Medical Futures Lab

Guest post by Jesal Shah

Our class readings have touched on technology/social media utilization across various demographics: the elderly, the low-income population, American adults, individuals with and without chronic diseases, etc. We also examined how the online infrastructure and community can be utilized in patient-disease narratives/data sharing (e.g. ePatient Dave) as well as creative physician expression (e.g. zDogg M.D.). However, our design project aims to create a physician-oriented campaign to increase HIV testing. This population emphasis poses a unique question: how can we best utilize technology for a group of physicians who are highly educated, scientifically engaged, restricted by time, ethnically mixed and varied in age, amongst other criteria. After all, eHealth, in addition to those involved in the technology process, is targeted to not only patients, but also physicians. Here are four out of several considerations when thinking about doctors and technology use:

1. Physicians rarely engage in e-mail conversation with patients.¹

This conclusion serves as an indicator for general informal outlets of patient-physician communication. There are significant barriers, such as general negative attitudes and inertia, reimbursement issues as well as patient confidentiality, which challenge much more organic forms of interaction through technology.

2. Time strengthens resistance to change.¹

Those within one decade of medical practice were more likely to use technology (tracked by online journal access and utilization of real-time clinical decision making services) in their profession than those in their third decade of work. This also reflects general trends of society and age. For our project, it may be interesting to examine age demographics of the Harris Health primary care physicians.

3. Patients have surpassed physicians in incorporating IT for health purposes.^{1, 2}

Patients tend to be much more willing to explore healthcare topics online than even physicians. Is this because of pedagogical methods in medical schools, information abundance online, poorly designed real-time clinical decision making services or something else?

4. Digital divide amongst Physicians: the adopters and the restrainers.

While there is considerable survey data that point to certain specific technologies/applications being adopted more widely by physicians, a study by Deloitte highlights the existing digital divide amongst physicians. They found that 78% of the 57% of physicians who don’t use smart phones for clinical purposes do not intend to change in the future. Those who adopted were more inclined to show greater enthusiasm for health technology in general.

Overall, this is only the beginning of the discussion surrounding physicians’ relationship with technology in the medical sphere. Hope to share more knowledge and firsthand experience in another blog post this semester!

1. Grant, Richard W., Eric G. Campbell, Russell L. Gruen, Timothy G. Ferris, and David Blumenthal. “Prevalence of Basic Information Technology Use by U.S. Physicians.” Journal of General Internal Medicine 21.11 (2006): 1150-155. Web. 8 Feb. 2015.

2. Baker, Laurence, Todd H. Wagner, Sara Singer, and M. K. Bundorf. “Use of the Internet and E-mail for Health Care Information: Results From a National Survey.” JAMA: The Journal of the American Medical Association 289.18 (2003): 2400-406. Web. 8 Feb. 2015.

3. Glenn, Brandon. “Nearly 60% of Physicians Don’t Use Mobile Technology for Clinical Purposes.” Medical Economics. N.p., 15 May 2013. Web. 08 Feb. 2015.

Guest post by Sanjana Puri

Every spring, thousands of high school seniors gripe, moan, and complain about the seemingly unfair process that is elite college admissions.  One complaint that stands out amongst them all: it’s done behind closed doors. Applications go in, acceptances and rejections come out, but nobody can see what happens inside.

But what happens when this door gets pulled open?

That’s what happened when a group of Stanford students asked the University in January for a copy of their admissions records.  According to the New York Times, the university was forced to comply, in accordance with a federal law that has been in place for years.  Students highlighted the 1974 Family Educational Rights and Privacy Act, which stipulates that students have a right to see their educational records.

Tina Fey in Admission (2013)

As someone applying to medical school, and a fairly recent alumnus of the college admissions process, I can sympathize with those who want to know the why in decisions. During the process, I felt both nervous and vulnerable. My admission into the most elite colleges seemed distant, behind a wooden door of admissions officers picking apart my carefully crafted application.

Translate that same feeling to a patient in a doctor’s office.

Patients eagerly await the arrival of results from a screening or bloodwork.  When the doctor arrives, the diagnosis and treatment seem out of their control, perhaps instead behind the privacy of a blue curtain. Depending on the situation, it can be a nerve-wracking experience.

Curtain & Patient in Grey’s Anatomy 

However, Stanford students took control into their own hands, empowering themselves and others throughout the country to level the information playing field.  Many said the comments on their application records were frank, like they were never intended to be read. But honesty can facilitate quality of applicants, accountability of the process, and advice for the future.

It’s time for patients to take action.

Now more than ever, patients have the opportunity to take control of their health. In the digital age, patients can have access to a PHR, or personal health record, a collection of information (immunizations, allergies, medications, etc.) pertinent to a person’s health. While different from an Electronic Health Record, which is controlled by doctors, employers, and insurance companies, a PHR enables patients to share information with all care providers and manage their health in between patient visits.

Americans who have access to their health information through personal health records (PHRs) report that they know more about their health, ask more questions, and take better care of themselves than when their health information was less accessible to them in paper records, according to a ground-breaking study released by the California HealthCare Foundation (CHCF)in 2010. However, only a mere 7% of Americans had used a PHR.

Advocate for your health.  Ask your doctor if they provide the option for a personal health record, and if not, encourage them to do so in the future.

The doors are open for you.