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The Use of Technology in Medical Practice

How do consumers and HCPs feel about new technologies and their impact on our health system?

Applications and online services are becoming the new normal. Personal computers are ubiquitous in the workplace, and many have 24-hour access through smartphones and a range of other devices. As a result of digital revolution coming to medicine, new tools are becoming available and are starting to be introduced in clinical settings. These include technologies such as mobile phone enabled self-monitoring of physiological metrics or replacements of traditional laboratory tests. These are raising questions about technology’s impact on patient-physician relationship, ethical standards, privacy and security. However, there is limited knowledge about the perceptions and support by consumers and healthcare professionals of these technologies. Kaiser Permanente has had two thirds of its members sign up for online appointment booking, test result collection and email. The US Veterans Administration also has over 600,000 users online. Patient online services can either be a) patient having access to their medical record, being able to view, edit or comment on their electronic health record (EHR) or b) human interaction to generate a personal response to a question, with your doctor or other healthcare worker by email or through a web portal.

The aim of this study is to assess the comfort level of both patients and their providers towards new technologies, and how it might impact on the provision, quality and safety of healthcare. A total of 21,812 healthcare professionals from Medscape responded to a 15 item survey. Consumers also answered the 15 item survey and provided their age and gender information. Healthcare providers who were involved were doctors, nurse practitioners, physician assistants, nurses or medical students. Both healthcare providers and consumers answered questions on the use of new technology, privacy, medical health records, cost and transparency, and lastly on their annual physicals. Statistical analysis used was the chi-square, linear regression and multinomial probit regression. Healthcare provider respondents were younger than consumer respondents with fewer females. Consumers were either college educated, Caucasian or married and the majority of the healthcare providers were doctors in either family medicine, internal medicine or in the pediatric unit. Consumers were more likely to prefer using technology for self-diagnosis (39.66%) of non-life-threatening conditions. Providers were however uneasy about its usage for self-diagnosing (13.80%). Health care providers didn’t support the use of smartphones to perform blood tests (P=0.029) but 50-60% of consumers supported the idea. Consumers expressed higher concerns in terms of privacy than providers (P=0.033).

The overall opinion of new technology in both providers and consumers differed significantly. More than 50% of providers felt it should be mastered to stay up to date; consumers however saw this new technology to be exciting. A number of consumers also felt this new technology is beyond them. For differences in healthcare providers, a higher percentage of physicians preferred the use of technology for diagnosis than medical students or nurses. Though medical students and nurses were interested in new technology, they preferred patients seek professional diagnosis. Doctors and nurses also agreed that patients should have access to doctor’s notes; this could however lead to patients’ anxiety, but will lead to better management of their health. Prior studies also suggest that patients’ access to their medical notes does not result in healthcare utilization. Providers were less willing to accept diagnostic information from their patient through smartphones. Consumers expressed more privacy concerns for new technology than providers; it was, however, surprising that less than half expressed any security concerns. This study had a number of weaknesses such as a small proportion of respondents of the Medscape member participation. Results therefore did not reflect a larger population of medical providers. Future studies are needed to collect in-depth descriptive statistics and diverse samples to further understand differences between consumers and providers. In view of this, an ongoing study at Kaiser Permanente in Oakland has developed a secure messaging portal that has patients’ health records. Patients are made to list their top two health concerns so it is visible to the physician the moment they open the patient charts.

In conclusion it was shown that both consumers and healthcare professionals are supportive of these technologies which can also improve healthcare.

Practice Pearls:

  • With a digital revolution coming to medicine, new tools are becoming available and starting to be introduced in clinical settings.
  • Though both providers and consumers agreed that access to electronic health records may increase patient anxiety, physicians believe that it will lead to better management of health.
  • Understanding the attitude of patients and physicians is beneficial before validation can occur prior to any widespread potential clinical implementation.

References

Boeldt, Debra L et al. “How Consumers and Physicians View New Medical Technology: Comparative Survey.” Ed. Gunther Eysenbach. Journal of Medical Internet Research 17.9 (2015): e215. PMC. Web. 7 July 2016.

De Lusignan, Simon et al. “Patients’ Online Access to Their Electronic Health Records and Linked Online Services: A Systematic Interpretative Review.” BMJ Open 4.9 (2014): e006021. PMC. Web. 7 July 2016.

Brown Adam et al. “The biggest Opportunity and Challenges in Digital Health: Hear from Global Leader!” The diatribe Foundation’s ADA 2016.