People are beginning to question why Virtual Health care hasn’t grown faster. The idea of sitting in your living room, skyping with your family practitioner on a chilly Tuesday afternoon is vividly appealing for all. [Of course this method should only be used for all non-serious cases and routine check-ups.]
A Mass. Doctor does just this frequently. In one particular case, a three-year old patient is terrified of the doctor’s office after a traumatizing surgery, so, Dr. Hartman of Westwood-Mansfield Pediatric Associates checks in on Anish while he’s in the comfort of his own home.
The problem that arises in the article falls back to the faithful issue in life – money.
How does a doctor charge billable hours for time spent online? Where’s the incentive for the doctor to even attempt these types of “New” healthcare techniques. For them Social Media seems to be unneccesary, mostly because of the demand of physcians, they’re needed they don’t have to normally go out there marketing themselves. Truthfully, how many of the doctors out there are going to give up their free evenings to skype with patients, for free? I guess until there’s a way to bill patients for an online/inhome visit, time will only tell.
In the recent Wolters Kluwer Health Point-of-Care survey, Google and Yahoo were cited by 46 percent of physicians as a frequent source of information about patients health, diagnosis, treatment and care. And 60 percent of physicians have admitted to changing their original diagnosis based on internet research.
These seem like alarmingly high numbers. Shouldn't we trust that our doctors are using more sophisticated forms of research than what we have available in our own homes?
What this study did not site is what type of sources the physicians in question were consulting from the search results. It is probably safe to say that most were referencing scholarly journals and other sources. It can also be assumed that they may be referencing online communities comprised of healthcare professionals all over the world. In some cases, the physicians may be doing a more throughout diagnosi.
Psychology Today recommends being "smart" while using these online resources. They recommend people "self-screen - but not self-diagnose." When consulting the internet regarding your personal ailments, consider the source--make sure the information is credible. Also consider the context in which the information is being used. You may want to reference a source like HealthFinder.gov which is ran by the U.S. Department of Health and Human Services, which offers information from trusted sources.
The Wolters Kluwer Health Point-of-Care survey also found that "53 percent (of physicians) believe that easier access to more medial knowledge by patients has had a positive impact on the doctor-patient relationship, leading to more informed discussions with patients." The survey also found that only one in five physicians believe this readily available information has been detrimental and lead to misinformation or an incorrect self-diagnosis.
Although internet diagnosis has some positive aspects, it has to be remembered that it is an easy and slippery slope into being a cyberchondriac.
In October 2009, Eric Topol shared that more has been learned about the underpinnings of disease in the last two and a half years than in the history of man. He shared this at TEDMED, an annual 3 day event with the mission to, "help America and the world understand the great challenges of health and medicine, connect the right people and inspire the leadership we need."
Eric Topol is a leading cardiologist who has embraced the study of genomics and the latest advances in technology to treat chronic disease.
Eric Topol says we'll soon use our smartphones to monitor our vital signs and chronic conditions. At TEDMED, he highlights several of the most important wireless devices in medicine's future -- all helping to keep more of us out of hospital beds.
He identifies many digital wireless devices that he suggests have already changed, and will continue to revolutionize, the way we address consumer driven healthcare. Some of those devices include:
GE's Handheld ultrasound - Vscan™ is a handheld visualization tool based on ultrasound technology providing black and white anatomic and color-coded blood flow images in realtime. It can easily be integrated into physical examinations allowing physicians to add a visual inspection into the body.
Vscan is optimized for clinicians who want a quick inspection of the heart, abdominal organs and urinary bladder and will provide insights into areas of OB/GYN, pleural fluid and motion detection and pediatrics.
iRhythm's Zio Patch - The Zio™ Patch is a breakthrough technology designed to improve the diagnosis of cardiac arrhythmias.It provides up to 14 days of continuous recording, which increases the likelihood of capturing abnormal heart rhythms.
Corventis PiiX - Corventis believes that medical device, wireless and information technologies can be harnessed to enable early detection and timely treatment of cardiovascular events...without impacting patient lifestyle. PiiX is a wearable device that automatically connects and wirelessly transmits phisological data. Designed for patient comfort, PiiX is lightweight, leadless and water-resistent to support continuous use.
Nike + ipod - Take Nike + iPod to the gym and minute by minute, mile by mile, you’re motivated by more than music. Connect your iPod to your cardio machine. Record your pace, time, and distance as you work out. Your iPod wirelessly sends workout data to nikeplus.com from wherever you are on the road. So right after your run, you can track your progress and analyze your performance.
Zeo Sleep Manager - Each morning, Zeo shows you how you really slept, including your time in REM and Deep sleep. Discover how changing lifestyle factors can help you improve your sleep. Take control of your sleep tonight and feel your best.
and Philips' DirectLife - The slow, step-by-step program starts by tracking how much you move every day. We’ll help you set goals and track your progress. We’ll make suggestions about how to increase your activity levels at your own pace, and provide you a personal coach who can help you stay motivated. It’s a program you can stick to for the long term, because it’s custom built for you.
The doctor/patient relationship is changing drastically every day as we involve New Media in more and larger aspects of our heath. We see it every day in ipods that track your steps per day and overall health, automated insulin pumps that regulate healthy dosages for those with diabetes, and tablets in doctors hands as they make their round. Google began to explore personal health records services recently in partnership with the Cleveland Clinic, but may have depended on users too much when it came to data entry, or so Dr. John Moore of MIT's New Media Medicine Group supposes.
"When we launched Google Health, our goal was to create a service that would give people access to their personal health and wellness information. We wanted to translate our successful consumer-centered approach from other domains to healthcare and have a real impact on the day-to-day health experiences of millions of our users.
Now, with a few years of experience, we’ve observed that Google Health is not having the broad impact that we hoped it would. There has been adoption among certain groups of users like tech-savvy patients and their caregivers, and more recently fitness and wellness enthusiasts. But we haven’t found a way to translate that limited usage into widespread adoption in the daily health routines of millions of people. "
A new venture from MIT has picked up where Google Health left off with a slightly different approach.
"CollaboRhythm is a platform that enables patients to be at the center of every interaction in their healthcare with the goal of encouraging them to be involved, reflective, and proactive so that they may become more self-efficacious. It includes relational agents that question and educate patients prior to visits and that help them manage chronic diseases. A collaborative workstation for the office allows for shared decision-making where the patient is actually encouraged to control the system. Data is stored in a patient-controlled health record, so that the patient has access to his or her information in any place at any time. Numerous medical devices for the home and office including glucometers, sphygmomanometers, pulse oximeters, and weight scales feed their data into the system. Finally, the whole system is designed for tele-collaboration. Care can be coordinated through cell phones, televisions, computers, as well as more novel devices like internet media displays."
One of the major concepts is for patients to take control of their health by documenting their health issues as they experience them and the doctors to update the patient's file after each visit. A more complete picture is possible when the doctors and patients collaborate on the file; the doctor on the patient's allergies and ..., the patient on their sleep and exercise patterns, family medical history and current prescriptions, thus giving a more complete view of the patient's health.
In today’s cyber world we are provided with resources and information on anything and everything. We can purchase all our clothing and home furnishings online. We can order a pizza online and have it delivered. We can even visit with a virtual doctor.
The internet provides us with services like WebMD and mobile applications like iTriage that will collect information on our symptoms and ailments then report back to us the possible causes, sicknesses and diseases.
But is this type of self-diagnosis doing more harm than good?
For instance this is what might happen if you ask “Dr. Google” what is wrong with you:
Some doctors feel that these online diagnostics are creating “cyberchondriacs,” a common term used to describe otherwise rational internet users who latch on to the worst diagnosis thrown at them by search engines, message boards and diagnostic services. For example, a user googles the cause of her three day migraine and most of the top results include brain tumor and scattered among the first page are some results about stress and eye sight issues but the user immediate jumps to the worst—brain tumor.
It is also ironic to note that even WebMD recognizes the peril of Cyberchondria buried within their Family Webicine blog from December 2008. But it does not dare to place this warning on its homepage as a valuable reference in easing the imaginations of their users.
So why are more and more people turning to self-diagnosis through the internet? Most health professionals just chalk it up to the rise in general internet usage and the prevalence of hypochondriacs throughout history.
Not only is this practice of online self diagnosis dangerous but it can also be deadly. Some people use the internet to gain piece of mind about an ailment when a doctor's appointment seems unnecessary or too costly without insurance. Some doctors feel that this practice is causing people to feel that regularly scheduled doctors appointments are unnecessary and this will cause a decline in preventative health measures in the long run.
Researcher's at WSU's Parent Health Lab in the School of Medicine received a three-year grant to research and develop a potentially mobile device that will moniter alcohol use in pregnant woman, particularly those who are considered at risk for increased alcohol consumption, which can lead to serious birth defects as well as decreased social and behavioral functions once the child is born.
Dr. Steven Ondersma, Ph.D, who is an associate professor Psychiatry and Behavioral Neurosciences at Wayne State University is leading this study, which he hopes will serve as a foundation for much larger-scale investigations and possible production of handheld mobile devices which will assist doctors and clinicians to ascertain the levels of alcohol used during pregnancy. Additionally the study will also examine how valid the alcohol bio marker, Ethyl Glucuronide is as an indicator of alcohol exposure.
This week I begin my examination of how universities are intersecting with new media and medicine to confront the overwhelming problem of healthcare in the United States.
This from NEWMEDIAMEDICINE – the MIT Media lab. It has a tag which reads: Radical new collaborations catalyzing a revolution in health
So who’s collaborating? On what? And how will this catalyze a revolution in health? And finally – what are they suggesting by “revolution?”
According to the website (http://newmed.media.mit.edu/intro) New Media Medicine is dedicated to shifting the focus on healthcare away from the traditional role of the doctor and giving more agency to the individual who is experiencing the health issue. The organization goes so far as to recommend putting the individual “on an equal footing with doctors, researchers, and other experts.” MIT is working on new technologies that will enable collaborations with individuals and their healthcare professionals and in doing so will allow the individual, it appears, a greater commitment to their wellness.
On the surface one could reasonably ask: isn’t the fact that one is ill reason enough to participate in the cure? But MIT feels that by allowing more involvement in the decision making process regarding therapy the individual participates more enthusiastically and, by virtue of this fact, has a greater chance of recovery. I have to say that this makes sense to me!
At present the team consists of 6 investigators whose expertise range from a medical doctor, to a software engineer, to a communications expert – and all the spaces in between. Each of the collaborators brings a special “heart” to the project and each seems to have a particular area of concentration with regard to the projects.
A short list of the projects includes “Collaborythm” – which is a speech and touch controlled system in which the doctor and patients make collaborative decisions about the patient’s care protocol: http://vimeo.com/4400829; “Collective Discovery” which seeks to interact with patient communities allowing communities to provide collective data and to use data effectively in community-wide practices involving healthcare decisions; and “Weight Mate” – subtitled: “getting to know your food moods” which uses smart phones to track dietary information and return context-sensitive information to the end user regarding trends toward health or illness. And there are more!
Always an innovator in technology, MIT is proving once again to thing strategically, and outside the box, about one of the nation (and the world’s) most pressing concerns.
