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04 July 2014

Doctor-Patient Communication over the Internet

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Internet and mobile devices are changing the way people communicate across all areas. In terms of physician-patient communication, many possibilities are opened up, for example, consultations and on-line medical follow-up. No-one doubts that. But new technologies also pose a big challenge for both patients and health professionals. To what extent are these opportunities being seized?

For more than a decade we have been hearing about the wonders of “electronic medical records” and “telemedicine”. Many people in Spain and other European countries already have an electronic clinical record created by a health service. Has this had a positive impact on people’s health? Has it at least made health systems more effective or efficient? As far as I know there is no objective information to be able to respond in the affirmative. One advantage they have brought is that administrative managers of health systems have more knowledge about and control over our medical information. 

In recent years, technology has continued to make advances in a way that the authorities and leading medical companies did not foresee.  Internet is reaching more and more people via mobile devices such as smartphones and tablets, allowing people to go on-line anywhere and at any time. People can now create their own health folder and ask doctors questions over the Internet. However, the main health systems do not allow us access to our personal medical information or to speak with our doctors. The pretext for this is data protection. It may be true that complete security is not guaranteed on the Internet, like in any other area of life. But personally the fact that my medical information is kept by the public system or by a large medical company in a medical record that has been opened without my consent, to which I have no access and I am not allowed to use directly, offers me no sort of guarantee. In fact, at the beginning of February 2014 The Guardian ran an alarming article according to which the National Health Service is considering selling patients’ medical information to the private sector.

There are endless possibilities for improvement, highly affordable systems and applications, even free-of-charge, which patients want to use and many doctors would accept gladly. But, the people in charge of the health system are reluctant to provide resources that encourage patients to become independent. Is it because they feel like they are losing control?

In my opinion, we are witnessing far-reaching changes that will radically transform the way we understand the health system. Just as has always been the way, the attitude of doctors will be decisive factor to determine the change. Traditionally, doctors are cautious when it comes to changing their method of working. This is logical and much appreciated. However, for young doctors using the Internet, smartphones and tablets comes as naturally as breathing. The impending change is therefore just a question of time. There is consistent data that points to this.

A recent international review reported on the possible beneficial impact of doctor-patient communication over the InternetIn Spain there is recent data regarding the use of Internet in relation to health. Javier García León has conducted an interesting critical analysis of this data. The results of the surveys undertaken in Spain are consistent with those conducted in other advanced countries.  Most patients are already willing to use the Internet to talk to their doctors. If these technologies are not used more often and better for doctor-patient communication it is not because patients do not want to, it is because doctors are not quite there yet. But this could all turn around at any time.

In 2011 and 2012 I was lucky enough to help design and launch the qoolife platform which gives patients a private medical folder via cloud computing, allows people to manage their own health and allows doctor-patient communication. As a pioneer of on-line medical consultation, I have been able to experience the advantages and disadvantages of on-line medical practice and share my experience with other doctors and health professionals who have ventured into this area one way or another. I think that most of them would agree with me that the obstacles in the way of change are not put up by patients, but rather by the leading health companies, both public and private. Indeed, most doctors are mentally prepared for the change, or at least young doctors most certainly are.

Rafael Pinilla

Doctor, Psychologist and Economist

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