Emerging Patterns of Communication in a Pharmacist-Patient Health Information System

1 Introduction Communication between healthcare professionals and patients is a major determinant of patients' satisfaction, patients' adherence, health outcomes, and ultimately of healthcare costs [1]. In most cases, however, personal communication between a healthcare professional and a patient is restricted to episodic face-to-face encounters. Once the face-to-face encounter comes to an end, structured communication ends. The absence of structured communication in time intervals between face-to-face encounters is a defining characteristic of current healthcare professional-patient interaction [2,3]. As a consequence, healthcare professionals lack the ability to guide patients outside the institutional space and to adjust supportive measures depending on particular situations and needs that arise during the therapeutic process. Pharmacist-Patient Health Information Systems (PPHIS) aim to address this limitation by enabling structured communication between a pharmacist and a patient subsequent to their episodic face-to-face encounter [2,3]. In multiple build and evaluation cycles and in close collaboration with 21 Swiss pharmacies over the duration of three years, a PPHIS prototype has been developed and continuously improved, following the design science research paradigm [4,5]. Research in this field has resulted in design principles for PPHIS [2], in the development of several PPHIS prototypes, and suggested a methodology for evaluating emerging patterns of communication between pharmacists and patients [3]. The current work builds upon this research and asks the following research question: What patterns of communication emerge in a PPHIS? This work specifically focuses on nutrition counseling in the context of diabetes mellitus and obesity. Nutrition counseling was so far limited to the face-to-face encounter in the pharmacy. Guidance of the patient and support of behavioral changes outside the pharmacy was not available in traditional counseling regimens although its effectiveness has been shown [6]. Nutritional counseling employing the PPHIS allows for structured communication subsequently to the face-to-face encounter, thus fundamentally expanding and augmenting healthcare professional-patient communication. In the following, the PPHIS and first results are described.