As the patient engagement juggernaut gathers pace, the National eHealth Collaborative has recently weighed in with a Patient Engagement Framework
This is set out in a very simple and useful tabular format and highlights the symptom checker as key tool to engage the patient. Significantly, it includes the tool under the "Engage Me" column supporting “engage and attract” and “retain and interact” activities.
This really shows how the movement has matured from believing that the patient could be informed by just providing a depositary of information but no real means of making sense of it. Now, the proponents of patient engagement realize that an engaged patient must also be an informed and empowered patient and tools must be provided to the patient to help them make sense of the information. Personally, I have always believed that helping the patient to research their own diagnosis with tools, like a powerful symptom checker, elevates the whole patient engagement movement another few notches. It really is crossing the Rubicon as it encourages patients to engage in the crucial but rarefied domain of formulating a differential diagnosis and clinical reasoning.
Since the patient is an expert on their symptoms, why shouldn’t they be encouraged to do this?
As the Framework also states, the provision of a symptom checker is aligned with Stage 1 of Meaningful Use.
In addition, the Bipartisan Policy Center’s recent report, Improving Quality and Reducing Costs in Health Care: Engaging Consumers Using Electronic Tools found that engaging consumers more fully in their own health and healthcare not only improves the experience of care for patients and their families, but also improves the quality and cost effectiveness of care. The new Accountable Care Organisations and those participating in Patient Centered Medical Home would be well advised to read these documents and make sure that they are offering these tools to their patients.
Lastly some fascinating results from the latest Pew Research survey. They now call those who search online for health information “online diagnosers”.
“When asked if the information found online led them to think they needed the attention of a medical professional, 46% of online diagnosers say that was the case. Thirty‐eight percent of online diagnosers say it was something they could take care of at home and 11% say it was both or in‐between.
When we asked respondents about the accuracy of their initial diagnosis, they reported:
- 41% of online diagnosers say a medical professional confirmed their diagnosis. An additional 2% say a medical professional partially confirmed it.
- 35% say they did not visit a clinician to get a professional opinion.
- 18% say they consulted a medical professional and the clinician either did not agree or offered a different opinion about the condition.
- 1% say their conversation with a clinician was inconclusive.”
It seems that patients are using tools like the symptom checker sensibly and going to see their doctor in almost half the occasions that they do search. Also very impressive is their accuracy rate of 41%-not bad for totally untrained lay people!
It seems increasingly obvious that the patients are a vast, untapped resource for healthcare professionals. Provided with the appropriate tools, like a symptom checker, the patients could be doing a lot of useful work before they even arrive at the consultation. Rather than complaining about patients coming in with lists or print outs, doctors should be channeling their patients' energy and motivation into saving them time and making the consultation more productive and, therefore, satisfying.
The USA today covered the Pew Research and asked their readers whether they “turn to the internet for medical diagnoses”. 85% answered yes!