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Using Information Therapy to heal a sick healthcare system

Posted Nov 18 2008 12:13am

Patients and doctors both feel the healthcare system today is sick . One reason for this is because it is so doctor-centric. Healthcare is fragmented and disorganized and there are too many specialists , most of whom have tunnel vision. Often your cardiologist has no idea what your gastroenterologist is doing – and they are so focused on treating the heart or the liver, that they sometimes forget that these belong to a human being ! To reform the healthcare ecosystem we need to put patients at the center !

Patients ( or their relatives and friends) are intelligent and capable; and because they have a lot at stake , they are motivated to get good health care and are willing to invest time and energy if given the right tools to ensure a good outcome. We believe that patients are the largest untapped healthcare resource – we just need to provide the tools direct to patients !

One of the major influences which is rapidly changing the equation between doctor and patient is the easy availability of medical information on the internet. The democratization of medical knowledge has helped to improve the balance of power, so patients no longer feel so exposed and vulnerable. The doctor no longer has a monopoly on medical knowledge, and patients are now hunting for this on their own. After all, knowledge is power ! The trouble is that it’s not easy to find reliable information , and patients often get lost and frustrated. They go to the doctor with reams of internet printouts, and often end up upsetting their doctors in the bargain, because they have to wade through tons of rubbish.

This is why doctors need to take the initiative and prescribe information. Information Therapy means providing the right information; to the right patient; at the right time.

If we agree that information therapy needs to be prescribed, how do we ensure that it is efficiently dispensed ?

One solution would be to have a patient education resource center at every point of clinical care. This would include the doctor's clinic ; the pathology laboratory ; the diagnostic center; the pharmacy ; and the hospital. When someone falls sick, these are their contact points with the healthcare system. Each of these represents an opportunity to educate the patient.

We know that for an information prescription to be effective , this information should be provided at the point at which the patient wants it. All of these are ”moment-of-truth” encounters when a patient wants to know more about his problem and his treatment options. Unfortunately most of these opportunities for educating patients are routinely lost. Patients are being forced to search out information for themselves. While it is true that thanks to google this has become a lot easier to do, the internet is not the most effective form of providing information therapy.

Let’s look at what happens to you when you fall ill today. You meet your doctor, who examines you , makes a tentative diagnosis , advises some tests and scans to confirm the diagnosis ; and possibly writes a prescription. Typically , you get to spend about 15 minutes with your doctor. During this time you have so many questions and are so stressed out that you usually do not retain most of the information your doctor tells you. You then go to the laboratory to get your blood tests done; and then to the diagnostic center to get an x-ray or a scan. You are dying to know what the results of the scan and blood tests mean , but they make no sense to you - and unfortunately , no one is willing to tell you. The standard answer from the technician is - You need to wait to see your doctor , who will explain these results to you. You then has to suffer through another 2 – 3 days of suspense, anxiety and tension, till the next appointment with the doctor. The interaction with the chemist is also not much better . All he does is fill the prescription , but you are still full of unanswered questions. Why this medicine ? What are the side effects ? Is there a cheaper alternative ? The answer is usually the same – Ask your doctor !

This is an unfriendly way of treating the patient, who is forced to wait ; or to use the internet to find information , which may often be wrong, outdated or unreliable. What a waste of the doctor’s precious time and energy . And what a wasteful use of the other healthcare personnel !

Let's look at an alternative scenario. While you are waiting to see your doctor, you can spend time at his clinic’s patient education resource center which has books and videos about the common clinical problems your doctor sees . At the end of the consultation, the doctor writes you an Information Prescription about the possible diagnosis ; and the tests , scans and medicines he has advised . These are “keywords” which you need more information on. This Information Prescription can be filled by any healthcare worker you encounter during your journey through the healthcare system. All you need to do would be to show the prescription and ask for information . The laboratory , the diagnostic center , and the pharmacy would also have a patient education resource center . This could just occupy a corner of about 50 - 100 sq ft and would have a core collection of basic books ; as well as pamphlets for the patient to take home ; and a PC or thin client with an Internet connection with links to reliable websites. If you need help , a staff member ( or another patient !) can help you find the relevant information.

The beauty of patient education is that it is inexpensive and easy to incorporate in daily practice. It should be an integral part of every patient encounter; and also offers the doctor, the laboratory and the diagnostic center a great way of marketing their services. Anyone who takes the time and energy to educate the patient is likely to create a lot of good will and get repeat patients . It also creates increased brand awareness in the community, as reliable health information is valued by patients and family members.

We know that medicines play an important role in helping patients get better , which is why doctors prescribe them . Information has an equally important role to play in medical treatment, and needs to be routinely prescribed and dispensed. This is an effective way of improving the medical care you receive . Every time you visit your doctor, please ask him to prescribe information !

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