Computers changing dynamic of medical consultation

From today’s edition of 6 minutes:
What the computer says about the GP

By Michael Woodhead

Like Charles and Di’s marriage, the doctor-patient relationship is looking a little crowded these days with the computer screen vying for attention, GP researchers have found.

In fact, the way a GP orients his or her computer  – and the screen in particular – says a lot about whether they have an patient-inclusive or patient-exclusive approach, says Dr Christopher Pearce from the Melbourne East General Practice Network.

In a study of 20 general practitioners’ room layouts Dr Pearce and colleagues found that most had adopted a patient-inclusive seating approach, and yet many still excluded the patient from full access to the computer screen.

While most GPs arranged their computers so that patients could see the screens, the patients often had to turn round to view it adequately, or were too far away to see the screen content and had to pull their chair forward, they found.

GPs were also reluctant to share use of the computer keyboard and mouse, they found, and sometimes even the computer printer could be a barrier between the doctor and patient.

Their study, published in the journal Primary Care Informatics (6, 111-117) does not imply that a  patient-excluding computer layout is bad, only that it results in different consultation behaviour patterns, they say.

“The screen now represents a third “face” in the consultation, one that is the object of regard of both the doctor and the patient. The keyboard and mouse are symbols of control over the computer, much in the same way that ownership of the stethoscope indicates status in the relationship,” they conclude.

See the full article here.

Enough health information, already!

Searching for healthcare information has consistently ranked among the most popular search activities on the Web – in fact, in the case of aging baby boomers, it ranks at the top of all Web activities, even higher than using email. So does that mean it has reached saturation point?

eMarketer reports on a new study by Harris Interactive that finds the number of adult Internet users searching for health information has plateaued. It reports: “Harris said that changes in its survey methodology could account for the dip, but its overall finding was that growth in the percentage of adult Internet users who looked for health information online had leveled off.”

It is not believed this is a reflection in the quality of the information. Harris found that “respondents were largely credulous about the health information they found online: 86% of online health searchers said the information they located on the Internet was reliable.”

So doctors will not get a reprieve of patients researching their symptoms on the Internet before fronting up to their surgery!

None of our patients is as smart as all of our patients

Following is an excerpt from a story I wrote that has just been published in Australian Doctor:

It’s not just doctors who are sharing stories on the Internet. In the US, a plethora of sites lets patients post observations on their disease progress and management, and search for similar people and post comments, ask questions, form relationships, etc. Sites in this area include Daily Strength (www.dailystrength.org), Caring.com (www.caring.com) and Trusera (www.trusera.com).

The one getting the most publicity at the moment is PatientsLikeMe (www.patientslikeme.com), which boasts as members thousands of people with diseases such as mood disorders, Parkinson’s disease, multiple sclerosis and amyotrophic lateral sclerosis. Founder David S Williams III says patients get more value from recording their health information when they share results with each another.

Williams says one of the most unexpected things that has happened on the site is the interaction springing from the comments members leave on each others’ profiles. “In many ways comments are not central to the site — forum and private messaging support more in-depth conversations.”But PatientsLikeMe has found that members read other people’s profiles to help them reach an informed person to ask advice and offer personally acquired knowledge to people who will benefit from it.

For patients who want to add a bit of expert advice to the mix, Organized Wisdom (www.organizedwisdom.com) offers a medical search service hand-crafted by ‘guides’ appointed by the site owners. The guides are a mixture of physicians and experienced web users. Sites such as DoublecheckMD (www.doublecheckmd.com) operate like consumer medicine information on steroids — they provide every possible adverse reaction, using natural language recognition to allow consumers to search medical texts and match symptoms with the drugs they’re on.

And of course no description of patient-centred Health 2.0 sites would be complete without mentioning doctor rating sites. One of the newest sites, Vitals.com (www.vitals.com), includes an algorithm extracted from physician peer reviews, while Xoova.com (www.xoova.com) offers a directory, ratings and online appointment bookings.