Without doubt, the practice of medicine has benefited hugely over recent years from the introduction of modern digital technologies. However, like all medical devices, drugs, and other therapies and interventions—we also have to consider the downsides as well as the obvious benefits. One aspect is the impact of technology on a core aspect of patient care; the consultation that takes place between a patient and a doctor.
The internet can provide a vast array of information for the user, which can include electronic medical records, pathology and imaging results. The attraction of accessing these knowledge bases means that the doctor is not always fully concentrated on the patient. Some patients not unreasonably find it a little upsetting when the doctor seems distracted. This can apply particularly to a number of our elderly patients, some of whom may not feel comfortable with the impact of this technology.
Tablet computers (such as the iPad) and smartphones (such as the iPhone) also have significant medical capabilities. In fact, the iPad mini has recently generated some positive feedback in a medical setting.1,2
Many patients will understand why the doctor may have to look up prescribing information on the paper version of the BNF, but it may seem odd to some if the doctor reaches for their smartphone to look at the BNF app. Equally, the doctor may grab their tablet computer for use in a care setting. If you think this is a little far-fetched then think again. According to a blog3 a substantial number of doctors in the USA are using their tablets “with 62% of those surveyed saying they use one for professional purposes”.
Although such devices offer great opportunities to bring knowledge and information into the consultation, it is important that we don’t get seduced by their sleek and sophisticated interface. They don’t always get it right. An interesting paper recently published showed that smartphone based clinical apps displayed a variable success rate compared with clinical endpoints and so may not be completely reliable.4
Perhaps we could explain to the patient what we are doing when we are interacting with a device or computer screen. Or share the screen of whatever device we are using with the patient so they can see what we are looking at.
Interacting intelligently with modern technology is the way forward, but it also requires commitment from us, the healthcare professionals. By all means use all the technology available at our disposal, but it should be utilised appropriately in partnership with our patients.
4.Wolf J, Moreau J, Akilov O, et al. Diagnostic inaccuracy of smartphone applications for melanoma detection JAMA Dermatology. 2013: 1-4