Patient Education and the Internet
As clinicians we understand the importance of patient education. Health information is now one of the most frequently sought topics on the internet. Most of these information searches are condition specific and are carried out before the clinical encounter to improve self-care, and after the consultation for reassurance. The result has been a shift in the role of the patient from passive recipient to active "informed" participant. Health professionals have responded in three ways:
• The health professional feels threatened and responds by asserting their expert opinion
• The health professional and patient collaborate in obtaining and analysing the information
• The health professional will guide the patient to relevant and reliable information
Most of us would prefer to imagine ourselves as falling into one of the latter two categories. The shift of mindset regarding self-education has occurred therefore we must ask three questions to decide how best to help our patients find the right information.
Will they use it?
In 2004 the patients most likely to seek internet medical education were younger and college educated. Now, well into 2009, people are more connected to the internet than ever before. There is no question that patients of all ages and backgrounds are interested in educating themselves. If the resource education source is evidence based, easily accessible, endorsed by the physician or physiotherapist, and free, then the chances of the patient using the information will increase.
Will they learn it?
Each person has a number of learning styles, some stronger than others. A visual learner needs to see and read words and images to most effectively learn; the auditory learner needs to hear the information or education provided; while the tactile or kinesthetic leaner needs to touch and feel for effective learning to ensue. No wonder half of the information received at the doctor’s office is forgotten. Internet based learning is most likely to appeal to the visual learner although the auditory learners can benefit by reading aloud the information received.
What will change?
Most of the patient education studies look at education in conjunction with some other intervention. Most the studies are condition specific; for example we can say that sub-acute and chronic back pain patients will likely experience less disablility by receiving a back care booklet. Similarly we can conclude that patients waiting for total knee replacements will likely benefit from therapeutic education. Potential advantages of Web-acquired information include helping patients make informed health care choices, shared decision-making with a collaborative, teamwork approach, more efficient use of clinical time, augmenting of physician-provided information, online support groups, and/or access to patients' own health information. Alternatively, factors such as misinformation due to highly variable quality of Web information, possible exacerbation of socioeconomic health disparities, and shifting of conventional notions of the physician-patient relationship present their own set of challenges for the health care provider.
The practice implication for any health professional is to become a "net friendly" clinician, engendering a genuine partnership with patients towards the highest quality health care.
Reference:
Wald HS, Dube CE, Anthony DC. Untangling the Web--the impact of Internet use on health care and the physician-patient relationship. Patient Educ Couns. 2007 Nov;68(3):218-24.
