Making patient care possible with an innovative solution

The patient, who lost her hearing in the mid-1980s, had begun to skip doctors’ appointments of late because to her, there was no use going.

She could never understand what a doctor was saying to her. The one appointment she kept was her annual mammogram. Last July, she received news that she had breast cancer.

The patient, who could once hear, does not know American Sign Language or how to read lips. When her breast surgeon, Dr. Michelle DeWing, had her first appointment with the patient, she used a white board, jotting explanations on a white board, then erasing them, in an effort to communicate. The patient’s daughter, who is also hard of hearing but can read lips, accompanied her mom to the appointment, which lasted 2.5 hours. The family has a hereditary condition that affects the nerves in their ears, leading to hearing loss.

After the lengthy appointment, Dr. DeWing reached out to Hector Moreno, an Americans with Disabilities Act coordinator, who works to provide access to medical care for patients who have special needs.

“I’m trying to put myself in their shoes and figure out what they need to battle this,’’ Moreno said. “She’s not coming here to be checked for some mild symptoms; this is a diagnosis that most people fear.’’

Moreno went to work and devised a system that the patient calls “a godsend’’ that has enabled her to communicate in real time with her provider and caregivers. Since the woman’s diagnosis came during the pandemic, one of the first things Moreno did was get clear masks for Dr. DeWing. That way, the patient’s daughter could read her lips.

Next, Moreno created a system, never before used at UCHealth, to provide real-time captioning on an iPad. The patient communicates with the doctor by reading captions – a transcript of the physician’s explanation. Then, the patient, who speaks clearly, responds to the doctor with questions.

“This is a medical condition, and we have to know every single thing that I have to take care of her: appointments, surgery dates, more appointments and it is every week. It’s important to know what the doctors are saying while they are treating her — it is very important,’’ the patient’s daughter said. “She needs the information first-hand from her provider, it shouldn’t be ‘tell me,’ and then I write it down for her. … This has been amazing.’’

Because patient privacy is a priority at UCHealth, Moreno worked with IT to ensure that all communication was via a secure WiFi connection, so HIPAA laws were followed. He also contracted with a live streaming captioning vendor and purchased items needed to secure the iPad to a pole, secured to a platform on wheels.

The patient was so grateful and tickled by Moreno’s innovative solution, she named it “Lucy’’ after Lucille Ball.

“They are constantly glad,’’ Moreno said. “They had not been able to get help with communication anywhere. It got to the point where this lady would only go out a few times a year to doctors’ appointments because it was frustrating.

“On top of that, we have the pandemic. And now everyone is wearing masks, so her daughter can’t even read anyone’s lips. … So it was extremely challenging,’’ Moreno said.

Moreno keeps track of the patient’s appointments, and books the vendor who provides the real-time captioning in one-hour increments. He has attended the patient’s radiation and follow-up appointments.

“I cannot imagine being in her shoes. In our mission statement, it says we improve lives in big ways and small ways. This is a small thing, but it is big for the patients. It’s her story, it’s her life,’’ he said. “At the end of the day, you go home thinking, ‘I think I did the right thing by facilitating communication for her.’’’