1. Display as participants enter and explain that this training was developed and created based on industry and educator input in conjunction with the Health Workforce Initiative Statewide Advisory Committee, California Community Colleges Chancellor’s Office, and Workforce and Economic Development Program. This is just one soft skills module of the comprehensive training package: “Hi-Touch Healthcare: The Critical 6 Soft Skills.”
Hi-Touch Healthcare

2. Information and Communication Technologies

3. What to Expect in this Presentation
Overview of the impact of information and communication technologies on the delivery of healthcare
Overview of how communication technologies influence messages in everyday encounters
Overview of the importance of nonverbal communication in the use of information and communication technologies
Quickly preview the session. 

4. Importance of Soft Skills
“Communication is the skill that can possibly have the greatest impact on effective healthcare delivery. It really is the key to clinical governance and demands as much attention, respect and sustaining as other seemingly ‘harder’ targets. However, often the mere mention of the importance of communication causes less than positive reactions in healthcare professionals.”
(Jelphs, 2006, senior fellow at the
Health Services Management
Centre at the University of Birmingham)
Explain that dismissing the value of learning about how to be a more competent communicator is not peculiar to the healthcare field, but a result of the “hindsight bias” or the “I already knew that” phenomenon. The hindsight bias is a phenomenon in which people overestimate their prior knowledge. To demonstrate the concept ask the participants if they have watched TV shows such as Jeopardy, Are You Smarter Than a 5th Grader and/or Who Wants to Be a Millionaire. Remind them of the context in which music is playing while the question or answer is displayed WITHOUT the answer to the question, but when the answer is provided everyone comments, “I knew that.” The reality is that they did not know the answer, but seeing the answer rang true to their personal experience which resulted in an overestimation of their prior knowledge. Because we have been communicating our whole lives and we have communication competencies, it is easy for us to hear information about effective communication and think “I already know that,” but it is important not to fall prey to the hindsight bias or to discount the value of enhancing one’s communication competencies.

5. “A lot of the diagnosis and monitoring functions will be done through little devices— smartphones— by the patient with computer assistance. So it’s a real big change in the model of how we render healthcare.”
-Eric Topol

6. Computer Mediated Communication in Healthcare
How did we get here?
Communication
Electronic Records Records
Patient Education
Telecare
The Health Information Technology for Economic and Clinical Health Act (HITECH Act) legislation was created in 2009 to stimulate the adoption of electronic health records (EHR) and supporting technology in the United States. Beginning in 2001, HITECH provided financial incentives for healthcare providers demonstrating “meaningful use” of EHRs. After 2015, penalties may be levied for failing to demonstrate such use.
EHRs do provide accurate, up-to-date patient information enabling quick access to patient records for more coordinated and efficient care.
Collaboration
Access
Efficient
Cost

7. Activity: Channel-Lean or Channel-Rich?
Write down the most recent technological change that impacts how you intake patient information, document, share or report patient information.
Pair up and discuss how the technology has changed the way you interact with colleagues and patients.
Is the technology channel-lean
or channel-rich?
Where is the patient?
(Animated slide)
(See detailed procedures on page 4 of the Trainer Manual.)
“Channel-Lean” are forms of communication in which the only point of reference for understanding the information or messages are the “words.”
“Channel-Rich” describes face-to-face communication where multiple social cues are available (body language, tone of voice, etc.).
Goal: To demonstrate what communication cues are lost in the use of information communication technologies and the impact from the loss of communication cues.
Materials Needed:
Blank sheet of paper for each participant
Procedures:
Instruct participants to write down the most recent technological change that impacts how they intake, document, share, or report patient information.
Instruct participants to pair up and discuss how this technological change has impacted the way they interact with colleagues and/or patients. Facilitate a discussion in which you point out that information communication technologies are “channel-lean” forms of communication. In other words, the only point of reference for understanding the information or messages are the “words.” In contrast, face-to-face communication is “channel-rich” because multiple social cues are available (body language, tone of voice, etc.).
Divide large group into partnerships. Using their examples of recent technological changes, ask partners to apply their understanding of “channel-lean” and “channel-rich” by comparing /contrasting the communication cues available in face-to-face communication and information communication technologies.
Lead a large group discussion in which the partners share their lists with the large group. More than likely, the following “cues” will be discussed:
Eye contact
Tone of voice
Gestures
Facial expressions
Contextual cues (location and situation)
Posture
Immediate feedback
Physical proximity (space)
Rate of speech (urgency or lack of)
Touch
Smell
How do channel-rich situations impact the ability to deliver quality health care? How do channel-lean situations impact the ability to deliver quality health care? What is gained and lost by using information communication technologies?
Lead a large group discussion in which the partners share their strategies for improving their use of information communication technologies.

8. Remember…
“A computer lets you make more mistakes faster than any invention in human history, with the possible exceptions of handguns and tequila.”
-Mitch Ratcliffe
Discuss how quickly mistakes can happen using mediated forms of communication and the inability to undo a sent message.

9. Advantages of Information and Communication Technologies
Enhances the patient-provider relationship
, social media, text messaging
Electronic health records
Telecare
Effective and rapid information sharing saves patients time and money
Provides patients with better access to medical records
Increases patient education
(Koivunen, Niemi, and Hupli, 2015)
Explain that there are significant advantages to using information and communication technologies. (Provide some examples specific to your healthcare setting.)

10. Disadvantages of Information and Communication Technologies
Diminishes face-to-face contacts
Diminishes collaborative diagnosis
Increases possibilities of misunderstandings
Increases workload from the volume of s
Increased potential for information loss
Can lead to “nursing the chart rather than nursing the patient.”
(Avison and Youndg, 2007; Koivunen, Niemi, and Hupli, 2015)
However, technologies encourage one to ignore the relationship dimension of a message. Technologies encourage one to prioritize the interaction or documentation of information and to ignore the human interaction component. Explain that messages have two dimensions: a task dimension and a relationship dimension. Both are important but need to be carefully balanced to ensure that the relationship dimension is not negatively impacted by the delivery of the task information. Continue this discussion with the activity in the next slide.

11. “Body language: Some say it’s just about 65%” ...(Burgoon, 1994)
(Animated slide)
Explain that, as can be seen on the chart, body language is the majority of the message when dealing with messages related to feelings and attitudes.
To illustrate this point ask the participants to use body language and non-verbal communication to explain the meaning of the word “turnip” as a type of vegetable. Emphasize that communicating this type of information can’t be done adequately through social cues. Next, ask participants to convey how they feel about the taste of a turnip, again using only body language and non-verbal communication. Emphasize that feelings and attitudes can be portrayed using social cues like body language and non-verbal communication.
Follow up by asking the participants to use the word “fine.” Ask one person to say, “How are you?” and have another respond using “fine” with a positive tone and then a negative tone. Note that the word doesn’t change, but the meaning does.
(Definition: Paralanguage refers to tone of voice and other non-verbal cues.)
Based on the work by Albert Mehrabian

12. WIIFM: What’s in it for me?
Effective use of information and communication technologies can enhance inter-professional collaboration.
Effective use of information and communication technologies is essential to the delivery of high quality health care.
Poor use of information and communication technologies is a common contributor of unintended patient harm.
It is important to understand the impact of information and communication technologies on the delivery of quality healthcare.
Remind participants why this information is relevant to them. (Try to use specific examples from your health care setting.)

13. Activity: Change the TECHNOLOGY How effectively do you use information communication technologies?
Individual work first
Review last three text messages
Review last three phone calls
Review last three job related mediated forms of communication (patient education, shift reports, electronic medical records, etc.)
Pair up and discuss observations
(Animated slide)
(See detailed procedures on page 6 of the Trainer Manual.)
(Note: “mediated forms of communication” are defined as human communication that occurs through the use of two or more electronic devices).
Goal: To demonstrate the advantages and disadvantages of information communication technologies in the delivery of healthcare.
Materials:
Blank sheet of paper for each participant
Procedures:
Instruct the participants to individually complete parts 1 – 3.
Provide the following instructions:
Part One: Using your cell phones, read the last three cell phone text messages that you sent and note the following on the sheet of paper provided:
Why did you send the message via text rather than use another technology (e.g. phone call or )?
Did you use abbreviated type-- txt msg or full sentences? Why or why not?
Finally, what if you were required to use a different technology to send the same message? What would change? (your degree of comfort? the content of the message? ) Write down a few of your thoughts.
Part Two: Using your cell phone again, list your last three phone conversations.
How were the messages similar or different to those you texted? Why?
Did the types of people differ based on the different technologies?
Make notes of any other observations you notice:
Were the emotional contexts different?
Were there nonverbal elements left out or added in?
Was it easier to express (communicate) your feelings vs. assigning tasks using one technology compared to the other?
Part Three: Write down the last three times you used a mediated form of communication to communicate while performing job duties. (Note: “mediated forms of communication” are defined as human communication that occurs through the use of two or more electronic devices).
Why did you use a communication technology?
Would another form of communication been more effective? Channel-rich or channel-lean? Why or why not?
Would you have changed the message if you had communicated with the person face-to-face? Why or why not?
Make notes of any other observations you notice (see previous questions in Part Two).
3. Instruct participants to pair up and share their observations of each of the three parts of this activity.
4. Lead a large group discussion in which the partners share their observations and discuss strategies for improving their use of information communication technologies.

14. Large Group Report Out
Option: what is our next step—how can we integrate this information into our day-to-day work environment? Or, if you could share one thing you learned today with a colleague, what would it be?

15. Thank you!
Questions? Comments?