HEALTH SERVICES ON THE NET –WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE DIFFERENCE?

(Panel session)

15TH INTERNATIONAL CONFERENCE ON WWW/INTERNET (ICWI)

MANNHEIM, GERMANY

OCT 28, 2016

HTTP://INTERNET-CONF.ORG/

The physician´sperspectiveIN THREE QUESTIONS & ANSWERS 1 – 2 – 3

What is the differencebetween searching the web and consulting a physician?

QUESTION &ANSWER 1:

The web only answersKeep in mind: answer quality depends on what you ask.„If you expect wise answers, you have to ask sensible questions“1

1 Johann Wolfgang von Goethe (Link)

1:

But the physician also asksAnd he may ask sensible questions to find a personaliseddifferentiated diagnosis.

1:

The net onlyreactsResults depend on user´s searchskills and health literacy.

IN OTHER WORDS:

The physicianinteractsResults depend on doc´sexperience, sense and sensibility.

Artificial intelligence (AI) & allgorithms try to immitate andplay doctor...

1:

...but fail:IN RESPONSE TO “I AM HAVING A HEART ATTACK,” “MY HEAD HURTS,” AND “MY FOOT HURTS.” ONLY SIRI GENERALLY RECOGNIZED THE CONCERN, REFERRED TO EMERGENCY SERVICES, AND IDENTIFIED NEARBY MEDICAL FACILITIES. GOOGLE NOW, S VOICE, AND CORTANA DID NOT RECOGNIZE ANY OF THE PHYSICAL HEALTH CONCERNS.1

1 Miner AS, Milstein A, Schueller S, Hegde R, Mangurian C, Linos E. Smartphone-Based Conversational Agents and Responses to QuestionsAbout Mental Health, Interpersonal Violence, and Physical Health. JAMA Intern Med. 2016;176(5):619-625. doi:10.1001/jamainternmed.2016.0400 (Link)

1:

How is quality of healthinformation on the net?

QUESTION &ANSWER 2:

Very heterogenous anddifficult to specify.But..

2:

...the overall quality isdissatisfying.That´s for sure!.

2:

A TEAM OF PHYSICIANS ANALYSIED 100 HEALTH ADVISINGWEBSITES ON 24 CRITERIAS (E.G. COMPLETENESS, MEDICALEVIDENCE, FAIR BALANCE OF INFORMATION, INDICATION OFSOURCES).

KEY RESULTS:• MORE THAN 30 % WHERE RATED AS

„POOR“ OR „VERY POOR“• THE AVERAGE SCALE WAS „FAIR“ (4)

Source: Central Krankenversicherungen AG (Editor), Praxis Dr. Internet – Studie zum Kranheitssuchverhalten in Deutschland sowie zur Qualität von Gesundheitsinformationen im Internet (Link)

Scale Website count

1 (Very good) -

2 (Good) 9 websites

3 (Satisfactory) 34 websites

4 (Fair) 24 websites

5 (Poor) 30 websites

6 (Very poor) 3 websites

Who is the provider and whatmight be his intension?

ALWAYS CHECK WHEN USING A WEB SERVICE:

Even wikipedia is struggelingfor acceptance as a reliablesourceSources: The Guardian, Is Wikipedia a reliable source for medical advice? (Link)Hasty RT et al.. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions. J Am Osteopath Assoc 2014;114(5):368-373. doi: 10.7556/jaoa.2014.035. (Link)Mühlhauser I et al., Does WIKIPEDIA provide evidence-based health care information? A content analysis, Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) doi:10.1016/j.zefq.2008.06.020 (Link)Wikipedia; Reliability of wikipedia (Link)

Why physicians do not recommend websites orhealth apps to their patients?

QUESTION &ANSWER 3:

Because they don´t knowthem?

3:

Mostly YES.(And the commonly given answer.)

3:

But main(& mostly unknown)reason is:

3:

They can´tprescribe them!!Lack of certifications means: recommending an app is a legal grey area

So they better keep hands off!

3:

A physician´scontroversial conjectiveCONCLUSION OUT OF 1 – 2 – 3

The net andthe healthcare sector areparallel universes……WITH A LOT OF MORE OR LESS WEAKCONNECTIONS IN BETWEEN.

CONTRARY TO ALL EXPECTATIONS & STATEDPOTENTIAL, THE NET´S OVERALL CONTRIBUTIONTO HEALTHCARE PROVISION IS STILL LOW.

CONTOVERSIAL CONJECTIVE:

Thank you!

TOBIAS NEISECKEPHYSICIAN & DIGITAL HEALTH EXPERTTWITTER: @TOBIAS_NEISECKEHTTP://MEDIZIN-UND-NEUE-MEDIEN.DE