Healthcare information for all
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m759 (Published 28 February 2020) Cite this as: BMJ 2020;368:m759All rapid responses
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Dear Editor,
Patients need access to their own information and results as well as quality general information - as recommended by the WHO in 2019** -
"Transmission of customized health information for different audience segments (often based on health status or demographic categories). Targeted client communication may include: i. transmission of health-event alerts to a specified population group; ii. transmission of health information based on health status or demographics; iii.alerts and reminders to clients; iv. transmission of diagnostic results (or of the availability of results)."
** Adhanom Ghebreyesus Director-General, World Health Organization supports health information for all. in the The 2019 WHO guideline: recommendations on digital in"terventions for health system strengthening he writes "Telemedicine, remote care and mobile health are helping us transform health by delivering care in people’s homes and strengthening care in health facilities.
"Harnessing the power of digital technologies is essential for achieving the Sustainable Development Goals, including universal health coverage and the other “triple billion” targets in WHO’s 13th General Programme of Work. Such technologies are no longer a luxury; they are a necessity. ….A key challenge is to ensure that all people enjoy the benefits of digital technologies for everyone. We must make sure that innovation and technology helps to reduce the inequities in our world, instead of becoming another reason people are left behind. Countries must be guided by evidence to establish sustainable harmonized digital systems, not seduced by every new gadget.
"..the recommendations examine the extent to which digital health interventions, primarily available via mobile devices, are able to address health system challenges along the pathway to UHC. "
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Competing interests: No competing interests
Dear Editor,
I read with great interest the article ‘Healthcare information for all’ [1].
One of the most important World Medical Association (WMA) recommendations is the following: ‘Combat myths and misinformation around healthcare through validated scientific and clinical evidence’ [2]. Action is now needed to take this and other WMA recommendations forward [1]. Here is a humble effort in this direction [3,4].
References
1. Pakenham-Walsh N, Godlee F. Healthcare information for all. BMJ 2020;368:m759.
2. WMA statement on healthcare information for all. Adopted by the 70th WMA General Assembly, Tbilisi, Georgia, 2019.
3. Jargin SV. Scientific Papers and Patents on Substances with Unproven Effects. Recent Pat Drug Deliv Formul. 2019;13(1):37-45 https://www.researchgate.net/publication/331613272
4. Part 2. Recent Pat Drug Deliv Formul. 2019;13(3):160-73 https://www.researchgate.net/publication/335253828_Scientific_Papers_and...
Competing interests: No competing interests
Dear Editor,
I read with great interest the article entitled ‘Healthcare information for all’.
Whilst the World Medical Association’s seven recommendations are to be welcomed, it is worth noting that there are still barriers to fulfilling the objective of providing healthcare information for all at home in the UK. In my practice, I see three main issues:
First, access to patient information between NHS trusts and between primary and secondary care is problematic. For example, staff might not have access to health records of another hospital within the same Trust, let alone between Trusts across the country - this is particularly important for accessing information from tertiary centres. An inability to access test results, radiology and clinic letters and documentation means rapidly obtaining a holistic view of the patient is impossible. Joining up systems so that doctors can view all patient records in one place would be a material improvement to the efficiency and effectiveness of the care we are able to offer.
Second, patients do not have a central store for their records. Good progress has been made with making GP records available online, but more needs to be done. Social enterprise Patients Know Best has shown that bringing records together and putting the patient at the centre is a model that patients find attractive. Empowering patients to take ownership of their health records will likely lead to a more informed patient population and more effective consultations with clinicians.
Third, patients are expected to absorb a lot of information when they come to hospital for a consultation. A number of new apps are available which record the consultation and then use technology to extract the key messages. Having a record of the consultation which can be referred to once the patient is back at home will help patient comprehension and, again, lead to a more informed patient population.
With some relatively minor changes to the way we handle patient records and interactions, we could make a major difference to how educated patients are about their conditions and how engaged there are in their care and treatment plans.
Competing interests: No competing interests
Re: Healthcare information for all
Dear Dr Pakenham-Walsh and Dr Fiona Godlee,
Your recommendations are great so far as they go. Why does the health community, though, fail to see that in addition to these recommendations (and other sensible ideas) - and not in competition with them - we need to start helping children develop a language that talks about illness as a part of normal life. The current crisis this seems to me to be a sad but obvious endorsement of the need to do this. Why is there so little work done on health literacy for children. So far as the dry academic subject is concerned, the work is around improving general literacy to a level where medical information can be understaff and not on inviting children to look at health and illness as their property. We have been doing this for several years now in Gloucestershire schools working with children from 4-14with enlightened funding from the CCG combining the insights and learning from both health and education. By doing this we can help children understand that they own their health, they have responsibility for it and that, generally, most of them will get better from most illness on their own - especially if they really do take on board those simple messages about lifestyle (and more so now about things like hand washing). And, we have had great results, as I have mentioned before (BMJ 2017; 358: j3986; BMJ 2007;335:628; https://doi.org/10.1093/pubmed/fdx003), showing that we can alter even young children's attitudes to illness.
Surely, it's time to start talking more openly and honestly with children about issues that will affect them all.
Competing interests: No competing interests