, this is new,” says Dr. Alisahah Cole, system vice president of population health at CommonSpirit Health. “This is not just new for our providers, but it's also new for the patients.”
For best practices, Dr. Cole provides three guiding principles to providers:
Tell your patients that a screening assessment is optional. Make it clear that you are not forcing them to answer any questions they are not comfortable with. They have the right to keep any information private
Assure patients that they do not have to answer specific questions if they do not want to, even if they agreed to participate in the assessment
Let your patients know that they can stop at any time
The MHT Assessment Tool
Social determinants are only one in a variety of multiple factors that drive mental health and substance abuse disorders
Our award-winning, HIPAA-compliant assessment screener gets to the bottom of your patient’s struggles and helps to diagnose and treat ignored or inadequately managed disorders.
We enable our clients to:
Increase overall quality of care
Feel comfortable and confident in diagnosis and treatment
Enjoy the convenience of automated integrations
Streamline professional referrals
Track progress and regression
If you’d like to learn how the MHT screener can help your practice, contact us today for your free 30-day trial.