Eric Topol, MD, Chief Academic Officer of Scripps Health, Editor-in-Chief of Medscape, and author of the “bible” of digital health, “The Creative Destruction of Medicine” joined us on camera to talk about the results of the recently released (September 2014) WebMD/Medscape Digital Technology Survey about doctors and patients perceptions of digital health technologies. The survey found that sometimes docs & patients see eye-to-eye and sometimes they do not.
How was the survey done
This is an interesting survey because doctors and patients were asked the same questions during almost the same time period. The consumer survey was done via WebMD, one of the leading providers of health information services for not only consumers but also physicians and other healthcare professionals as well as other stakeholders such as employers and health plans. The survey was available on the WebMD site from August 20-27, 2014. All site visitors have an equal probability of answering the survey – and 1,102 of them did. The clinician survey was done via Medscape, an important source of clinical news, health information, and point-of-care tools for health professionals. The site serves PCPs, specialists, medical students, and other health professionals. According to a WebMD press release, the survey “was fielded August 22-September 8, 2014, via email invitation that included generalists and specialists. The occupations invited to respond were physicians, nurse practitioners, nurses, physician assistants, and medical students.” All had been active on Medscape within the prior 12 months. Of the 1406 clinicians who responded, 827 were physicians, 152 nurse practitioners, 85 nurses, 107 physician assistants, and 235 medical students.
And, the findings are:
- 84% of patients said technology should be used by patients to assist in the diagnostic process compared to 69% of physicians. Further, when asked whether patients should be allowed to self-diagnose using technology without provider input, just 17% of physicians said yes. So docs are ok with patients using digital health tools as long as they are the ones to make the final diagnosis. [Check out Dr. Topol’s response to my support for do-it-yourself (DIY) healthcare in the video below – it mirrors this finding.]
- 63% of both doctors and patients thought smartphones should be used for routine blood tests (when technology permits) and docs and patients also were more or less in agreement about using smartphones to transmit EKGs and rhythm strips. About half of patients thought digital health devices should be used to replace office visits for eye and ear exams compared to about a third of docs. When it came to skin problems, 63% of patients compared to 47% of doctors thought this was reliable enough to avoid a face-to-face visit.
- Most doctors and patients thought that patients should be able to see their electronic health record and most thought it should not be limited to parts of the record that the doctors chose to share. [This is a pretty amazing change from the time when Eric and I were residents together at University of California San Francisco – then, there was no question, we owned the record and patients should not be allowed to see what we wrote…period…end of story.]
- The next question is interesting because, taken literally, it implies that some of the information recorded by physicians may not be entered into the EHR. See below:
- 54% of patients say they own their medical records vs 39% of doctors who say they own them. Although there is confusion on the part of doctors and patients, but some medical associations are pretty clear that the records belong to physicians. Check this out: The Texas Medical Association states, “Although the medical record contains patient information, the physical documents belong to the physician. Indeed, the medical record is a tool created by the physician to support patient care and is an asset of the practice.”
- There is strong support among both patients and physicians for a patient’s right to see their lab and diagnostic test results, but the majority of patients and about 3/4 of physicians felt that physicians should review the test results before sharing them so that they would be able to discuss the results with their patients.
- The majority of patients and doctors don’t view privacy and security issues as barriers to using digital health technologies for communication or for accessing and sharing electronic medical records.
There are many more interesting findings in the survey – including a discussion of the difference in responses between docs and medical students as well as nurse practitioners, nurses, and PAs – that can be found via this link to the full survey results.