A 52-year-old woman comes to the office complaining of a two-month history of pain and swelling in the small joints of her hands, feet and knees. She says, “Doctor, I’ve been searching the Internet, and I think I have rheumatoid arthritis. I have some questions for you.”
The healthcare system in the U.S. is changing rapidly and dramatically. Integral to these changes is the development of new models of care, which incorporate e-health. E-health is defined by the World Health Organization (WHO) as “the use of information and communication technologies (ICT) for health. In its broadest sense, eHealth is about improving the flow of information, through electronic means, to support the delivery of health services and the management of health systems.” It also encompasses the delivery of health information for health professionals and health consumers through the Internet and telecommunications.
For many clinicians and patients, adjusting to this electronic healthcare environment has been challenging, time consuming and frustrating. In the past, only the physician had access to up-to-date scientific medical knowledge, and patients relied on this expertise and judgment for their care-management decisions. Advances in social media and online health materials have exponentially increased the amount of readily available medical information. Now, patients have direct access to medical information through a wide variety of online health resources, including patient portals where they can enter their medical records and email their doctor through the electronic health record; health information websites, such as the American College of Rheumatology, the Arthritis Foundation and MedlinePlus.gov; social networking; medical advice blogs; YouTube; “Dr. Google” with symptom search capability; telemedicine; and online doctor consults.
Healthcare providers want informed and actively engaged patients; however, this greater accessibility to health information has brought new challenges. For example, according to Pew Internet Project’s research and other reports, 60–80% of the adults in the U.S. have searched the Internet for health information, with 35% trying to self-diagnose their medical condition. However, only 41% of these “diagnosers” had physician confirmation of their condition. Also notable, three-quarters of the people seeking health information on the Internet “never,” “hardly ever” or only “sometimes” check the source of the information.
Although it’s easy to find arthritis and other health information on the Internet, the quality and reliability of the information are extremely variable. Website information is not required to meet specific standards, such as peer review. Finding reliable, unbiased and current information in a format that is understandable and usable is frequently complex and challenging.