Canada's health-care system needs to embrace the idea that people can get personal health information from Facebook, text messages and Wikipedia-like sites, so they won't block up hospital ERs and doctors' offices with their questions, says a Toronto doctor and information technologies expert.
The health system today is unsustainable, and will get worse as a wave of aging baby boomers, burned-out caregivers and obese children start knocking on hospital doors, says Dr. Alejandro Jadad, founder of the Centre for Global eHealth Innovation, who is speaking Thursday night at a public lecture in Edmonton.
Canada already spends between $150 billion and $170 billion annually on health care, 98.5 per cent of which is invested in curative rather than preventive medicine. But chronic diseases such as diabetes or heart disease have no cure, Jadad noted. Health regions constantly claim to need more doctors, nurses and MRI machines, Jadad said, but more money won't cure a system that is focused on waiting for people to get sick before offering expensive treatments.
"It's not a matter of lack of resources," Jadad said. "Other places are doing a better job with less money."
Canada needs to refocus attention on patients, allowing them to participate in their health through electronic innovations, he said.
"We have a health system that is used to top-down control. We (as physicians) assume we are the only source of information for people," Jadad said. "One of the challenges we have faced (as patients) is that as soon as we are diagnosed with a disease, it seems as if we become incompetent. We get 40 points deducted from our IQ, to a point that we are expropriated from our ability to make decisions."
But imagine being able to see your entire health record electronically -- complete with blood tests and MRI results -- and then make decisions with suitable guidance from health professionals, he said. Electronic health records are crucial as young people forsake e-mail in favour of sharing information on YouTube, Hi5 or MySpace.
"We have a (young) generation that is digitally native, but (health) decisions are made by digital immigrants, people who mistrust these gadgets, and we need to explore how far we can take it," Jadad said.
For instance, an automated scheduling system could phone patients to remind them of doctors' appointments. Such a system cut down on missed or forgotten appointments by nearly 50 per cent in Spain, saving the country money.
People could dial in by phone or website to get Pap smear or mammography results. Currently, doctors don't phone patients with lab results unless the results are abnormal. That leaves many patients nervous, wondering if they were forgotten. Some phone their clinic and take up time.
Need to ask your doctor a question? Why not head to a Wikipedia-like site where patients, doctors and nurses compile frequently asked questions and offer answers that can be changed and improved? That would save unnecessary clinic or hospital visits, giving doctors more time for crucial issues. Hospitals should be reserved for surgeries, major emergencies, intensive care and experimental therapies, not outpatient clinics that check blood pressure, Jadad said.
"Doing outpatient clinics in a university hospital, just to follow people with chronic diseases, is equivalent to buying milk at the corner store by helicopter, because it's probably the most expensive environment in society," he said.
People should check their blood pressure at home, then send the results by telephone or Internet. Even virtual communities, such as cancer support groups on Facebook, could be good for our health, Jadad said.
Studies have shown that breast cancer patients sharing information on the Internet were collectively able to decipher which web pages were trustworthy and which ones were not. Most mistaken information was corrected within five hours.
"We are talking about creating a community of care that would enable people to play an optimal role in relation to health," Jadad said, noting peer-to-peer health advice improves health outcomes. "There are things patients can do better than anybody else because they live with the disease."
---
Autor(en)/Author(s): Jodie Sinnema
Quelle/Source: The Edmonton Journal, 10.04.2008
