The way most doctors and health care professionals do their jobs has hardly changed over the past thirty to forty years. Contrast this with the enormous changes in, transport, manufacturing and telecommunications.
The combination of technological change, the demands of business and the rise of consumerism are causing radical changes in the way healthcare is practiced around the world. President Obama, with his promotion of information technology, broadband networks and electronic health records, is poised to accelerate these changes in health practices. They will be the 21st century’s equivalent of the public health initiatives of sanitation and nutrition which revolutionized healthcare in the twentieth century. Integration of online technologies will see doctors and patients working together using shared electronic health records with patients having much more say in their treatments. The development of widely available broadband networks and video mail will eventually bring electronically delivered healthcare into everyone’s home.
3 processes are underlying these dramatic changes across the health industry:
1. Evolution: The evolutionary processes are the new tools, the hardware and software of the computer industries; and changed business processes in healthcare. We need to substantially redesign many of the traditional processes used to practice medicine so that we can take advantage of the new available multimedia technologies. Technology, and in particular, Internet technology, is transforming the medical landscape. As a practicing physician, I no longer write any notes on paper – all my clinical work is electronically recorded. House staff attend rounds armed with a vast array of reference information stored in hand-held personal digital assistants. The iPod is their reception platform for lectures presented as podcasts and vodcasts.
2. Revolution: The revolutionary changes are easier access to information and knowledge on the Internet, leading to fundamental transformations are occurring in the area of healthcare delivery. Patients are increasingly expert in their own diseases and have more collaborative relationships with their doctors. The provision of clinical care is changing rapidly as information technologies become increasingly used and accepted, with a move away from episodic care to concentrating on continuity of care, especially for patients with chronic disease who will create the greatest disease burden in the future. Care is gradually moving away from a focus on the service provider to that of the informed individualized patient and from an individual provider approach to treatment to a team approach. Increasingly, less focus is placed on treating the illness and more is placed on wellness promotion and illness prevention. This is the model of “Information Age Healthcare.”
3. Devolution; The devolutionary changes will see organizations becoming more localized and less hierarchical. The world of healthcare will be flatter than it is now. Over the next fifty or so years large hospitals as we know them will reduce in number, leaving fewer centers of expertise staffed by super-specialist doctors and other health professionals. Healthcare will become a more distributed enterprise. We will be able to increasingly concentrate our scarce health resources on wellness promotion, instead of just the treatment of illness. There will be more resources available, for instance, to undertake the mass immunization campaigns that we need around the world.
Our health system has to meet the challenges contained in the crucially important report from the Committee on Quality Healthcare in America published by the Institute of Medicine. This influential report noted that “information technology must play a central role in the redesign of the healthcare system.” It is wonderful to see President Obama driving the current widely acknowledged broken US Health system in this direction and it is essential that he is strongly supported in this endeavor.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
Thursday, February 19, 2009
Tuesday, February 17, 2009
5 tips to make the most of your medical consultation
What are the most important questions to ask your doctor to make sure you get the most out of your consultation, and consequently receive the most appropriate treatment?
Consultations with your doctor can be rushed and stressful, and it is common for patients to forget to ask key questions during the actual consultation itself. How can you make sure that you remember to ask the questions that are of most concern to you?
As a practicing physician, here are my suggestions:
1. Do as much research as possible before you see your doctor – let’s face it you don't go and see your accountant to do your taxes without collecting information beforehand, and thinking about the issues you want to discuss. Do the same with your doctor. The Internet is the easiest source of information to use, and the US Government Agency for Healthcare Research and Quality (AHRQ) has an excellent site where you will find a comprehensive series of questions on many different health topics.
2. Write down your questions - and if necessary take a list with you, including a second copy for your doctor.
3. Prioritize your questions - ask the most important ones first - don't waste time asking about the payment process when you are really worried about whether you have cancer or diabetes.
4. Take someone with you if you have questions that are really concerning you - two sets of ears are better than one - and make sure you have discussed your needs with your friend or family member before the consultation so that they can help you get answers if necessary.
5 Write down the answers - even if this is just a rapid note. Research has shown that only 20% of the information given during a medical consultation is remembered one week later - but if it's written down, the percentage recall is much higher
Asking good questions is essential in any medical consultation, and it is incumbent on patients to take responsibility for their health and find out as much as possible of relevance so that they can make good decisions in partnership with their doctors.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.What are the most important questions to ask your doctor to make sure you get the most out of your consultation, and consequently receive the most appropriate treatment?
Consultations with your doctor can be rushed and stressful, and it is common for patients to forget to ask key questions during the actual consultation itself. How can you make sure that you remember to ask the questions that are of most concern to you?
As a practicing physician, here are my suggestions:
1. Do as much research as possible before you see your doctor – let’s face it you don't go and see your accountant to do your taxes without collecting information beforehand, and thinking about the issues you want to discuss. Do the same with your doctor. The Internet is the easiest source of information to use, and the US Government Agency for Healthcare Research and Quality (AHRQ) has an excellent site where you will find a comprehensive series of questions on many different health topics.
2. Write down your questions - and if necessary take a list with you, including a second copy for your doctor.
3. Prioritize your questions - ask the most important ones first - don't waste time asking about the payment process when you are really worried about whether you have cancer or diabetes.
4. Take someone with you if you have questions that are really concerning you - two sets of ears are better than one - and make sure you have discussed your needs with your friend or family member before the consultation so that they can help you get answers if necessary.
5 Write down the answers - even if this is just a rapid note. Research has shown that only 20% of the information given during a medical consultation is remembered one week later - but if it's written down, the percentage recall is much higher
Asking good questions is essential in any medical consultation, and it is incumbent on patients to take responsibility for their health and find out as much as possible of relevance so that they can make good decisions in partnership with their doctors.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
Consultations with your doctor can be rushed and stressful, and it is common for patients to forget to ask key questions during the actual consultation itself. How can you make sure that you remember to ask the questions that are of most concern to you?
As a practicing physician, here are my suggestions:
1. Do as much research as possible before you see your doctor – let’s face it you don't go and see your accountant to do your taxes without collecting information beforehand, and thinking about the issues you want to discuss. Do the same with your doctor. The Internet is the easiest source of information to use, and the US Government Agency for Healthcare Research and Quality (AHRQ) has an excellent site where you will find a comprehensive series of questions on many different health topics.
2. Write down your questions - and if necessary take a list with you, including a second copy for your doctor.
3. Prioritize your questions - ask the most important ones first - don't waste time asking about the payment process when you are really worried about whether you have cancer or diabetes.
4. Take someone with you if you have questions that are really concerning you - two sets of ears are better than one - and make sure you have discussed your needs with your friend or family member before the consultation so that they can help you get answers if necessary.
5 Write down the answers - even if this is just a rapid note. Research has shown that only 20% of the information given during a medical consultation is remembered one week later - but if it's written down, the percentage recall is much higher
Asking good questions is essential in any medical consultation, and it is incumbent on patients to take responsibility for their health and find out as much as possible of relevance so that they can make good decisions in partnership with their doctors.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.What are the most important questions to ask your doctor to make sure you get the most out of your consultation, and consequently receive the most appropriate treatment?
Consultations with your doctor can be rushed and stressful, and it is common for patients to forget to ask key questions during the actual consultation itself. How can you make sure that you remember to ask the questions that are of most concern to you?
As a practicing physician, here are my suggestions:
1. Do as much research as possible before you see your doctor – let’s face it you don't go and see your accountant to do your taxes without collecting information beforehand, and thinking about the issues you want to discuss. Do the same with your doctor. The Internet is the easiest source of information to use, and the US Government Agency for Healthcare Research and Quality (AHRQ) has an excellent site where you will find a comprehensive series of questions on many different health topics.
2. Write down your questions - and if necessary take a list with you, including a second copy for your doctor.
3. Prioritize your questions - ask the most important ones first - don't waste time asking about the payment process when you are really worried about whether you have cancer or diabetes.
4. Take someone with you if you have questions that are really concerning you - two sets of ears are better than one - and make sure you have discussed your needs with your friend or family member before the consultation so that they can help you get answers if necessary.
5 Write down the answers - even if this is just a rapid note. Research has shown that only 20% of the information given during a medical consultation is remembered one week later - but if it's written down, the percentage recall is much higher
Asking good questions is essential in any medical consultation, and it is incumbent on patients to take responsibility for their health and find out as much as possible of relevance so that they can make good decisions in partnership with their doctors.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
Thursday, February 12, 2009
Are you a cyberchondriac?
What is Cyberchondria?
This is one of the most recent words spawned by the Internet, and is a form of Internet addiction driven by anxiety. In brief it is the anxiety caused by too much searching for health information, that is often contradictory, and which causes the searcher to believe that they have excessively serious illnesses, or diagnoses that are out of proportion to their symptoms.
I have just put the common symptoms “headache, nausea, dizziness” into Google, and in the first ten responses could find diagnoses ranging from the flu, to stomach ulcers right up to a range of serious neurological disorders, including brain cancer.
Everyone gets hypochondriacal on occasions, and believes that they have illnesses where none exist. Patients who in the past had “hypochondriasis” tended to present to their doctors with the latest medical dictionary or pharmaceutical book. Alternatively, they had heard tales of woe from a friend, a colleague, or the local gossip suggesting that the minor symptom that they had may be a sign of impending doom and a long and prolonged death.
.
It’s quite natural, therefore, that as we all now have access to huge amounts of health information on the Internet, that some people might start imagining that they have dreadful illnesses. This is certainly happening. There is no doubt that some patients are presenting with symptoms of “cyberchondria”. I have seen several in my own practice. The most serious case I have seen was a very intelligent university student, who had to be literally withdrawn from the Internet because he was spending up to 18 hours per day searching for “cures” for his fantasy illnesses. Luckily he had understanding parents who did not have a computer at their home and who let him move back with them for several months so that he could be “dried out” in an Internet free environment.
What should you do if you think you, or a loved one, is a cyberchondriac? The first step is to go and talk to your doctor, seek reassurance about your symptoms, make sure that they are properly medically investigated, and use your doctor as a health information analyst, so that you can understand which symptoms are of concern, and which are not.
“Treatment” generally consists of providing reassuring and accurate information about an individual’s health status, and teaching them how to work together with their doctor to analyze the health information that they found on the Internet more critically and more accurately. Much of the health information on the Internet is of good quality, but there are also large numbers of websites with incorrect, or even bizarre, information that has been placed for commercial, philosophical or political purposes, that can make people very confused, anxious and cyberchondriacal. I have for a number of years handed out information to patients on the best websites to go to for health information, and on how to search easily for high quality accurate health information.
If you are in this situation, then you should certainly consult with your doctor, and over time, learn to use the Internet more effectively to improve your health. It is a wonderful tool for this purpose and is currently used by about 10 million Americans each day who search for health information for themselves or a loved one.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
This is one of the most recent words spawned by the Internet, and is a form of Internet addiction driven by anxiety. In brief it is the anxiety caused by too much searching for health information, that is often contradictory, and which causes the searcher to believe that they have excessively serious illnesses, or diagnoses that are out of proportion to their symptoms.
I have just put the common symptoms “headache, nausea, dizziness” into Google, and in the first ten responses could find diagnoses ranging from the flu, to stomach ulcers right up to a range of serious neurological disorders, including brain cancer.
Everyone gets hypochondriacal on occasions, and believes that they have illnesses where none exist. Patients who in the past had “hypochondriasis” tended to present to their doctors with the latest medical dictionary or pharmaceutical book. Alternatively, they had heard tales of woe from a friend, a colleague, or the local gossip suggesting that the minor symptom that they had may be a sign of impending doom and a long and prolonged death.
.
It’s quite natural, therefore, that as we all now have access to huge amounts of health information on the Internet, that some people might start imagining that they have dreadful illnesses. This is certainly happening. There is no doubt that some patients are presenting with symptoms of “cyberchondria”. I have seen several in my own practice. The most serious case I have seen was a very intelligent university student, who had to be literally withdrawn from the Internet because he was spending up to 18 hours per day searching for “cures” for his fantasy illnesses. Luckily he had understanding parents who did not have a computer at their home and who let him move back with them for several months so that he could be “dried out” in an Internet free environment.
What should you do if you think you, or a loved one, is a cyberchondriac? The first step is to go and talk to your doctor, seek reassurance about your symptoms, make sure that they are properly medically investigated, and use your doctor as a health information analyst, so that you can understand which symptoms are of concern, and which are not.
“Treatment” generally consists of providing reassuring and accurate information about an individual’s health status, and teaching them how to work together with their doctor to analyze the health information that they found on the Internet more critically and more accurately. Much of the health information on the Internet is of good quality, but there are also large numbers of websites with incorrect, or even bizarre, information that has been placed for commercial, philosophical or political purposes, that can make people very confused, anxious and cyberchondriacal. I have for a number of years handed out information to patients on the best websites to go to for health information, and on how to search easily for high quality accurate health information.
If you are in this situation, then you should certainly consult with your doctor, and over time, learn to use the Internet more effectively to improve your health. It is a wonderful tool for this purpose and is currently used by about 10 million Americans each day who search for health information for themselves or a loved one.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
Monday, February 9, 2009
Electronic Health Records and President Obama - 7 reasons why his initiative is right
Copywrite Peter Yellowlees MD. 2009
President Obama has been widely quoted as saying that he wants the federal government to invest in electronic health records so all medical records are digitized within five years. He plans to strengthen the security and privacy governance arrangements for health information currently in place, ensure that health information cannot be sold or passed on without patient consent, and increase the range of penalties for those who do not protect health data appropriately. Hopefully there will also be serious reconsideration of introducing a national patient identifier for healthcare as part of this initiative. This healthcare initiative is essential to move the American healthcare system of care into the Information Age, and has the potential to dramatically improve the way all Americans are treated when they are sick.
It is important to look at the many positive reasons why the introduction of electronic health records is so important for Americans, and not get lost in detailed technical or philosophical debates, as tends to often be the case around this topic. There are seven areas of major gain for Americans with the introduction of a national electronic health record system:
1. We are in the Information Age, and healthcare, which is an Information Industry, needs to be modernized just like the banking, communications and media industries, and made more efficient, through the more effective use of health information. Numerous studies have demonstrated how electronic health records both reduce medical errors, and increase overall quality of care.
2. The Internet and its associated multimedia environments are here to stay. Their existence will facilitate the development of an entirely new information infrastructure for healthcare, incorporating electronic health records, and numerous other multimedia environments and analytic tools. Investments in health are likely to continuously move away from bricks and mortar to bits and bytes, and the Obama plans will kick start this approach.
3. Health consumers have already taken to using the Internet for healthcare. Approximately 10 million people in the USA search online for information about their health, or the health of their loved ones, every single day – a total of 140 million Americans have already undertaken such searches. People trust their doctors and like to discuss information they have found on the internet with them. Most health consumers already assume that much of their health information is already electronic and are increasingly accustomed to the idea of their personal information being maintained online. Major companies, such as Google and Microsoft, have illustrated this change in attitude by introducing their own personal health record systems.
4. A well introduced national health electronic information infrastructure will lead to better security and privacy than we have with our current paper records. Our present records have minimal capacity to be audited for inappropriate access by those who should not be seeing them, and are probably accessed much more than we realize.
5. Electronic health records will allow us to leverage new technologies such as virtual reality environments, telemedicine programs, multimedia applications, genetic databases and increasingly sophisticated search and decision support tools. We will certainly be using these tools routinely in future as we move increasingly to a personalized consumer focused health system, whereas at present many of these approaches are used only sporadically.
6. With the simultaneous move to some kind a national health insurance initiative, another goal of President Obama, the existence of electronic health records is simply essential to be able to provide care to the current 47 million Americans who are estimated to be uninsured.
7. Disease prevention, health promotion and chronic disease management are all essential solutions to the American healthcare crisis that need to be promoted and enhanced over the next decade. All of these approaches to care are made much more effective in the setting of good quality health information on both individuals and communities that can really only be provided electronically.
The need for national electronic health records is essential to allow us to improve the American healthcare system, and to make our healthcare services more personalized and consumer focused as we move increasingly into delivering healthcare in today’s information age. We need to support President Obama in this important initiative.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://http://www.informationagehealth.com/ and most online bookstores.
President Obama has been widely quoted as saying that he wants the federal government to invest in electronic health records so all medical records are digitized within five years. He plans to strengthen the security and privacy governance arrangements for health information currently in place, ensure that health information cannot be sold or passed on without patient consent, and increase the range of penalties for those who do not protect health data appropriately. Hopefully there will also be serious reconsideration of introducing a national patient identifier for healthcare as part of this initiative. This healthcare initiative is essential to move the American healthcare system of care into the Information Age, and has the potential to dramatically improve the way all Americans are treated when they are sick.
It is important to look at the many positive reasons why the introduction of electronic health records is so important for Americans, and not get lost in detailed technical or philosophical debates, as tends to often be the case around this topic. There are seven areas of major gain for Americans with the introduction of a national electronic health record system:
1. We are in the Information Age, and healthcare, which is an Information Industry, needs to be modernized just like the banking, communications and media industries, and made more efficient, through the more effective use of health information. Numerous studies have demonstrated how electronic health records both reduce medical errors, and increase overall quality of care.
2. The Internet and its associated multimedia environments are here to stay. Their existence will facilitate the development of an entirely new information infrastructure for healthcare, incorporating electronic health records, and numerous other multimedia environments and analytic tools. Investments in health are likely to continuously move away from bricks and mortar to bits and bytes, and the Obama plans will kick start this approach.
3. Health consumers have already taken to using the Internet for healthcare. Approximately 10 million people in the USA search online for information about their health, or the health of their loved ones, every single day – a total of 140 million Americans have already undertaken such searches. People trust their doctors and like to discuss information they have found on the internet with them. Most health consumers already assume that much of their health information is already electronic and are increasingly accustomed to the idea of their personal information being maintained online. Major companies, such as Google and Microsoft, have illustrated this change in attitude by introducing their own personal health record systems.
4. A well introduced national health electronic information infrastructure will lead to better security and privacy than we have with our current paper records. Our present records have minimal capacity to be audited for inappropriate access by those who should not be seeing them, and are probably accessed much more than we realize.
5. Electronic health records will allow us to leverage new technologies such as virtual reality environments, telemedicine programs, multimedia applications, genetic databases and increasingly sophisticated search and decision support tools. We will certainly be using these tools routinely in future as we move increasingly to a personalized consumer focused health system, whereas at present many of these approaches are used only sporadically.
6. With the simultaneous move to some kind a national health insurance initiative, another goal of President Obama, the existence of electronic health records is simply essential to be able to provide care to the current 47 million Americans who are estimated to be uninsured.
7. Disease prevention, health promotion and chronic disease management are all essential solutions to the American healthcare crisis that need to be promoted and enhanced over the next decade. All of these approaches to care are made much more effective in the setting of good quality health information on both individuals and communities that can really only be provided electronically.
The need for national electronic health records is essential to allow us to improve the American healthcare system, and to make our healthcare services more personalized and consumer focused as we move increasingly into delivering healthcare in today’s information age. We need to support President Obama in this important initiative.
This article is based on excerpts from the recently published book “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://http://www.informationagehealth.com/ and most online bookstores.
5 simple search strategies to find quality health information on the Internet
Copywrite Peter Yellowlees MD. 2009
Approximately 10 million people in the USA search online for information about their health, or the health of their loved ones, every single day. 140 million Americans have already undertaken such searches. A number of recent studies have reviewed this activity and three factors stand out:
1. Searching on the Internet for health information is a remarkably common activity in America
2. While many people find health information that seems helpful, most do not really know if it is reliable.
3. People trust doctors to deliver high quality health information, and information from the internet discussed with doctors, who are the “health information experts” often leads to changes in treatment.
As a practicing physician I have long been recommending certain websites and search strategies to my patients. I have now written a book (Your Health in the Information Age – how you and your doctor can use the Internet to work together) and created a website that will be helpful in finding high quality health information. The website - http://www.informationagehealth.com/ –contains the links to high quality health information mentioned in the book.
So what are the 5 search strategies?
1. Quick and dirty.
For a quick simple search there is nothing wrong with doing rapid searches at http://www.google.com/ or http://www.yahoo.com/ , and at least scan the first 20 or so results. Just remember that Google displays two types of results, sites ranked by a commercially secret algorithmically derived measure of popularity, which is what most people look at first, and sponsored paid links. The second quick and dirty approach to undertake routinely is to go to a couple of quality information sites as your first stop beyond the search engines. I recommend http://www.wikipedia.com/ the amazing open source encyclopedia with great breadth and depth, but a level of inaccuracy, and http://www.medlineplus.gov/ which is a Government run site and is, in my opinion, the best overall consumer health site on the Internet.
Many patients want to go beyond this level of search however, and I would suggest the following strategies;
2 Professional journal searching
There are several free programs on the Internet which allow you to search professional peer-reviewed scientific papers from the health and medical journals. The two main professional databases are:
“Medline” (http://www.ncbi.nlm.nih.gov/PUBMED at the NIH and
“Psycinfo” (http://www.apa.org/psycinfo/ at the American Psychological Association
3 Search evaluated Internet subject gateways
The beauty of Internet searches is that you can pick up useful reliable information which hasn’t always been published in peer-reviewed journals, but which has been checked for accuracy by teams of medical reviewers. The gateways I use are the US National Library of Medicine ( http://locatorplus.gov/ ) or Healthfinder ( http://www.healthfinder.gov/ ) in the US, or Intute (http://www.intute.ac.uk/ ) or NHSDirect (http://www.nhsdirect.nhs.uk/ ) in the UK. Other sites are devoted to collecting peer-reviewed “best practice” treatment guidelines (http://www.guideline.gov/ ) which you can use to compare with your own treatment regime. If you want information on evidence-based medicine you cannot go past the Cochrane Library ( http://www.cochrane.org/ ) and I frequently recommend eMedicine (http://www.emedicine.com/) which is emerging as the “wikipedia of healthcare”.
4 General Web searches
Now we move to the open areas of the Internet that you will find via search engines. Here you will have to start questioning the quality of the information you retrieve much more critically as most of it will not have been subjected to any real quality review mechanism, and much will have a commercial bias. Use the methods at http://www.discern.org.uk/ to evaluate the quality of information on general sites, and in principle tend to focus on mainstream sites run by government agencies or universities.
5 Discussion lists and newsgroups
This is where you can waste most time, and where information is least reliable - but it can be fun, and is sometimes helpful, particularly if you want to communicate with others who have similar needs. You may even be lucky and join a group where there is a real expert. There are many groups on the Internet – just put in a search string with the word group, as well as whatever topic you are researching. The largest number of health related ones seem to currently be at Google groups (http://groups.google.com/group/HealthyLiving )
Once you have undertaken your searches the most important next step is to discuss your findings with you doctor. The role of many doctors in gradually changing, and they are increasingly becoming “information analysts” helping patients find good quality health information that will lead to good healthcare decisions. More details are available in my book.
This article is based on excerpts from “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.informationagehealth.com/ and most online bookstores.
Approximately 10 million people in the USA search online for information about their health, or the health of their loved ones, every single day. 140 million Americans have already undertaken such searches. A number of recent studies have reviewed this activity and three factors stand out:
1. Searching on the Internet for health information is a remarkably common activity in America
2. While many people find health information that seems helpful, most do not really know if it is reliable.
3. People trust doctors to deliver high quality health information, and information from the internet discussed with doctors, who are the “health information experts” often leads to changes in treatment.
As a practicing physician I have long been recommending certain websites and search strategies to my patients. I have now written a book (Your Health in the Information Age – how you and your doctor can use the Internet to work together) and created a website that will be helpful in finding high quality health information. The website - http://www.informationagehealth.com/ –contains the links to high quality health information mentioned in the book.
So what are the 5 search strategies?
1. Quick and dirty.
For a quick simple search there is nothing wrong with doing rapid searches at http://www.google.com/ or http://www.yahoo.com/ , and at least scan the first 20 or so results. Just remember that Google displays two types of results, sites ranked by a commercially secret algorithmically derived measure of popularity, which is what most people look at first, and sponsored paid links. The second quick and dirty approach to undertake routinely is to go to a couple of quality information sites as your first stop beyond the search engines. I recommend http://www.wikipedia.com/ the amazing open source encyclopedia with great breadth and depth, but a level of inaccuracy, and http://www.medlineplus.gov/ which is a Government run site and is, in my opinion, the best overall consumer health site on the Internet.
Many patients want to go beyond this level of search however, and I would suggest the following strategies;
2 Professional journal searching
There are several free programs on the Internet which allow you to search professional peer-reviewed scientific papers from the health and medical journals. The two main professional databases are:
“Medline” (http://www.ncbi.nlm.nih.gov/PUBMED at the NIH and
“Psycinfo” (http://www.apa.org/psycinfo/ at the American Psychological Association
3 Search evaluated Internet subject gateways
The beauty of Internet searches is that you can pick up useful reliable information which hasn’t always been published in peer-reviewed journals, but which has been checked for accuracy by teams of medical reviewers. The gateways I use are the US National Library of Medicine ( http://locatorplus.gov/ ) or Healthfinder ( http://www.healthfinder.gov/ ) in the US, or Intute (http://www.intute.ac.uk/ ) or NHSDirect (http://www.nhsdirect.nhs.uk/ ) in the UK. Other sites are devoted to collecting peer-reviewed “best practice” treatment guidelines (http://www.guideline.gov/ ) which you can use to compare with your own treatment regime. If you want information on evidence-based medicine you cannot go past the Cochrane Library ( http://www.cochrane.org/ ) and I frequently recommend eMedicine (http://www.emedicine.com/) which is emerging as the “wikipedia of healthcare”.
4 General Web searches
Now we move to the open areas of the Internet that you will find via search engines. Here you will have to start questioning the quality of the information you retrieve much more critically as most of it will not have been subjected to any real quality review mechanism, and much will have a commercial bias. Use the methods at http://www.discern.org.uk/ to evaluate the quality of information on general sites, and in principle tend to focus on mainstream sites run by government agencies or universities.
5 Discussion lists and newsgroups
This is where you can waste most time, and where information is least reliable - but it can be fun, and is sometimes helpful, particularly if you want to communicate with others who have similar needs. You may even be lucky and join a group where there is a real expert. There are many groups on the Internet – just put in a search string with the word group, as well as whatever topic you are researching. The largest number of health related ones seem to currently be at Google groups (http://groups.google.com/group/HealthyLiving )
Once you have undertaken your searches the most important next step is to discuss your findings with you doctor. The role of many doctors in gradually changing, and they are increasingly becoming “information analysts” helping patients find good quality health information that will lead to good healthcare decisions. More details are available in my book.
This article is based on excerpts from “Your Health in the Information Age – how you and your doctor can use the Internet to work together” by Peter Yellowlees MD. Available at http://www.informationagehealth.com/ and most online bookstores.
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