Digital Empathy | Digital Health & Care Innovation Centre

Summary

'Digital Empathy' employed participatory design methods to investigate the role of empathy within emergent and future models of digital healthcare services, for example, Video Conferencing (VC) consultations. This project had a particular focus on delivering care for people living with long-term conditions, such as diabetes.

A number of factors have an impact on empathy, including patient pre-conceptions and individual characteristics, the behaviours and beliefs of the clinician, and the setting of the consultation. Our overall aim was to explore whether a persons' perception of empathy changes in a digital context, and to identify factors that are deemed important to empathic VC consultation, and specifically to:

Define empathy and digital empathy in the context of health and social care services;
Explore ways to enhance the empathic experience in the treatment of long-term conditions, for example, during a virtual diabetes clinic;
Map the potential for new technology, or the use of existing technology in new ways, to create or enhance digital empathy in the broader context of health and social care.

Image credit: Louise Mather

Empathy in Digital Interaction

Empathic communication has been successful in various telehealth uses, not least in the area of palliative care and psychosocial interventions, where the empathic relationship is a fundamental part of the consultation (van Gurp, van Selm, Vissers, van Leeuwen & Hasselaar, 2015).

The empathic clinician-patient relationship relies on two entities: the behaviours, verbal/non-verbal, intonations etc. of the clinician, and the perceptions of the patient. Some research has demonstrated that there may be no real differences in clinician behaviour on the part of the clinician between digital and face-to-face interviews (Edison, Fleming, Nieman, Stine, Chance & Demiris, 2013); however, the patient may perceive the level of empathy as different. Miller (2011) argues that without the detailed analysis of how and in what way the subtlety of communication changes in clinical video conferencing, and the impact on health service and health outcomes, the uptake by patients and interested clinicians will be necessarily slow due to lack of confidence.

For the individual living with diabetes, quite complex information is often exchanged in consultations. Because of this, other factors may be important to consider in how the consultation is assessed as empathic. For example, the presence of the Diabetes Specialist nurse in the room with the individual may have value as a conveyer of information, technical expert and empathic conduit (Doolittle & Allen, 1997). Situational anxiety that some patients may experience prior to consultation may also be heightened by the digital technology medium and this too may possibly be alleviated by the presence of a health care professional in the room.

Whatever the circumstances and factors that emerge as necessary for video-conferencing (VC) consultations to be judged as empathic, this may require additional training. As such there is a need to investigate and develop ways of expressing our digital personhood and to isolate the factors that are deemed important to empathic VC communication. This may include patient pre-conceptions, or other individual characteristics, and the corresponding behaviours and beliefs of the clinician as well as the setting, including the presence of a diabetes specialist nurse. It is also important to consider how we can develop training in this area.

Empathy is understanding other people’s feelings, having sympathy for the feelings and appreciating them.

Workshop Participant

Findings

Our findings highlighted key factors such as access to shared and meaningful data; clear verbal communication; providing choice of preferred pathways for continued care; presence of the diabetic nurse; preparation and access to information before consultation; and receiving a summary to take away afterwards as some of the key factors that have an impact on empathic VC consultation.

Our recommendations focus on some of the ways in which the existing VC consultations may be enhanced, including visual representation of data and sharing of information. People’s perception of overall empathy in the care they receive, however, is shaped based on multiple interactions with the different people and environments that they interact with on a routine basis beyond their formal consultations with the diabetic consultant.

Emerging themes attempt to describe the ecosystem of diabetes care, such as a team approach between different healthcare professionals, and a choice of preferred pathways for people living with diabetes to receive continued care. These themes are important when considering systemic changes towards creating empathic digital health services in future.