Monday, October 11, 2010

Doctor-Patient Interaction and Web 2.0

This is a guest post by Joy Paley. has been covering interesting medical uses for Web 2.0, such as using Twitter to find out real time information about Swine Flu. Web 2.0 is defined by interactivity: it allows people to contribute in new ways to the Net, and in response they find that they can get more out of it.

But, while 2.0 can be a fun and useful tool for disseminating medical info, are there any potential institutional uses of Web 2.0 for medicine? A new paper from the symposium The Effects of Health Information Technology on the Physician-Patient Relationship explores just that. Two medical ethicists, Bernard Lo and Lindsay Parham, discuss emerging uses of Web 2.0 in physician-patient interaction and the potential issues that they bring. Here’s a summary of their findings.

Potential medical uses of 2.0 technology

Personally controlled health records (PCHRs): PCHRs can be thought of as the Web 2.0 of electronic medical records (EMRs). While EMRs are controlled only by health professionals at clinics and hospitals, personally controlled health records would allow patients, from their home, to input health information into their chart. The paper gives the example of a diabetic patient inputting their blood glucose levels, in order to provide a more comprehensive health record.
• Physician-rated websites: Today, up to three-quarters of Internet users search for health information on the Net. However, research also points out that most people never check the websites they are reading for signs that the information is accurate, such as a date, references, or physician review of the site. Websites clearly rated by physicians could give those surfing for health info a quick and easy way to determine if what they’re reading is trustworthy.
• Health-based social networking sites: One important aspect of Web 2.0 is the idea of collective knowledge. And, while many already seek group help in forums or chats based on specific health concerns, health-specific social networks could be a more streamlined and efficient way to facilitate this interaction. 

Potential Benefits and Issues

Increased patient interactivity in their own health care could bring a lot of potential benefits, many of which focus on increasing the flow of information and enabling patients.

• Bettering the information in health records by using PCHRs could lead to more accurate diagnosis and treatment.
• Rather than completely depending on the doctor for explanations of technical issues, patients could use the Internet to further their understanding.
• Giving patients more power over their own health could make them more committed to bettering their health.
• The greater exchange of information could lead to a stronger relationship between doctor and patient. Instead of spending clinical visits exchanging basic information (which would have already been conveyed by PCHR and email) the two could discuss more detailed information about the patient’s situation.

However, as you might expect, the crossroads of medicine and Web 2.0 isn’t without its issues, many of which center around the problems of inaccurate information and privacy.

• While the personally controlled health record allows patients more interactivity, there is the chance that patients might enter misleading or wrong information onto their chart.
• As social networks have gained in popularity, it has become clear that people are willing to share reams of private information on them; combining this with personal health information could be problematic.
• The great wealth of info on the Internet puts patients in a more empowered role, one that could potentially affect the doctor-patient relationship in a straining way. While patients might feel helpful bringing outside information to their doctor, many doctors see this as a frustrating decrease in the efficiency of visits.

The paper’s authors ended their examination of Web 2.0 and the doctor-patient relationship by calling on society to make sure this new technology impacts medicine in an ethically viable way: “Laws, regulations, and incentives can enhance the benefits of these information innovations, reduce their risks and burdens, and provide more equitable access.”

Joy Paley is a blogger for An Apple A Day and a writer specializing in online nursing programs for Guide to Healthcare Schools.

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