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Using mHealth to Create the Internet-Enabled Doctor

With WebMD and Google competing for the consumer's attention, providers have to learn how to use digital health tools to their advantage.

By Eric Wicklund

- With sites like WebMD and the newly-reconfigured Google giving consumers healthcare data at their fingertips, providers have to learn how to adapt. Consumers have to understand that they can’t simply go online to have all their healthcare questions answered – in many cases their best resource is still the primary care physician.

So what should a doctor do to get in front of the mHealth-enabled consumer? Michael Warner, MD, a critical care specialist and chief medical officer for Ask The Doctor, recently answered a few questions via e-mail:

Why are consumer-facing sites like WebMD and Google potentially dangerous to people researching healthcare information?

Dr. Warner: Patients who use these sites to search their symptoms may have convinced themselves that they have a certain condition. This may lead them to ignore symptoms that don’t fit with what they feel they have. This is known as confirmation bias.

Additionally, Google fails to address the ‘art’ component of medicine in its symptom search. Medicine is, of course, a science, but it’s also an art. Google is only hitting on the science component by listing out a set of symptoms. This leaves out a critical component of diagnosing. Doctors are taught to take into consideration past conditions and family history, while also asking pointed questions to create a list of potential diagnoses. Then, they order the appropriate investigations to confirm or deny their hypothesis. Patients may now be coming to doctors with a strong position that they have “x” condition, derailing this time-proven process of using the patient’s story to help determine a diagnosis.

READ MORE: Cedars-Sinai Adds 2 More Digital Health Tools for Patient Care

What should doctors be doing to help their patients (and others) who want quicker and easier access to healthcare information?

Dr. Warner:  Physicians should become familiar with the online resources available to patients and identify the best ones. Additionally, including links on the office website to appropriate resources can be helpful for patients looking for a trusted source. Physicians should also take the time to explain why the Internet’s ‘diagnosis’ should be taken with a grain of salt. While Google’s symptom search can provide background information, patients should still consult a physician or healthcare professional to ensure they have the correct diagnosis.

How should a doctor go about creating an online platform that might address these issues?

Dr. Warner: Many patients turn to the Internet because it is more convenient than sitting in a waiting room to have a question answered. If physicians are able to use technology to answer questions, their waiting rooms will be less busy and patients will be happier. Physicians should make themselves available to their patients over secure e-mail. Many healthcare-related questions can be answered over e-mail, as they do not require a physical examination, lab or imaging tests or referral to another physician. Having this option available may dissuade patients from turning to the internet for answers to their healthcare-related questions.

If a provider wants to design the right mobile-enabled site, he/she should know questions to address. So what questions should a consumer ask before turning to sites like Google and WebMD?

READ MORE: New Study Gives mHealth High Marks in Children's Health

Dr. Warner: Question No. 1: Is the problem I am facing emergent or potentially life threatening?

In most cases, patients have a sense of how emergent or dire their medical situation is. For example, a middle-aged man with crushing chest pain will likely contemplate that he could be having a heart attack. If a patient feels he/she may have a condition requiring acute intervention (such as urgent medication or procedure), he/she should call 911 or go directly to the hospital.

Question No. 2: Do I have timely and convenient access to healthcare professional who can help me with my issue?

Patients with seamless access to their own physician are best to seek help from them before scouring the Internet for information. Unfortunately, many patients do not have a primary care practitioner or do not have one who will answer questions over e-mail or offer same day appointments.

Question No. 3: How reliable is the information on the site I am using?

READ MORE: mHealth Apps Aid Remote Monitoring of Elderly Patients

It is difficult for consumers to assess the quality and validity of healthcare information they find online. The best online healthcare information will have the following features:

  • Updated regularly;
  • Have specific author(s) (unlike a site like Wikipedia);
  • Include references from peer-reviewed medical journals;
  • Are not industry (e.g. pharmaceutical) sponsored;
  • Written in “lay” (non-medical) language which is easy to understand and also medically accurate.

Question No. 4: What is the risk to me if I get bad information or if I come to an incorrect conclusion?

There is no substitute to receiving customized answers to one’s health questions directly from a physician. It is possible to arrive at the correct answer to a health-related question using the Internet, but it is far from guaranteed. The patient must consider the downside risk of making a mistake. If this risk is deemed significant, then the patient should seek out advice directly from a physician.

What should consumers look for in a site when they want to research information online?

Dr. Warner: There are different variables a consumer should consider depending on the type of question they have.

The risk of using the Internet is relatively low because consumers seek knowledge rather than actual healthcare. The main risk is getting bad information, compared to the much more dangerous risk of arriving at an incorrect “self-diagnosis.”

For consumers attempting to use the Internet to self-diagnose, they should tread carefully. There is no substitute to having a physician assess a patient’s story and provide a diagnosis or list of potential diagnoses. Any Internet tool designed to fulfill this role will be limited by an incomplete data set about the patient. Platforms that allow the patient to enter some personalized information, such as past medical history, current medication and family history, are more likely to yield reliable answers if this information is evaluated by a physician rather than a computer.

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