Dealing With Patients Who Surf the Net
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This document discusses the rise of e-patients and participatory medicine. It notes that many patients now research health topics online and want to be active partners in their care. It categorizes different types of e-patients and their levels of internet use and involvement. It also describes different physician approaches to e-patients, from internet-hostile to internet-friendly. The document advocates that physicians embrace participatory medicine by encouraging patients' online research and viewing them as collaborators rather than just recipients of care.
![“[Most doctors] really
do like to think they
have ALL the answers.
This will never
change, I am afraid.”
Pew Internet Project e-Patient Survey
Image by caricaturas
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Dealing With Patients Who Surf the Net
- 1. The Informatics Client: Dealing with Patients Who Surf the Net Iris Thiele Isip Tan MD, MSc, FPCP, FPSEM Image from asifthebes http://www.sxc.hu/photo/1060873 3 May 2011 Philippine College of Physicians Annual Convention
- 2. Image from zizzy0104 http://www.sxc.hu/photo/794884 Do you practice Participatory Medicine? Have you met the e-Patient? Are you Internet-hostile?
- 3. Web 1.0 “the mostly read-only Web” Image from liquene http://www.flickr.com/photos/liquene/3900145161/
- 4. Image from adactio http://www.flickr.com/photos/adactio/78600196/ Web 2.0 “the wildly read-write Web”
- 5. Crowd-sourcing Harnessing collective intelligence Image from antigone78 http://www.flickr.com/photos/antigone/457089364/
- 6. Physician as INTERMEDIARY: gatekeeper of health information Image by judepics http://www.flickr.com/photos/judepics/2059494008/
- 7. APOMEDIATION Less reliance on traditional experts Image by migclick http://www.flickr.com/photos/migclick/2535570629/
- 8. “As opposed to the doctor-centric, curative model of the past, the future is going to be patient-centric and proactive.” Elias A. Zerhouni MD, NIH Director Dec 2007 Image by JD Hancock http://www.flickr.com/photos/jdhancock/4100030094/
- 9. “Movement in which networked patients shift from being mere passengers to responsible drivers of their health ... providers encourage and value them as full partners” Society for Participatory Medicine Image by Liz Grace http://www.flickr.com/photos/liz-grace/5078868809/ Participatory Medicine
- 10. Patients as members of collaborative treatment teams Community health decision-making Image fro m http://ww network w.sxc.hu/ photo/98 5516 “Mindfully” involved in treatment Online community/ “Participatory Medicine” support group from Wikipedia
- 11. Image from zizzy0104 http://www.sxc.hu/photo/794884 Do you practice Participatory Medicine? Have you met the e-Patient? Are you Internet-hostile?
- 12. 3 Categories of e-Patients* from Cain, Sarasohn-Kahn & Wayne (2000) “Health e-People: The Online Consumer Experience” The Well Image by WebWizzard http://www.flickr.com/photos/webwizzard/3931165028/ The Acutes Facing a new medical challenge The Chronics Chronic but stable illnesses * Includes caregivers
- 13. Image by iwd http://www.sxc.hu/photo/1129780 60- 5- 30- 65% 1 6% 2 35% 3 The The The Well Acutes Chronics every several few everyday times a months month Internet Access from Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare”
- 14. 8 out of 10 American internet users have searched online for at least 1 major health topic! from Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare”
- 15. Diet, nutrition, Exercise Specific vitamins, or fitness disease or supplements 42% medical problem 51% 66% Prescription or Medical treatment or OTC drugs procedure 40% 51% Health Topics Searched Online from Pew Internet & American Life Project Nov 2004 Survey
- 16. e-patient & Empowerment From Von Knoop at al of Boston Consulting Group (2003) “Vital Signs: e-Health in the United States Severity of Condition High In control Involved Moderate Informed Low Accepting Godlike Partner Supplier Attitude Toward Physician
- 17. From Von Knoop at al of Boston Consulting Group (2003) Image by iwd http://www.sxc.hu/photo/1129780 “Vital Signs: e-Health in the United States 1 2 3 4 Accepting Informed Involved In control Doctor- Doctor- Junior dependent Autonomous dependent & medical but informed patients uninformed partners Rarely go Go online Prefer to Make their online for before or make joint own decision health after MD visit decisions but even if MD information defer to MD disagrees
- 18. “Paradoxically, a patientʼs interest in knowledge may not always accompany an interest in the medical decision making process.” Gerber & Eiser, Journal of Medical Internet Research 2001 Image by nightRPstar http://www.flickr.com/photos/ninjanoodles/1586212326/
- 19. Image by Kurhan http://www.sxc.hu/photo/1314902 Informed decision-maker Knowledge-acquirer Physician-Patient Encounters Gerber & Eiser, Journal of Medical Internet Research 2001
- 20. Image from carbonNYC http://www.flickr.com/photos/carbonnyc/3440688097/ Interested in learning more about the treatment decided on by MD The Knowledge-Acquirer Provides some personal values to the physician Gerber & Eiser, Journal of Medical Internet Research 2001
- 21. http://www.flickr.com/photos/72341818@N00/4555752947/ Extra time to discuss what patient knows Avoid frustration of not being the sole source of information The Informed Decision-Maker Possesses both preference and knowledge Gerber & Eiser, Journal of Medical Internet Research 2001
- 22. Image from zizzy0104 http://www.sxc.hu/photo/794884 Do you practice Participatory Medicine? Have you met the e-Patient? Are you Internet-hostile?
- 23. Image by Niklas Hellerstedt http://www.flickr.com/photos/niklashellerstedt/2414448568/ Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare” Internet-hostile Clearly uncomfortable with, and sometimes seem to feel offended by patientʼs attempts to learn more online
- 24. “[Most doctors] really do like to think they have ALL the answers. This will never change, I am afraid.” Pew Internet Project e-Patient Survey Image by caricaturas http://www.flickr.com/photos/caricaturesbynelson/2031107541/
- 25. Image by southerntabitha http://www.flickr.com/photos/tabithahawk/567135091/ Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare” Internet-friendly Encourages patientʼs online efforts
- 26. Image by Charles Williams http://www.flickr.com/photos/charlesonflickr/3926259585/ Patients will likely seek a “second opinion” on the internet Gerber & Eiser, Journal of Medical Internet Research 2001 The Internet Prescription Recommend websites to the patient
- 29. Look for the HON Code seal Health on the Net Foundation Medical information you can trust! http://www.hon.ch also provides HONtools, HONsearch, HONtopics
- 30. Image by Yogendra174 http://www.flickr.com/photos/yogendra174/4437447471/ Do not underestimate patientsʼ ability to provide useful online resources Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare”
- 31. Image by steved_np3 http://www.sxc.hu/photo/1339516 Do not overestimate the hazards of imperfect online information Database of Adverse Events Related to Internet Use (DAERI) reported only a single case of possible fatality from 2000-2004 Tom Ferguson, MD & the e-Patients Scholars Working Group (2007) “e-patients: how they can help us heal healthcare”
- 32. Image from zizzy0104 http://www.sxc.hu/photo/794884 Do you practice Participatory Medicine? Have you met the e-Patient? Are you Internet-hostile?
- 33. Thank You http://www.endocrine-witch.net @endocrine_witch Image from http://wthr.frumph.net/