The danger of self-diagnosis
Aleks Krotoski wrote an article in the Guardian not too long ago about the increasing frequency with which people are tending to self-diagnose themselves courtesy access to the web, and specifically Google. She summarizes the findings of a report by Bupa and the London School of Economics:
…most alarmingly, only a quarter of the people surveyed checked the reliability of health information they found online by looking at the credibility of the source. In other words, a typical medical consultation follows this trajectory: 1) you discover a growth, 2) do a Google search, 3) believe the first result that confirms your expectations.
I spoke to Dr .Annabel Bentley, Medical Director at Bupa Health and Wellbeing, and she pointed out that while this is a real danger and that nothing can replace a physical consultation with a doctor, especially in emergency and extreme cases (“there’s a lot of value in seeing patients, no matter what - cultural nuances can be misunderstood or altogether missed over the phone, for example"), there is something to be said for the way in which technology could reduce the burden on the system, especially in the UK (“although asking for a prescription over the phone has some restrictions as there are legal requirements for the doctor prescribing the drugs"). Aleks, for example, also mentions:
NHS Direct's telephone and online services have dramatically reduced the burden on GPs for common ailments – 60% of the more than 350,000 web inquiries every month are completed within the service and don't require any further attention.
Technological solutions looking for a problem
Annabel made a very valid point when she said that startups that are looking to make an impact in this space have to prove how they improve the patient experience, as opposed to being a solution without a properly-defined issue to address. In the US, online services in health have caught on because they often eliminate the need for patients to travel to see their doctor, and therefore reduce costs considerably. In the UK, the Bupa/LSE report found that almost 2 in 3 people would like to access their medical records online, 1 in 3 would text images of their conditions to their doctor and almost half would like to email their doctor. On the occasional days when I realise I have to visit my doctor, I rue over the fact that I can’t just look up his calendar online and slot myself into an opening he may have. Tyler Cowen, an economist who writes the popular Marginal Revolution blog has a similar complaint, he writes that medicine is ‘not impersonal enough’.
Where are the startups that address this need in the UK? Of course, buy-in from medical professionals is vital for this, and in the US Dr. Jay Parkinson and his organisation Hello Health have come to the fore to solve exactly these kind of issues.
Technology in the operating theatre
Following last week’s news of the computer Watson retiring from the hit American quiz show Jeopardy, TechCrunch reported that Watson’s owner IBM has signed a deal with Nuance Communications to research and improve the machine to advance the healthcare industry. From the press release:
The research and technology initiative will combine IBM’s Deep Question Answering (QA), Natural Language Processing, and Machine Learning capabilities with Nuance's speech recognition and Clinical Language Understanding (CLU) solutions for the diagnosis and treatment of patients that provide hospitals, physicians and payers access to critical and timely information.
The technology will take up to 2 years to be ready - it will be interesting to see how it shapes up. This is another example of how technology can assist doctors in their work by using methods that did not really exist decades ago.
Another relevant piece of news is the recent release of DrChrono, an iPad app that will allow doctors to perform a variety of administrative tasks online, such as scheduling patient appointments, writing prescriptions, enabling reminders, taking clinical notes, accessing lab results, and inputting electronic health records. As TechCrunch notes, in the US there is a strong incentive for doctors to start using apps like these as the Obama administration is keen to see all medical records moved online in due course.
Government prodding is crucial to the widespread adoption of technology in health (or, for that matter, in any industry – TVs in the UK mandatorily having to switch from analog to digital by 2012 for example). While reforms like that can arguably be difficult to see through due to the layers of red tape, clearly there is an audience for health issues online. The Save our NHS campaign created recently by a group of individuals is just one example: the petition has gathered more than 29,000 supporters from across the UK in the matter of a few days.
Where does this leave us?
Last week’s Slideshare presentations are a small indication of the growing number of professionals across the world who believe in the power of social media and technology in healthcare. But the adoption of technology in the field needs to be formalised with, for example, an incentives structure like the Obama administration offers. Houston Neal, Director of Marketing at a company called Software Advice writes about this in more detail here, and has spoken to some doctors who are all pro-social media.
Things are certainly changing: a few institutions like the Mayo Clinic, now have a separate Center for Social Media to explore developments in the field, for example. Within reason, healthcare can be hugely bolstered by effective online services that are carefully designed with the patient (or doctor, as the case may be) in mind - resisting this is likely to be futile in the long run.