HIM 350 Module 5 Patient Communication Short Paper Example

Sent Is Not Understood: Patient Communication at Sandstone Behavioral Health

[Student Name]

Southern New Hampshire University

HIM 350: Communication and Technologies

Module Five Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

Sent Is Not Understood: Patient Communication at Sandstone Behavioral Health

The Project One audit found that Sandstone Behavioral Health's most valued communication with clients happens informally, through case managers' texts, while its official channels miss many clients. Robocall reminders reach disconnected numbers, the portal serves mainly younger clients with email and written materials are hard to read. This paper reviews research on reminders, health literacy and access and proposes changes to how Sandstone communicates with clients between visits.

Text Reminders Work

Guy et al. (2012) combined the randomized trials of texted appointment reminders and reported a consistent lift in attendance, roughly a 50% gain in the odds of showing up, that held whether the clinic was a doctor's office or a hospital department and whatever the lead time of the message. Sandstone's clients agree: 43% of those surveyed preferred texts to calls. Replacing robocalls with texts, while keeping a call option for clients without mobile phones, is well supported.

Two-Way Messages and Privacy

A two-way reminder that lets clients confirm, cancel or ask to reschedule is more useful than a one-way notice. But reminders from a behavioral health agency can reveal sensitive information if someone else sees the phone. Sandstone's texts will identify only "Sandstone" and the date and time, never the clinic type or clinician, and clients will choose at enrollment whether to receive texts at all. For the substance use disorder program, reminders will contain no program name.

Why Health Literacy Matters

Berkman et al. (2011) pulled together the research on reading and numeracy skills in health and tied weak skills to heavier hospital and emergency use, more trouble following medication directions or reading labels and, for older people, worse health and earlier death. Many Sandstone clients face additional barriers, such as the effects of trauma, psychosis or substance use on attention and memory. Communication that assumes strong reading skills will fail them.

Checking Understanding

Schillinger et al. (2003) audio-recorded diabetes appointments for people with limited reading skills. Doctors seldom asked those patients to say new instructions back, yet when they did, the patients tended to have better blood sugar control. This technique, often called teach-back, applies to behavioral health as well: having a client describe, without prompting, how a new medication should be taken or when the crisis line is the right call shows whether the message landed.

Materials People Can Read

Stossel et al. (2012) evaluated patient education materials available through common point-of-care resources and found most were written above the reading levels recommended for patients. Sandstone's handouts on medications and coping skills tested at an eleventh- to college-level reading grade. The agency will rewrite its twenty most-used handouts in plain language, aiming for a sixth- to eighth-grade level, using short sentences, common words, headings and pictures, and will test drafts with clients from the peer advisory group.

The Digital Divide

Kontos et al. (2014) drew on a federal health information survey and found that online health activities, from emailing a clinician to viewing records, fell off among adults with less schooling and lower incomes. At Sandstone, portal enrollment is lowest among clients over 60, those without email and those in the most rural areas. Any plan that relies only on the portal will widen existing gaps.

Making the Portal Usable

Three portal changes would help. Enrollment by text message link, without requiring an email address, would remove one barrier. A short in-person or phone walkthrough, offered by front-desk staff or peer specialists, would help clients who have never used a portal. And simplifying the home screen to show only the next appointment, messages and a crisis line number would reduce confusion. Clients who prefer not to use the portal will continue to receive information by phone and mail.

Language Access

About 18% of Sandstone's clients prefer Spanish. Federal civil rights law obliges agencies receiving federal money to serve clients who speak limited English effectively, which in practice means qualified interpreters, translated vital documents and reminders in the client's preferred language. Currently, reminders go out only in English and some clinics rely on bilingual staff without interpreter training. The plan adds Spanish reminders, professional translation of the rewritten handouts and video remote interpreting for less common languages.

Disability Access

Clients who are deaf or hard of hearing need captioned or interpreter-supported video visits, and clients with visual impairments need portal and web content that works with screen readers. Recent federal disability rules require health care organizations receiving federal funds to make web and mobile content meet recognized accessibility standards on a phased schedule. Sandstone's IT team will test the portal and website against those standards and fix barriers.

The Human Channel Still Matters

The audit showed that clients value their case managers' personal contact above every automated tool. Technology should support that relationship, not replace it. When the secure texting platform proposed in Project Two arrives, case managers will be able to keep the check-in messages clients appreciate, now inside a documented and protected system. Peer specialists, who share lived experience with clients, will help with portal walkthroughs and plain-language testing, bringing credibility that staff alone cannot provide.

Measures

Table 1 lists the changes with a measure for each. Reporting results by age, language and insurance will show whether changes help the clients who have been missed.

Table 1. Patient Communication Changes and Measures

Note. Baselines from the Project One audit and scheduling reports.

Conclusion

Communication with clients succeeds only when it reaches them in a form they can use and understand. Evidence supports text reminders, plain-language materials and checking understanding, while research on literacy and the digital divide warns against relying on tools that exclude many clients. Sandstone's changes pair digital options with human support and alternatives, so every client can receive and act on what matters.

References

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Guy, R., Hocking, J., Wand, H., Stott, S., Ali, H., & Kaldor, J. (2012). How effective are short message service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Services Research, 47(2), 614-632. https://doi.org/10.1111/j.1475-6773.2011.01342.x

Kontos, E., Blake, K. D., Chou, W.-Y. S., & Prestin, A. (2014). Predictors of eHealth usage: Insights on the digital divide from the Health Information National Trends Survey 2012. Journal of Medical Internet Research, 16(7), Article e172. https://doi.org/10.2196/jmir.3117

Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C., Leong-Grotz, K., Castro, C., & Bindman, A. B. (2003). Closing the loop: Physician communication with diabetic patients who have low health literacy. Archives of Internal Medicine, 163(1), 83-90. https://doi.org/10.1001/archinte.163.1.83

Stossel, L. M., Segar, N., Gliatto, P., Fallar, R., & Karani, R. (2012). Readability of patient education materials available at the point of care. Journal of General Internal Medicine, 27(9), 1165-1170. https://doi.org/10.1007/s11606-012-2046-0