New information technologies in medical practice
13 March, 2017:
New information technologies have entered medical practice. The role of the internet has frequently been investigated regarding advantages and disadvantages. In August, Medscape surveyed 1423 health-care providers, including 847 physicians, and 1103 patients to assess their attitudes toward new emerging technologies in medicine [1]. Here are the most important results of this survey. Further reading can be found in references [2-8].
Smartphones
Smartphone apps to monitor blood glucose levels or cardiac irregularities have already arrived and are in use by many patients. When patients and physicians were asked whether they support taking this technology one step further – using technologies to self-diagnose non-life-threatening medical conditions, twice as many patients as physicians said they did. But half of the respondents agreed that all final diagnoses should be made by a qualified health professional.
Access to physicians' notes
Physicians and patients disagree widely on how much access patients should have to physicians' notes. Twice as many patients as physicians felt they should have access to lab results as soon as they are available, regardless of whether they might cause patients to worry or panic. Physicians wanted to have more control over how and when lab results were released. More than seven of ten physicians felt that they should review all lab results before providing patients with access to the results. Patients with cancer, in particular, exemplify the risks of immediate access to lab results. Patients may be able to see results of such tests as tumor markers – a potentially high-anxiety experience – before their physician has been able to put the results in context.
Electronic health reports
One of the most significant differences between patients and physicians was in their perception of how electronic health reports (EHRs) affect a practice. An overwhelming majority of patients – four out of every five – believe that EHRs help physicians and their staffs work more efficiently. About one out of every two physicians reported that EHRs either made no difference or reduced their efficiency and a majority also reported that EHRs decreased the amount of face-to-face time they had with patients.
Patient portals
Nearly three-quarters of physicians reported the integration of patient portals at their main practice site. However, 53% reported that they rarely used this technology to communicate with patients. Patients, however, seem to prefer having another way to contact their physician and a large majority of them use patient portals.
Telemedicine
Patients and physicians showed similar levels of support for new approaches to delivering and receiving patient care, such as telemedicine and 'doctor on demand' apps for smartphones and tablets. Forty-eight percent of patients felt that telemedicine tools can effectively help solve the shortage of primary-care physicians in the United States, compared with just 35% of physicians. Both patients and physicians continue to value an in-person appointment, even as telemedicine technologies gradually become more available. Patients indicated a much higher degree of comfort than physicians with managing chronic diseases and prescriptions via email or video visit.
Personal encounter
Patients were significantly more concerned with a physician's experience and professional credentials, and much less concerned with the personal connection they felt to a physician. Alternatively, physicians felt that the personal connection they made with patients was the single most important aspect of the patient/physician experience, and that a physician's experience and credentials were less important.
Shared decision-making
A vast majority of patients reported that they preferred their physicians to provide them with options and then come to a decision on their own. However, a significant number of patients – one in five – preferred to take an even greater degree of ownership over their health-care decisions, reporting that they preferred to do research and develop treatment options on their own in advance of an appointment, before then making a decision in consultation with their physician. Some of these results may have some importance for the care of the menopausal woman: providing information via portals can empower women. Staying in contact and being able to answer questions using new technologies can strengthen the doctor–patient relationship; practising shared decision-making, especially when it comes to different treatment options, seems to increase the ownership of therapy by patients.
Johannes Bitzer
Universitatsspital Basel, Basel, Switzerland
References
- Miller G. Physician and patient attitudes toward technology in medicine.
http://www.medscape.com/features/slideshow/public/technology-in-medicine?nlid=109612_3243&src=WNL_md - Terry KJ, Fiore M. Docs willing to share medical practice with patients? Sort of. Medscape News & Perspective, September 22, 2014
http://www.medscape.com/features/slideshow/public/digital-medicine-report - Who owns medical records: 50 state comparison. Health Information & the Law Project
http://www.healthinfolaw.org/comparative-analysis/who-owns-medical-records-50-state-comparison - Peckham C, Kane L, Rosensteel S. Medscape EHR report 2016: physicians rate top EHRs. Medscape News & Perspective, August 25, 2016
http://www.medscape.com/features/slideshow/public/ehr2016 - Sixth annual benchmark study on privacy and security of healthcare data. Ponemon Institute, May 12, 2016
http://www.ponemon.org/library/sixth-annual-benchmark-study-on-privacy-security-of-healthcare-data-1 - Goldzweig CL, Orshansky G, Paige NM, et al. Electronic patient portals: evidence on health outcomes, satisfaction, efficiency, and attitudes: a systematic review. Ann Intern Med 2013;159:677-87
http://www.ncbi.nlm.nih.gov/pubmed/24247673 - Ammenwerth E, Schnell-Inderst P, Hoerbst A. The impact of electronic patient portals on patient care: a systematic review of controlled trials. J Med Internet Res 2012;14:e162
http://www.ncbi.nlm.nih.gov/pubmed/23183044 - 2014 survey: physician appointment wait times and Medicaid and Medicare acceptance rates. Merritt Hawkins
http://www.merritthawkins.com/uploadedfiles/merritthawkings/surveys/mha2014waitsurvpdf.pdf