How It Works

How It Works

Origins

The concept for What the Doctor Said grew from Dr Sarah Doyle’s experiences working in a busy emergency department (ED). Sarah noticed many patients and families leaving the ED without a clear understanding of their discharge instructions. She saw the need for a communication system allowing doctors to create and deliver high quality, personalised discharge instructions to patients.
Providing written instructions can assist with discharge communication. Unfortunately, studies show that printed generic resources are commonly at levels of readability that are too high for the general population. Combining common messages with tailored advice and the use of images can also help patients understand their advice but are not standard in current discharge communication practice.

Why it Works

What the Doctor Said addresses these challenges to provide high quality, personalised discharge instructions that doctors can create and send to their patients in seconds.
We found that patients receiving instructions from the WTDS system compared with those receiving usual advice for pain relief were:
  • more satisfied with the instructions
  • more likely to recall their pain medicines
  • more likely to have received information on pain medicine side effects
We launched Version 2.0 of our system as part of a large patient registry for acute respiratory infection in the ED at Perth Children’s Hospital in 2020 where it is still being used today. We are currently working in partnership with the East Metropolitan Health Service in Perth, WA on the OPIOIDS Trial. This trial aims to determine the efficacy of providing advice for oral opioids from the WTDS system to patients being discharged from the ED and surgical outpatient settings. This work has been funded by way of a Future Health Research and Innovation Fund Innovation Seed Grant from the WA Government.

Publications on our system

Doyle S, Pavlos R, Carlson S, Barton K, Bhuiyan M, Boeing B, Borland M, Hoober S, Blyth C Efficacy of Digital Health Tools for a Pediatric Patient Registry: Semistructured Interviews and Interface Usability Testing With Parents and Clinicians JMIR Formative Research 2022;6(1):e29889 doi: 10.2196/29889
Doyle, S. K., Rippey, J. C., Jacques, A., Rea, A. M., Kaiser, B. N., Miller, S. M., & Anstey, M. H. Effect of personalised, mobile‐accessible discharge instructions for patients leaving the emergency department: A randomised controlled trial. Emergency Medicine Australasia 2020 Dec;32(6):967-973. doi: 10.1111/1742-6723.13516. Epub 2020 May 7

References

Engel, K. G. et al. Patient Understanding of Emergency Department Discharge Instructions: Where Are Knowledge Deficits Greatest? Acad Emerg Med 2012 L19(9):E1035–E1044 doi:10.1111/j.1553-2712.2012.01425.x.
Vashi, A. & Rhodes, K. V. “Sign Right Here and You’re Good to Go”: A Content Analysis of Audiotaped Emergency Department Discharge Instructions. Annals of Emergency Medicine 2011:57(4).doi:10.1016/j.annemergmed.2010.08.024

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    We are in the final stages of making Version 3.0 available to all so cannot sign you up just yet.

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    What the Doctor Said has been successfully piloted at two sites and over 1000 sets of instructions have now been provided to patients. We are continuing to develop our system based on research to create the best possible experience. Once the 3.0 is released, we will open up for additional medical providers. We’re happy to chat with you about our system and add you to our list for when 3.0 becomes available.