Saturday, September 11, 2010


In trying to organize an end of summer activity recently, I sent a series of e-mails to a group of friends over a period of three weeks. Some people didn’t respond to the e-mails. Consequently, I ended up calling several people by phone.

At the party, a number of people with cell phones had them out the whole evening and were texting, checking e-mail and playing games. For some, this was a bit like watching TV and doing a crossword puzzle at the same time. What was in their hand seemed to hold most of their attention, but every so often they’d take a minute to look up and maybe join in the conversation.

I found myself noting the differences in parties before everyone had cell phones and the internet. We would call to arrange activities, gather at one another’s homes, talk at length, and enjoy what we were doing. Rarely was there a phone call to interrupt us. Actually, I only remember one call when a friend needed to rush home and assist with the birth of twin lambs.

This has made me think a lot about how we communicate and the tools we have to do it with-land lines, cell phones, fax, text, tweet, Facebook, Skype, e-mail etc. Has technologies made us better communicators? Does it take us more time? Do we keep in touch more? And most important for this blog, do we have a better relationship with our health provider(s) because there are now so many ways we can “connect?”

A recent study of 35,423 people with diabetes, hypertension or both diseases, found that those who e-mailed their physicians about test results and other aspects of care, kept their blood pressure, cholesterol and blood sugar levels under much better control than those who didn’t. In short, e-mailing with your provider actually improved health. Health Affairs, July 2010

Even though many chronic conditions organizations encourage an e-mail relationship between patient and provider, it only takes place in about 1 of every 10 patients, with less than a third of physicians inviting patients to e-mail them. The reason for this is simple-health plans pay less for online consultations. E-mailing Your Doctor Can be Good For Your Health- But Not for the Physician’s Bottom Line

However, more and more medical practices and clinics see the value of e-mail connection and are providing some services, such as prescription refills, setting up appointments, simple questions etc. A number of people that I’ve worked with e-mail their provider their list of questions before they come for a face-to-face appointment. When I’m an advocate for a medical appointment, with the patient’s permission, I e-mail my summary of the visit to both the provider and the patient.

If you are not using e-mail with your provider, ask if this is an option. Be clear how you want to use it and make sure you agree on which situations merit its use and which ones don’t.

Texting, a very popular and growing way for many to communicate, is probably not a first choice for most providers. But, like most things, there is a time and place for it. During the winter, I work in first aid at one of the local ski areas. We found texting to be one of the quickest ways to reach the family and friends of our patients, since people seem to respond quicker to a text than a cell phone call.

Skype, which allows you to see the person as you talk to them, is a very interesting feature of internet connection. The son of one of the nurse practitioners I work with was away and developed a rash. Using Skype, she was able to look at it and diagnose it. Some health care facilities are starting to explore it’s potential. If you think about it, the space station has been using aspects of this for some time to track how astronauts are doing.

It’s important that you discuss with your provider the best ways for you to communicate with them and vice versa. Each situation is going to be slightly different, but spelling it out upfront can help foster better health for you.

The next part of the communication issue for people dealing with chronic conditions is sharing information with families and friends. Hands down, the internet has made this much easier.

I’ve blogged about this before, but to recap-there are free websites that you can set up where people type in a password and learn how you are doing. Caring Bridge and Cares Pages are two excellent examples. I’ve seen both sites used in a variety of situations and always with good results. Many families have told me it significantly reduced the amount of time they had to explain what was going on and they really appreciated the notes of support and encouragement people left. The downside is that passwords can be given out, allowing other people to gain entry to your information.

My preference is Lotsa Helping Hands. This free site only allows entry to people who have been approved by the site moderator. They have their own unique password for their e-mail, which they need to use each time they log in. In addition to learning how the person is doing, you can sign up to help-make meals, do chores, provide rides etc. It also provides a way for a select group of people to have access to medical information. This latter feature is very helpful when adult siblings, who live in different parts of the country, are trying to arrange for care for an aged parent.

Skype is a wonderful way to keep people connected. Hospitals are recognizing the usefulness of this service and many will make arrangements to bring this to the hospital bedside. Many mobile phones and even iPod Touch include it. Skype offers a variety of free features including voice and video calls to anyone else on Skype; conference calls with three or more people; and instant messaging, file transfer and screen sharing. The potential of this service is enormous and is worth taking the time to learn and utilize.

When you are dealing with chronic and/or life threatening conditions, e-mail, texts, web, Skype etc. can all be very helpful. Truth be told, we’re still figuring out how to take advantage of this new and frequently changing technology. Just be clear with providers, families and friends what is your preferred means of communicating.

In terms of personal communication, I find I can stay connected to more people using tools like e-mail, Facebook, and blogs. Trying to organize something seems to take a lot more time, since people are developing preferences for ways they like to be contacted. I have one friend that prefers to be texted, so I find I’m communicating with them less and less as I don’t have thisg as a feature on my cell phone. For those that use cell phone primarily, the connections can be of poor quality particularly where I live. When it’s all said and done, nothing beats a face to face conversation.

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