Online healthcare including telehealth telemedicine is becoming more accepted by both patients and doctors, and is, I believe, finally at a tipping point. By 2015 online communication between patients and doctors and the routine use of multimedia information will be the norm.
Patients will still be seen in person but our improved capacity to communicate electronically is, as Clayton Christensen has put it, a “disruptive innovation” that will revolutionize healthcare delivery. Providers and patients will be routinely using these new technologies, such as email, telemedicine, electronic records, social networks and wireless mobile applications with patients. This will make healthcare more affordable, accessible and efficient for all. Choice of communication tool will increasingly become common, with patients being able to make decisions on how to communicate with their doctors based on convenience and cost, as well as on medical necessity. Increasingly video consults will be integrated into medical clinics, with patients being seen both in person and by video, phone or email during the average clinic session.
These changes will be supplemented and strengthened by the availability of multimedia data. Electronic clinical information will be more freely available than today for both patients and doctors to review, comment on, pass to others for second opinions, and compare with clinical databases and disease registries. This data will be in multiple electronic formats – numeric, text-based, audio, digitized still pictures, video, radiologic, genomic and 3D streams. It will include data emanating from multiple medical monitoring and diagnostic devices as well as from ubiquitously available consumer devices such as cell phones. Patients and physicians will have to learn to navigate a “sea” of data, using new techniques to evaluate and analyze the relative importance of specific data points and elements of clinical information. The capacity of patients to analyse and compare their own health data with other grouped data from people who have similar demographic backgrounds or illnesses will increase the power and knowledge of patients within the doctor-patient relationship, and will improve health decision making by all.
These two changes will mean that by 2015 the relationship that many patients have with their doctors will have expanded beyond the in-person interaction of today, and will increasingly occur literally anytime, anywhere in both online and in-person environments. Doctors will need to manage their practices differently, and in particular will have to work out how to arrange cover for themselves so that they do not become overwhelmed by constant work related messages, and patients will have to learn who to trust in an increasingly distributed health environment, as more and more people get involved in their “care” from their friends on a social network site to a specialist from another state seen on telemedicine for a second opinion.
Almost all my patients now want to communicate with me via email, and all assume (correctly) that I keep all of my records electronically. These are big attitudinal changes and lead me to be confident that the tipping point for the increased use of online healthcare is happening right now.