A smarter way to practiseBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1124 (Published 22 February 2011) Cite this as: BMJ 2011;342:d1124
All rapid responses
Giving a leaflet to a patient when they are about to walk out of the
door is not enough anymore. A large part of our job is sharing information
with patients. In my opinion, patients who are better informed are better
partners when it comes to discussing a diagnosis or treatment. A well
informed patient can take more responsibility for their own health. There
is of course an information overload and this has to be managed somehow.
Increasingly the information is getting mobile. It's a fact of life, we
can't change this or stop this and we shouldn't. The only way forward is
to take part in this information revolution.
The death of a patient from malaria prompted me to develop an iPhone application for Travel
Health. Travellers sitting in the back of a bus in rural Africa or an
airport departure lounge in South East Asia can now take the information
with them in the form of an App. This can sit next to the thousands of
songs, films and games. And perhaps this will remind them to take those
Interestingly, most downloads of the Dr. iSeb Travel Health
Application are from the USA, partly because it's a much bigger country
with many more iPhones, but also perhaps because American patients are
more used being well informed. The next thing patients expect their Health
Care Professional to do, is to inform them through twitter on a regular
basis. Try it, you may get a large following.
Competing interests: I developed an iPhone application for Travel Health called: Dr iSeb, otherwise no competing interests.
Smartphones are part of modern life and need to be accepted as such.
Attempts to ban them from hospital environments must not be necessarily
regarded as anachronistic but needs to be understood as an attempt to
provide stress free environments for patients in hospitals in order to
support the recovery process.
However, it needs to be highlighted that the merit in using smart phones
lies more in the ability to access information at any time, from anywhere
any how, a concept which is still in it's infancies, rather than in the
idea of storing information on the phone, which is worse than removing a
(encrypted) data stick out of it's designated environment and should be
avoided at any cost.
Healthcare models are changing and over the last decades we have been
witnessing a shift in care models from the classical hospital based,
specialist focused model to a novel, distributed, patient centered care
model, where the point of care is successively shifting away from
hospitals towards GP practices, patient homes, care homes, day hospital,
etc (supported by statistical data on average length of stay, hospital bed
days and hospital beds on national(UK) and European level).
Smart phones will be able to unfold their true potential once the
infrastructure will be in place to access data in a safe and secure manner
across several domains and networks. More and more care will be delivered
by an increasingly diverse group of formal and informal carers who might
lack expert knowledge on a personal level but will be empowered by their
mobile "smart phone" or "smart device". These devices will allow access to
real time data via secure portals. Authentication will take place with the
help of "new age" identity providers, such as PayPal, VISA, Google, etc.
Apple already stores the credit card details of all their ITunes customers
online. Novel technology will also empower patients to view their data
kept on file by any health care or care provider and will provide
important interfaces with providers of virtual care such as NHS24 in
Scotland or NHS Direct in England. Latest Information Communication
technology such as Service Oriented Architectures such as Cloud Computing
and the Future Internet will play a key role in integrating multi-modal
data across several domains and networks in real time and will help to
improve the mobility of information and people. Expect huge changes over
the next 5 years.
Competing interests: No competing interests