Personalizing Feedback

In most doctors’ appointments, patients are given feedback on their health status, recommendations to improve their health, or both by their physician. Provision of feedback and recommendations are opportunities for physicians to foster patient engagement and cement patient adherence to treatment plans, but only if done right. Personalizing feedback and recommendations can enhance their impact on the patient and improve quality of care.

A number of recent qualitative studies have explored how personalized rather than general recommendations can impact patient care in a positive way. One such assessment of clinician opinions on providing recommendations to patients concluded that suggestions given to patients should be more individualized. General lifestyle recommendations such as “exercise more” or “follow a healthier diet” do not resonate with the patient, nor are they easy to follow. They leave the patient feeling helpless and, according to one physician, “do not translate into people’s lives.” Therefore, according to this review, “effective approaches to lifestyle behavior change require individualization and personalization”.

The feedback providers give to patients should be more personalized as well. Effectively communicating test results or reviewing progress reports is necessary for the patient to understand his or her health status. A recent review of the literature identified “five interdependent characteristics of health-related feedback” in order to determine how to most effectively deliver feedback messages about behavioral or disease risk. These five characteristics were: clarity of the feedback message, personal meaningfulness of the feedback, frequency of the feedback, guidance and support accompanying the feedback, and interplay between feedback and patient characteristics. What is required is a systematic approach to care that is collaborative and personalized to the individual.

Personalized health planning (PHP) is an operational model or clinical workflow developed at Duke that fosters patient engagement through a collaborative health goal setting process that personalizes both recommendations and feedback. In the PHP model, the patient begins by completing a health self-assessment, through which they identify their priorities and values in life and determine what they want their health for. It lets the individual identify the areas where they are motivated to make lifestyle changes based on what’s important to them. Following this self-assessment, patient and provider engage in shared goal setting and create a personalized health plan for the patient to follow. If done well, this process has the potential to drastically increase the personalization of recommendations and feedback given to the patient. First, the emphasis on patient-driven health care within the PHP model encourages providers to frame their recommendations and feedback in the context of the patient’s priorities and what they believe is important to them. Second, personalized health planning can make general recommendations highly specific and actionable through use of the SMART goal setting methodology. Goals that are Specific, Measurable, Action Oriented, Realistic, Timed, and based on the input of the patient are more likely to translate into lifestyle changes that enhance health and mitigate the development of chronic disease.

For more on the personalized health-planning model, see here. This model can inform and ultimately improve the process by which providers give recommendations and feedback to patients.

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