MAKING THE CONNECTION FOR HEALTH

A Digital Tool to Bring Green Space Use Recommendations into the Medical Exam Room

Presenter: Lisa Brandabur Kremer, MD

Presenter Status: Graduate student

Academic Year: 22-23

Semester: Spring

Faculty Mentor: Fawn Canady

Department: Graduate and Executive Programs

Funding Source/Sponsor: Class Project

President's Strategic Plan Goal: Connectivity and Community Engagement

Abstract:
Abstract BACKGROUND Influencing patient behavior change in a healthcare setting is a complex endeavor involving multiple aspects of an individual's life and the society around them. Industrialized societies are suffering from chronic illnesses caused by an increasingly sedentary lifestyle and the mental health results of our desk-bound isolation(Tikkanen, R., and Abrams, M., 2020). The exploration of how medical practitioners can positively influence their patients led to the realization that the practitioners themselves are in need of healing(Murthy, 2022). An investigation into the bidirectional relationship of humans to the natural environment led to the development of this thesis. Outdoor activity and communing with nature provide mental and physical health benefits, and the bond with nature is associated with an increased likelihood of human pro-environmental behaviors(Jennings, Yun & Larson, 2016). Reconnecting Healthcare practitioners with nurturing recommendations fostering health and community is a step towards recapturing the mission of most Healthcare workers: to provide care to keep their patients in the best health possible(Murthy, 2022). Because the website describing the fifty Sonoma County Regional Parks have information arranged geographically, recommendations by activity can require a time-consuming search through many park sites. In this project we explore using the technology of a website organized by park activity and EPIC Electronic Medical Record to expand the healing role of nature in medicine. RESEARCH QUESTIONS Is it possible for a Medical Practitioner to connect the patient to individualized recommendations of greenspace use during a routine medical appointment. Q1: Can the EHR be used to connect to an outside website Q2: Can a website designed in an inverted fashion by activity be used to create individualized recommendations within the time constraints of a routine medical appointment? METHODS In a previous project, a website was created to streamline the search process. Four website testers were recruited through convenience sampling and timed while completing two tasks designed to assess connectivity of the website to the EHR, and functionality of the website in creating real-time recommendations. 1). while using the EPIC electronic Medical Record and a simulated patient encounter, testers were asked to read a pre-populated patient history and physical exam, and then access the website from the patient record. 2). Testers were then asked to create an assessment and recommendation from the website by placing names of the Sonoma County Regional Parks that offer the recommended activity in the templated Patient Instructions, and printing the After Visit Summary. RESULTS All four testers were able to perform both tasks within the designated time frame. These results show that connectivity of the medical office visit using the EHR to create individualized recommendations for green space use is possible, and that a simple website design allows a rapid search and creation of recommendations within the confines of a standard office visit. FUTURE DIRECTIONS An expanded partnership between the Sutter Medical Group of the Redwoods and local greenspace organizations is being explored. Ways in which this could be enacted include formal support for website design and upkeep, visible Medical Group partnership in park volunteer activities, and educational signage in the medical clinics describing programs available at the parks. Jennings V, Yun J, Larson L. 2016, Finding Common Ground: Environmental Ethics, Social Justice, and a Sustainable Path for Nature-Based Health Promotion. Healthcare. 4(3):61. https://doi.org/10.3390/healthcare4030061 Murthy, V., 2022, Health Worker Burnout, Priorities of the Surgeon General, US Department of Health and Human Services, Office of the Surgeon General. https://www.hhs.gov/surgeongeneral/priorities/health-worker-burnout/index.html Tikkanen, R., and Abrams, M.K., 2020, U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? Commonwealth Fund, . https://doi.org/10.26099/7avy-fc29