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Future of Consumer Healthcare

Future of Consumer Healthcare. Lisa Gualtieri, PhD, ScM , Course Director Tufts University School of Medicine July 22, 2011. “The internet saved my life”. It isn’t easy to find pictures of bat’s teeth. “Armed” with information, Diana educated the people who treated her. e-patient Dave.

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Future of Consumer Healthcare

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  1. Future of Consumer Healthcare Lisa Gualtieri, PhD, ScM, Course Director Tufts University School of Medicine July 22, 2011

  2. “The internet saved my life”

  3. It isn’t easy to find pictures of bat’s teeth

  4. “Armed” with information, Diana educated the people who treated her

  5. e-patient Dave • “Nothing beats a smart partner who listens to you and wants you to do well.”

  6. Janice Adams: “I asked our doctor if I should look something up on the Internet and he said, ‘No. Come and ask me; it’s too frightening if you read the wrong things.’ And we do.”

  7. Volker Wulf: “My sister is a doctor.”

  8. Scott Bateman and Adrian Reetz

  9. Scott’s feet

  10. AnjaHabas-Korbar: “It was easier to get information from the Internet than from doctors… being in pain is motivating.”

  11. Lynda’s story • Linda has vertigo • “I go online all the time” • Specialists have blinders • Ear, nose, and throat doesn’t talk to allergist • Impact of seasonal allergies • Not alone - others have it worse

  12. Nancy Flournoi: “I looked up side effects for my husband’s medication and one was ‘stops breathing’. The doctor didn’t bother to tell him that.”

  13. Ron Perkins: “I don’t find credible sources. Maybe they’re all sponsored by the drug companies?”

  14. What is typical for online health seeking? • Is it Diana? • Is it Dave? • Is it Janice? • Is it Scott? • Is it Anja? • Is it Nancy? • Is it Ron?

  15. People’s use of the web for health • Different frequencies • Different reasons • Different contexts • Different skills • Different needs • Different health literacy skills

  16. Some commonalities • People generally look on their own • Common triggers • Pain • Economic • Immediacy • Determine if doctor needed • Learn what doctor didn’t say • Learn what didn’t ask

  17. Healthcare is changing • Use of the Internet for healthcare directly impacts far more people today than EHRs • Potential to bridge disconnect • Concierge medicine • Shared medical appointments (SMAs) • Walk-in clinics • Telehealth • Home visits

  18. “Don’t ask, don’t tell” • Technology becomes a cognitive prosthetic device for many • Are patients less likely to ask their doctor questions because they plan to look it up?

  19. Interventions can avoid “don’t ask, don’t tell”

  20. Easy to have eye contact with a barista

  21. Technology can get in the way

  22. Idealistic scenario Patients Physicians Technology

  23. Technology can be a partner

  24. Take a historical perspective • Pre-internet…

  25. Marcus Welby brought medicine into our homes

  26. Democratization of medical information

  27. Incredible opportunities!!!

  28. And many pitfalls

  29. Pitfalls include • People using the web instead of a doctor • People using poor quality or deceptive information – the barriers have dropped • People misusing or misunderstanding information • People obsessively searching • People who are scared to death • People confronting their doctors or not telling their doctor about their Dr. Google diagnosis

  30. Patient centeredness - AHRQ • Patient centeredness • Healthcare that establishes a partnership among practitioners, patients, and their families • To ensure that decisions respect patients' wants, needs, and preferences • Patients have the education and support they need to make decisions and participate fully • Patient-centered care • Encourages patients to comply with treatment regimens • Can reduce the chance of misdiagnosis due to poor communication • Has been shown to reduce underuse/overuse of medical services • Can reduce the strain on system resources and save money by reducing the number of diagnostic tests and referrals • Can sometimes increases providers' costs, especially in the short run

  31. How can the pitfalls be avoided Patients Physicians Technology

  32. Better health literacy skillsBetter training of healthcare professionalsBetter health website design

  33. Better health literacy skills • How to search • What to look for – dates, authors, seals • How to communicate with a physician • What to believe

  34. Better training of healthcare professionals • What and when to ask patients about Internet use • What and when to recommend websites • Which sites to recommend • How to increase health literacy skills

  35. Better health website design • Test on real users with mixed health literacy skills in context • Conduct formative evaluations from the start • Have clear health goals and measure success at achieving them • Use better imagery • Clear branding and accreditation

  36. Quality of health websites • Annals of Oncology found nearly 50% of 32 most popular web sites on Complementary and Alternative Medicine for cancer are not good quality • 3 qualified as "outright dangerous“ • Action plan proposed: cancer organizations and other impartial interest groups should investigate websites and create and administer a ‘seal of approval’, for safety and reliability, such as the HONcode • This fundamental study should raise patients’ awareness on the variability of the quality of web sites on CAM for specific diseases.

  37. Accreditation • Works when • Accreditation exists • Processes are transparent • Processes are not criticized • Healthcare consumers know to look • Happens in other domains • Is there a better way in healthcare?

  38. Introduce intermediaries Patients Intermediaries Physicians Technology

  39. Do intermediaries exist now?

  40. Which resources have you used to obtain information on a health-related question?

  41. Healthcare network: Where could the intermediaries be? Government & Policy Makers Health Insurance Pharmacy Health Wholesalers Pharmaceuticals Health Providers Consumers Medical Equipment R&D Laboratories Other Equipment

  42. Intermediaries help patients • How to search and what to search for • How to identify the quality of websites • How to detect the quality of expert-generated content • How to use user-generated content • When to contribute user-generated content • How to communicate with physicians about web use

  43. Intermediaries help physicians • What their patients are doing online • What resources their patients need • How to communicate with patients about web use

  44. Toward a better future Patients Intermediaries Physicians Technology

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