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Talking to Your Patient About Digital Health

Posted on March 22, 2106 by Dr. Rashaad Bhyat

“The digital world has been in a separate orbit from our medical cocoon, and it's time the boundaries be taken down.”
– Dr. Eric Topol1

Not long ago, I began to notice that my advice to patients on various matters was not having the intended effect. Occasionally, I noticed a telltale glazed look in peoples’ eyes when I described a medical issue.

And so, I tried to update my approach for the digital age by introducing the prescription of digital resources – it was quite well-received.

One of the key roles of any physician, particularly family physicians, is to serve as a resource to our patients.2

This role can take many forms, but frequently involves helping patients navigate a complex healthcare system.

Our modern age is defined by the rise of abundant information, accessible to many people, unfiltered, through the ubiquity of the Internet and mobile phones. The volume of accessible peer-reviewed medical information in particular, can seem daunting.3 

As physicians, we can mitigate the overwhelming nature of information overload by guiding our patients through these waters, to the best of our abilities. We can harness our knowledge of digital health technologies to give patients a framework for understanding how their health information is currently managed, and crucially, how patients can manage it themselves. We can enhance patient awareness of the advantages and limitations of current technologies.

For example:
Are you consulting a random internet video on how to treat that spot on your face? This is perhaps not a great idea, particularly if the solution involves scrubbing it with peroxide.4

Are you consulting an evidence-based YouTube video on how to stay active, authored by a reputable thought leader such as Dr. Mike Evans?5 This is perhaps an excellent idea, one that might work well as a part of the overall strategy to manage your diabetes.

Most importantly, we can keep an open dialogue with patients and recognize that our role as a health resource may gradually morph into that of a health coach.

Here are some of the potential digital health topics that we might raise with our patients:

  • Apps (particularly for mobile devices) – Apps should be chosen carefully, and tailored to the patient and their medical concerns. The Canadian Medical Association (CMA) recently released this useful guide on recommending mobile health apps to patients. Also, Dr. Kendall Ho of UBC provides handy tips on how to select a digital health app in this post.
  • Websites – Appropriate websites can be very condition-dependent, and might range from reputable general information (such as the College of Family Physicians of Canada CFPC’s patient resource page, or the U.S.-based Medline Plus) to very specific information (such as The Portico Network’s resource page on Mental Health topics, for patients and families).
  • Personal health records (PHRs) and patient portals – These tools are rolling out across the country in different capacities, and are creating a new relationship between patients and their health information. We can encourage patients to find out if their local health care organization offers this service (e.g. the CHEO MyChart service).
  • Electronic medical records (EMRs) and electronic health records (EHRs) – We can explain the difference between these concepts and provide examples in the Canadian context (an example of an EMR might be the software your primary care provider is using to manage your health information; an example of a functioning EHR is Alberta’s Netcare). This blog post provides a simple definition. Do systems speak to each other? This topic, known in the industry as interoperability, is a crucial discussion point. Many patients may assume that information systems in health care are all connected and share information seamlessly, similar to the banking industry. This situation is improving gradually.6  However, the reality is that we have many isolated silos of information in health care, and patients should be aware of this current state.

We can also educate ourselves further on some of these topics. The Association of Faculties of Medicine of Canada (AFMC) has partnered with Infoway, for example, to produce a series of free, accredited e-health webinar workshops for interested clinician educators. The content of these workshops, along with useful supporting materials, has been posted in the form of an eHealth Toolkit Collection, on the AFMC website.

These conversations relating to health care in the digital era are becoming essential – we should embrace and learn from them.

What kinds of conversations are you having with your patients about digital health? I would be interested to hear about them.

Have a comment about this post? We’d love to hear from you.

4This a real example of internet advice gone wrong.

rbhyat 100Dr. Rashaad Bhyat is Clinician Leader, ACCESS Health at Canada Health Infoway. He is a family physician with a special interest in Digital Health. He currently practices in an EMR-enabled family practice in the Greater Toronto Area.

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