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Asking the Right Questions to Tell a Better Story

September 21st, 2017 / Angela Liu

Storytelling matters in health care.

This was a lesson I learned right away at CCI. On my second day at work, I found myself at our Safety Net Innovation Network (SNIN) convening, attending a storytelling workshop facilitated by a former Pixar employee. At the training, this master storyteller asked a volunteer tell us about a time she was lost (hiking on a trail, lost her friends, fell into river with her backpack), while he dutifully scribed these main details of the adventure on the wall.

Afterwards, we collectively interrogated the volunteer to flesh out details of her story: How did you feel when you fell in? What happened to the backpack? How did your friends react? The facilitator then re-told the story, adding in the additional sensory and emotional dimensions that we’d teased out by asking those questions.

I’m always quietly awed at the power of a well-crafted story to engage listeners and spark empathy. But as SNIN sought to demonstrate to attendees, it can also helps us better care for patients.

How? I’m convinced that one answer to this question lies within health care data analytics and population health management. I imagine the data in electronic health records as a source of many potential stories, with each patient record representing one person’s health care journey; when we look at these encounters in aggregate, we can gain insight into trends that tell a population-level story. These insights can impact how providers deliver care – but, like the Pixar workshop showed me, we have to be asking the right questions.

As part of our summer sprint of data analytics webinars for the Safety Net Analytics Program - Los Angeles (SNAP-LA), Jason Cunningham and Dana Valley of West County Health Centers described how they do just that in their Tableau in Action webinar. Since implementing Tableau, a business intelligence and analytics software, in their clinics, West County has put their health care data into the hands of their frontline staff in the form of customized data dashboards. The dashboards vary widely, but several common characteristics: they were developed responsively to staff needs; they display data in a visually appealing way; and they provide the options to drill down from big to small picture.

A West County provider working on preventing heart attacks and stroke in our PHASE program checking up on their hypertensive patients can ask, How many of my patients with hypertension have it under control?, and immediately get an answer by pulling up the hypertension Tableau dashboard that displays these patient panels. Another screen displays tobacco screening rates by provider in a horizontal bar graph, with each bar stylized in white and yellow to echo the appearance of a cigarette.

Many of the dashboards also allow the user to slice the population in different ways: by age, by co-morbidity, by risk factor, by location. With these tools, it’s easy (and exciting) to imagine the rabbit hole of questions one can go down: How many of these hypertensive patients also have diabetes? Who are these patients and when are they next coming in? How can we intervene during that visit to ensure we address these issues?

Health care challenges are complex and multidimensional. That’s why all stakeholders – front-line staff, data analysts, administrators, and leadership – must look at the data and keep asking questions to see the full story of what’s happening in the safety net and how we can address the most pressing challenges together.

The right questions are ones that clarify. They inspire you to think in new ways and challenge old assumptions. They force you to reflect and drive a dialogue.

Asking the right questions allow us to flesh out a more complete picture of patients’ stories; these stories can ultimately inform more actionable, strategic, and effective care plans. And these stories are essential to engaging and sparking empathy.