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Notes from the field of public involvement

Monday, 30 January 2006

Patients using the internet - not what clinicians might expect

Ask most clinicians about patients using the internet and they come up with anecdotes about sheaves of downloaded information some of dubious provenance being waved about and questions being asked that might put them (the clinicians) on the spot about treatments and pharmaceuticals they may have scarcely heard of if at all. Is that what patients really want the internet for?

Maybe not according to findings from a Dutch study published in this month's Annals of the Rheumatic Diseases (van Lankveld et al, "Disease related use of the internet in chronically ill adults: current and expected use", 2006; 65: 121-3 http://ard.bmjjournals.com) . The Department of Rheumatology at Nijmegen followed up 220 patients attending their clinic over one week with a questionnaire to assess patients' current and intended future use of the internet for three functions: "seeking information", "mutual support", and "care provider contact". They found, not surprisingly, that patients used the internet frequently to find information about their condition and treatment. What they also found, rather to their surprise, was that most patients thought they would use this medium more in future for communicating with clinicians and getting their questions answered.

New Channel for Expert Patients...
This adds a new dimension to discussions in the UK about what "expert patients" could be doing. Based on this Dutch study, using the internet to communicate directly with their health care providers should be part of the "what next" options for people with chronic conditions like diabetes, rheumatic disorders, CHD and musculo-skeletal conditions who learn to exercise more self-care and gain greater control over their disorder. Interestingly, here in Wandsworth, we have the highest access to broadband of any borough in the country: 25 fast connections per 100 people, followed by Westminster, Hammersmith and Fulham, Tower Hamlets, Windsor and Maidenhead, Chiltern, Mole Valley, Kensington and Chelsea, Islington and South Buckinghamshire. That's a lot of people who could be emailing their GPs and consultants and not just for repeat prescriptions.

...Or just queuing in the Rain?
Are clinicians and NHS IT systems up to the "it's good to talk" challenge? They should be because this kind of immediate contact is a real part of what a patient-led NHS is going to be about. Or is there another message about patients seeing the internet as a way to avoid the stresses of the face to face in favour of the arms-length contact channel? Is the internet the equivalent of the ATM where customers queue in the rain outside the empty branch rather than undergo conversation with the cashier. Growing patient experience with electronic communication will reveal this.

Andrew Craig | Send feedback