The vastness of the internet is both a blessing and a curse for healthcare stakeholders. It can be a research tool where users can find answers and be more informed about matters regarding their health, for instance. But widely available clinical information can come at the cost of misinformation and misdiagnoses if individuals rely solely on information found online, and some experts argue excluding providers as an information resource threatens the art of medicine.
Healthcare organizations and search engines have proactively tried to eliminate any misinformation and ensure the quality of online information is high. Last February, Google worked with physicians from Rochester, Minn.-based Mayo Clinic to fact check the results of 400 health-related web searches. More recently, Google rolled out its "symptom search" feature. With the help of Boston-based HarvardMedicalSchool and Mayo Clinic, Google created "digital cards" that will appear at the top of search results when somebody enters a health-related search. The cards will mention if the patient can self-treat the ailment or should seek professional medical care.
Patients seeking answers to health questions on their own is generally a positive thing, but when they diagnose themselves using the internet, it can turn dangerous, says Michael Warner, MD, CMO of digital health platform Ask The Doctor.
"Patients using [the internet] to self-diagnose 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," Dr. Warner said in emailed comments to Becker's Hospital Review. "Patients may misdiagnose themselves and may even demand investigations or treatments based on their self-diagnosis without taking into consideration other potentially important symptoms or past conditions."
Dr. Warner says tools like symptom search still carry an "unknown degree of accuracy" but patients view such tools as an alternative to a physician assessment. Google doesn't seem to have a solid stance on this issue. On one hand, Google says in a post announcing symptom search it offers information on self-treatment options, but on the other hand, the company says symptom search and all other medical information on Google is for informational purposes only, and individuals should always consult a physician for medical advice.
Self-diagnosing or self-treating can be potentially harmful to patients who may land on an incorrect self-diagnosis or run the risk of confirmation bias. And, solely relying on the internet to do so threatens the practice of medicine and diminishes the expertise with which clinicians examine and diagnose patients, Dr. Warner says. "The art of medicine includes having a doctor ask iterative questions to create a prioritized list of potential diagnoses, then order the appropriate investigations to determine the most likely diagnoses," he says. "If too much emphasis is placed on what Google pulls up as a result rather than this process, the patient has a chance of being misdiagnosed."
If the art of listening to patients to arrive at a diagnosis is what is missing in health-related internet searches, that is what Dr. Warner's company Ask The Doctor wants to restore. The platform seeks to personalize healthcare interactions on the internet to provide advice and answers to patients.
Patients submit questions and any supporting information and documentation online to a physician who reviews the information and responds via email. Ask The Doctor combines the convenience of the internet with the personalized attention and expertise of a care provider.
But Dr. Warner says Ask The Doctor is not another telemedicine platform seeking to eliminate travel time and make access to care more convenient; rather, it aims to enhance the interaction between patient and provider.
"We do not focus on making the traditional doctor-patient encounter more convenient. Instead we focus on helping patients who are not serviced well by the traditional doctor-patient encounter or the telemedicine alternative," he says.
Traditional encounters between physicians and patients tend to be transactional, whether done via telemedicine or face-to-face, Dr. Warner says. As such, they don't serve the patients seeking information or advice from a physician, which is what Ask The Doctor intends to do.
The company is essentially a humanized Google. Sending a question to an Ask The Doctor provider can be equated to typing a query in the Google search bar. Physicians working for Ask The Doctor don't write prescriptions or make referrals; rather, they simply give advice, offer insights into diagnoses, provide clinical information and can help interpret test results.
But Dr. Warner acknowledges the powerful role of the internet and that people will continue to turn to Google for answers and information. And he says the internet can be an "excellent source" to glean information if patients use reliable and validated resources. Google has been mindful of that, evidenced by its partnership with Mayo Clinic for symptom search.
Healthcare is in a dichotomous era of digitization and patient engagement. While new technology enables remote monitoring and telecommunication, stakeholders are renewing efforts to connect with and engage patients. While technology can eliminate the need for face-to-face interaction, especially with consumers' growing on-demand mindset, there's still a case for human touch in healthcare.
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