Computers that Show Recognition of Patients' Symptoms

The goal of automated symptom management has often been nar- rowly defined as collection and reporting of data. Yet, an automated system can do more. These s ystems can mimic h uman reassurance f or patients th at t heir symptoms have been recognized. Patient engagement has long been recognized as central i n s ymptom management. An el ectronic s ystem was b uilt t o co llect the Treatment Related Symptom Checklist (TRSC) and to reassure patients. In this pa per w e di scuss t he de sign of t he s ystem a nd pr ocedures t aken t o s how recognition of pa tients' s ymptoms. The lit erature o n cl inician-patient in terac- tions was r eviewed selectively. Methods used by clinicians to promote patient engagement during m edical hi story were identified. Similar methods w ere i n- corporated i nto t he s ymptom management s ystem i n or der t o f acilitate under- standing by t he pa tient. These i ncluded ( a) co nversational data co llection as opposed t o s urvey s tyle or s tandardized questionnaires, ( b) s hort response phrases indicating understanding of the reported symptom, (c) use of open end- ed questions to reduce asking long lists of symptoms, (d) leading questions that ask fo r confirmation of expected symptoms, (e) re view o f s ymptoms at d esig- nated stages, and (d) alerting patients when computer has informed the clinician about patient-reported symptoms. We are in the process of pilot testing the sys- tem a mong onc ology pa tients i n one hospital. E xamination of e xisting i nfor- matics k nowledge e ases i ntegration o f w ell es tablished p aper-based t ools i nto automated systems.