Docs get mHealth help to handle tough conversations

From the mHealthNews archive
By Eric Wicklund

This just in: Physicians don't know everything. Sometimes they need help, such as in talking to a patient about a sensitive issue.

A 10-year-old mHealth company that has been developing educational content to help consumers handle those awkward discussions is now turning its attention to healthcare providers. Kognito, based in New York, is partnering with the American Academy of Pediatrics to launch "Change Talk: Childhood Obesity," a web-based module and mobile app designed to help providers begin and maintain that conversation with both parents and their children.

Company CEO Ron Goldman said the push to help providers with their side of the conversation came from the providers themselves. Recent surveys conducted by the AAP, he said, indicated physicians "have an interest in how to better manage conversations on health behaviors."

"It goes well beyond just communication skills," said Goldman. "We are helping the doctor improve emotional engagement (and) improve the patient experience."

Kognito could be at the forefront of a wave of mHealth companies that are turning their attention away from the consumer market and looking back at providers. It's a tacit understanding that consumers might be adapting easily to patient-centered healthcare, but providers might need a little help.

That's especially true in conversations about such topics as obesity, sexually transmitted diseases, substance abuse and mental health concerns, such as PTSD (which Kognito has been addressing with the Department of Veterans Affairs). Those conversations require a certain skill to begin and maintain – something called "motivational interviewing."

“Studies suggest that motivational interviewing is an effective model for engaging young patients and their families in conversations about changing behaviors associated with obesity, such as poor diet and lack of physical activity, but we know that successfully managing these conversations and seeing results can be challenging,” said Sandra Hassink, MD, FAAP, medical director of the AAP Institute for Healthy Childhood Weight, in a press release issued by Kognito. “Partnering with Kognito gives us the ability to introduce the first virtual practice environment for health professionals to learn, build and apply motivational interviewing tactics when engaging in conversations with young patients and their families about necessary changes in their health behaviors."

Goldman said Kognito develops an online conversation with an avatar that takes seven to 10 minutes for a provider to complete. Through that session, the provider learns how to help his or her patients (and their family members) identify motivation for and ultimately support behavior changes.

The sessions aren’t meant to offer a cookie-cutter approach to solving problems, Goldman said, adding that sometimes the conversations might be easy and the patients receptive, while other times they won't be so accepting. Not every mother or father will take kindly to a suggestion that their child eats too much or doesn't exercise enough – providers need to know how to choose the right words and tone.

That's why Kognito's Conversation Platform is designed to help providers not only with the first discussion, but offers sessions to continue that conversation.

"The challenge was to come up with scenarios that challenge and engage," Goldman said. "We have to be realistic, and that means being frustrating and difficult."

Goldman expects that the company's arsenal of educational content for consumers can be turned around and modified for providers. "What we have done through the years is build up a growing portfolio of conversations," he said. "We know that motivational interviewing is a model on how to bring about behavioral changes."

Kognito isn't abandoning the consumer-facing side of the business. Recently the company announced a partnership with Active Minds, a Washington, D.C.-based non-profit focused on mental health issues with young adults, to create "At-Risk for College and University Students." The online and mobile platform is designed to help college students recognize psychological distress in fellow students and coach them on helping those friends seek counseling.

“This will help thousands of students learn more about mental illness and suicide risk, but more importantly develop the confidence necessary to help their peers, and ultimately save lives,” said Alison Malmon, the founder of Active Minds, which counts chapters in more than 400 campuses around the country.

In time, this may be an ideal platform for campus health counselors as well.

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