More information, please… vs. empirical evidence

November 2, 2007

I have read More information, please from Newsweek Health about the experience of Cleveland Clinic providing clinical information to patients using the Internet

At the Cleveland Clinic, under a program called MyChart, patients are even given access (via a password-protected Web site) to their medical charts. They can get test results, renew prescriptions and request second opinions, among other options. This taboo-breaking initiative—110,000 participants so far, with thousands more signing up every month—has already shown results. Diabetes patients who use MyChart, for example, do a better job of controlling their glucose levels. “There’s no question about the enormity of the change,” says Cosgrove. “We’ve embraced this.”

The article also deals with the growth of health Internet seekers and physicians’ attitude about this fact. I would differentiate these two points. The growth of health Internet seekers is based on empirical evidence but there isn’t enough empirical evidence -or the evidence is not clear enough – about the physicians’ attitude and about how patients manage the information (see the Patient Empowerment Paradox)

As part of the Project Internet Catalonia, a study of the use of the Internet in health related issues among the population at large, the patients’ associations, and the health professionals, had been done using Internet surveys adapted to each one of these groups. I have presented some of the results at Towards a Social Science of Web 2.0 – Health and the Internet: still Web 1. See below some of the key findings related to healthcare professionals and the Internet users:

  • Professionals are connected to Internet and make an intensive use of the Net, mainly for questions related to the search and consultation of information.
  • The use of the Internet as a communication medium with other professionals of the sector is extended among all the professionals, but the levels of use of the Internet or the electronic mail to communicate or interact with their patients or users is scarce.
  • The increase of the information flows available in the Internet has not been accompanied by an increase in its interaction.
  • However, we have to emphasize a tendency that indicates that those professionals who develop their professional practice in competitive markets make more intensive use of the Internet and the electronic mail to interact with their patients or users.
  • Most professionals positively value the relevance of the contents available in the Internet and they do not consider that the patient search for information is negative either for the professional – patient relationship or for the patients’ management of their health.
  • However just a small percentage of professionals recommend their patients to consultation health information on the Internet or even talk about the Internet with them. This is probably due to the lack of time during their face to face visits.
  • Nevertheless, the behaviour of the pharmacists shows us a new case where the factors related to the market oriented context is the key. These professionals do not have time constrictions and are more accessible that the rest of the professionals, given the physical distribution of the pharmacies.

The Internet survey carried out by Internet users shows us:

  • Internet users are characterized by: the high proportion of women, a high education level, easy access to the Internet from their own home, and a high frequency of use. They integrate the use of different sources of information in their activities related to the health. However, physicians are the key source.
  • Women have a more active role than men with all the sources, including the Internet
  • The frequency of use of the Internet for questions related to health is far from the levels that would allow us to talk about ciberchondriacs.
  • The people’s interest on patients support groups as an information source remind us of the importance of lay knowledge, since the utility and the confidence of this source is very high.
  • The main consequence of the Internet use for questions related to health is the increase of information available. Just a low percentage of people makes decisions relative to the diagnosis or treatments of their health problem. This data supports the hypothesis of the people’s consciousness when they manage the inherent tension to the use of the Internet, emphasizing the need of the physicians as an expert.