Patients Looking for Information on the Internet and Seeking Teleadvice

Eysenbach, Günther; Diepgen, Thomas L.

doi:10.1001/archderm.135.2.151

Cited by 145 publications

(54 citation statements)

References 7 publications

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“…Eysenbach & Diepgen [2] provided a more thorough analysis of 209 emails sent to a university department of dermatology in a four-month period between April and August 1997. Forty percent of all emails could have been answered by a librarian, 28% of all emails were suitable to be answered by a physician via email alone, and in 27% of the cases any kind of consultation would not have been possible without seeing the patient.…”

Section: Resultsmentioning

confidence: 99%

“…The latter constitute about 27% in one study [2]. It can also be learned that patients are not always able to distinguish between questions that are suitable to be answered via email and those that aren't.…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, the situation is difficult for the physician, as he or she may not be sure about the ethical duties and the legal consequences of his or her actions. Guidelines may help to better define such contacts to avoid misunderstandings [1,2]. There have also been concerns that what we call Type A encounters here may "disturb delicate balances in the patient-physician relationship, widen social disparities in health outcomes, and create barriers to access" [3].…”

Section: Introductionmentioning

confidence: 99%

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Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship — systematic review and expert survey

Eysenbach¹

2000

J Med Internet Res

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BackgroundMany health information providers on the Internet and doctors with email accounts are confronted with the phenomenon of receiving unsolicited emails from patients asking for medical advice. Also, a growing number of websites offer "ask-the-doctor" services, where patients can ask questions to health professionals via email or other means of telecommunication. It is unclear whether these types of interactions constitute medical practice, and whether physicians have the ethical obligation to respond to unsolicited patient emails.ObjectiveTo improve the quality of online communication between patients and health professionals (physicians, experts) in the absence of a pre-existing patient-physician relationship or face-to-face communication, by preparing a set of guiding ethical principles applicable to this kind of interaction.MethodsSystematic review of the literature, professional, and ethical codes; and consultation with experts.ResultsTwo different types of patient-physician encounters have to be distinguished. "Traditional" clinical encounters or telemedicine applications are called "Type B" interactions here (Bona fide relationship). In comparison, online interactions lack many of the characteristics of bona fide interactions; most notably there is no pre-existing relationship and the information available to the physician is limited if, for example, a physician responds to the email of a patient who he has never seen before. I call these "Type A" consultations (Absence of pre-existing patient-physician relationship). While guidelines for Type B interactions on the Internet exist (Kane, 1998), this is not the case for Type A interactions. The following principles are suggested: Physicians responding to patients' requests on the Internet should act within the limitations of telecommunication services and keep the global nature of the Internet in mind; not every aspect of medicine requires face-to-face communication; requests for help, including unsolicited patient questions, should not be ignored, but dealt with in some appropriate manner; informed consent requires fair and honest labeling; health professionals and information providers must maintain confidentiality; health professionals should define internal procedures and perform quality control measures.ConclusionsDifferent media are appropriate at each point on the continuum between dispensing general health information and handling patient problems that would require the practice of medicine to solve. For example, email is a sufficiently capable medium for giving out general health information, while diagnosis and treatment usually requires at least advanced telemedical technology. Patients have to be educated that it is unethical to diagnose and treat over the Internet in the absence of a pre-existing patient-physician relationship, and if the interaction is limited to a single email. More research is needed to establish more evidence regarding situations in which teleadvice is beneficial and efficient.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship — systematic review and expert survey

Eysenbach¹

2000

J Med Internet Res

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“…Patients can easily access medical information that for a long time was only available to medical professionals. They can meet and interact with doctors and other patients online, actively taking part in their diagnosis and treatment using information from health websites (Eysenbach & Diepgen 1999;Ziebland 2004). To capture the changing relationships between patients and doctors in the 'information age healthcare system' (Eysenbach 2000) and inspired by Giddens's notion of the reflexive consumer (Giddens 1991), sociologists have introduced new conceptualizations of patient identities, including the reflexive patient, the informed patient, the healthcare consumer (Eysenbach 2000), the online self-helpers (Ferguson 1997), the net-empowered medical end-user (Ferguson 2002), the resourceful patient and the expert patient (Muir Gray 2002).…”

Section: Introductionmentioning

confidence: 99%

Constructing the digital patient: Patient organizations and the development of health websites

Oudshoorn

Somers

2006

Information, Communication & Society

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CONSTRUCTING THE DIGITAL PATIENT Patient organizations and the development of health websitesIn order to understand the constraints and challenges of realizing the democratic potentials of the Internet, this paper focuses on the attempts of three Dutch patient organizations to develop health websites. The authors describe how these patient organizations had to overcome specific barriers to develop their digital services. All three organizations faced certain constraints that had negative consequences for the plans they wanted to realize. Lack of financial resources and manpower were the main reasons why these patient organizations could not develop interactive parts of their website or provide personal advice services. Other barriers the patient organizations had to overcome were getting access to digital expertise to build the websites. The paper shows that the development of a website is a very demanding task, even for patient organizations that have in-house expertise with computers and Internet. Moreover, the paper shows that patient organizations do not consider the involvement of patients as crucial for the design of health websites. This research thus confirms previous research findings that users, in this case patients, are largely absent from the design process of information and communication technologies Finally, the paper shows how patient organizations' websites contribute to a redefinition of the patient from being a passive actor towards one who is an active participant in his or her care.

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“…The inquiries of cancer patients reflect their search for therapies, such as mistletoe therapy [16,17] that might have a positive impact on the course of their disease and reduce chemotherapy-induced adverse effects. Patients with chronic conditions inquire about CAM therapy options because their previous treatment had failed and/or because they were afraid of the adverse effects or hoped to reduce the dose [18]. Some users contacted the online consultation service to obtain a second opinion from a competent reliable university institution.…”

Section: Discussionmentioning

confidence: 99%

Medical Online Consultation Service in CAM at the University Hospital Zurich

Schmidt-Weitmann

Bühler

et al. 2014

Complement Med Res

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Background: The University Hospital Zurich offers medical online consultation services in individual health concerns. We examined the need for users' information in the field of CAM. For this purpose, the content of the questions, the users' profiles, and the online responses of the physicians were analyzed. Methods: The retrospective study analyzed 154 (1.3%) out of 11,827 questions and responses, selected by a literature-based keyword list between 2006 and 2007. They were evaluated by means of an inductive category system described by Mayring using a professional text analysis program (MAXQDA). Frequencies and mean values of the categories were statistically determined. Results: Users (aged 39.2 ± 16, females 61%) asked questions, which were in 73% allocated to herbal medicine, 7% to homeopathy, and 2% to acupuncture. The questions referred to medical fields, such as gynecology (18%), dermatology (13%), psychiatry (11%), and oncology (8%). One third of the responses provided detailed information about herbal treatment options. Conclusions: The email-based online consultation service was used as a source of medical information in order to get more professional consultation in the field of CAM. Future scientific evaluation should investigate if online consultation services which are embedded in an environment of highly qualified health professionals may contribute to a better health literacy and empowerment of the patients.

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Patients Looking for Information on the Internet and Seeking Teleadvice

Cited by 145 publications

References 7 publications

Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship — systematic review and expert survey

Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship — systematic review and expert survey

Constructing the digital patient: Patient organizations and the development of health websites

Medical Online Consultation Service in CAM at the University Hospital Zurich

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