The impact of informatics

Cybermedicine

Almost every doctor in the developed world has witnessed a patient arriving at the surgery laden with information downloaded from the internet. Such patients are likely to have a detailed knowledge of their own condition or that of their child or of a hypothetical disease. The ensuing conversation can cause headaches for the doctor, who might have to convince a patient that he or she is actually wrong, but the situation may provide a positive outcome for the whole discipline of medicine.

The physician of the 21st century should be prepared for such a scenario because this situation is likely to continue, says Gunther Eysenbach from the University of Heidelberg: "As the educated patient has the same access to information as the doctor, it will lead to a quality leap in medicine. [The patients] will be able to challenge doctors and force them to keep up to date. It will drive the pace of evidence based medicine."

Eysenbach believes that, as the internet develops, international boundaries are likely to fall: "People are already contacting foreign doctors directly by email, and in the future we are likely to see doctors and medical experts becoming more accessible via video conferencing."

In the near future we are likely to see the emergence of telecare and teleprevention. For example, a chronically ill patient with HIV or diabetes or a chronic skin condition may have questions regarding everyday treatment. Instead of booking an appointment, he or she may simply send an email that the doctor can answer promptly.

To prove his point, Eysenbach looked at the user profiles for the website of a dermatology atlas that was originally intended for health professionals. It was obvious that, although hospital specialists, primary care physicians, and medical students used the information, just as many consumers and patients obtained access to the same data. This result can be repeated with many of the other 17 000 websites currently listed under health on the Yahoo medical listing.

Eysenbach likes to make the distinction between telemedicine and cybermedicine. According to him, cybermedicine is the science of applying internet and global networking technologies to medicine and public health (see figure). Cybermedicine deals with global exchange of open, non-clinical information--mostly from patient to patient but sometimes from patient to physician and from physician to physician--while telemedicine deals mainly with the exchange of clinical data in a closed setting. Telemedicine applies to diagnostic and curative medicine, while cybermedicine applies to preventive medicine and public health. Despite these differences, Eysenbach sees cybermedicine and telemedicine as related disciplines, and, as concerns about data security are resolved, the boundaries will become increasingly blurred.
 
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Rapid Responses:

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