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HEALTH SERVICES ON THE NET - WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE DIFFERENCE? - The physician´s perspective

15th International Conference on WWW/INTERNET 2016
28 – 30 October, Mannheim, Germany
http://internet-conf.org/

HEALTH SERVICES ON THE NET - WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE
DIFFERENCE?
(Panel Session)
Thomas Wetter, Célia Boyer, Tobias Neisecke, Jonas Pendzialek and Monika Pobiruchin

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HEALTH SERVICES ON THE NET - WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE DIFFERENCE? - The physician´s perspective

  1. 1. HEALTH SERVICES ON THE NET – WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE DIFFERENCE? (Panel session) 15TH INTERNATIONAL CONFERENCE ON WWW/INTERNET (ICWI) MANNHEIM, GERMANY OCT 28, 2016 HTTP://INTERNET-CONF.ORG/
  2. 2. The physician´s perspective IN THREE QUESTIONS & ANSWERS 1 – 2 – 3
  3. 3. What is the difference between searching the web and consulting a physician? QUESTION &ANSWER 1:
  4. 4. The web only answers Keep in mind: answer quality depends on what you ask. „If you expect wise answers, you have to ask sensible questions“1 1 Johann Wolfgang von Goethe (Link) 1:
  5. 5. But the physician also asks And he may ask sensible questions to find a personalised differentiated diagnosis. 1:
  6. 6. The net only reacts Results depend on user´s search skills and health literacy. IN OTHER WORDS: The physician interacts Results depend on doc´s experience, sense and sensibility.
  7. 7. Artificial intelligence (AI) & allgorithms try to immitate and play doctor... 1:
  8. 8. ...but fail: IN RESPONSE TO “I AM HAVING A HEART ATTACK,” “MY HEAD HURTS,” AND “MY FOOT HURTS.” ONLY SIRI GENERALLY RECOGNIZED THE CONCERN, REFERRED TO EMERGENCY SERVICES, AND IDENTIFIED NEARBY MEDICAL FACILITIES. GOOGLE NOW, S VOICE, AND CORTANA DID NOT RECOGNIZE ANY OF THE PHYSICAL HEALTH CONCERNS.1 1 Miner AS, Milstein A, Schueller S, Hegde R, Mangurian C, Linos E. Smartphone-Based Conversational Agents and Responses to Questions About Mental Health, Interpersonal Violence, and Physical Health. JAMA Intern Med. 2016;176(5):619-625. doi:10.1001/jamainternmed.2016.0400 (Link) 1:
  9. 9. How is quality of health information on the net? QUESTION &ANSWER 2:
  10. 10. Very heterogenous and difficult to specify. But.. 2:
  11. 11. ...the overall quality is dissatisfying. That´s for sure! . 2:
  12. 12. A TEAM OF PHYSICIANS ANALYSIED 100 HEALTH ADVISING WEBSITES ON 24 CRITERIAS (E.G. COMPLETENESS, MEDICAL EVIDENCE, FAIR BALANCE OF INFORMATION, INDICATION OF SOURCES). KEY RESULTS: • MORE THAN 30 % WHERE RATED AS „POOR“ OR „VERY POOR“ • THE AVERAGE SCALE WAS „FAIR“ (4) Source: Central Krankenversicherungen AG (Editor), Praxis Dr. Internet – Studie zum Kranheitssuchverhalten in Deutschland sowie zur Qualität von Gesundheitsinformationen im Internet (Link) Scale Website count 1 (Very good) - 2 (Good) 9 websites 3 (Satisfactory) 34 websites 4 (Fair) 24 websites 5 (Poor) 30 websites 6 (Very poor) 3 websites
  13. 13. Who is the provider and what might be his intension? ALWAYS CHECK WHEN USING A WEB SERVICE:
  14. 14. Even wikipedia is struggeling for acceptance as a reliable source Sources: The Guardian, Is Wikipedia a reliable source for medical advice? (Link) Hasty RT et al.. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions. J Am Osteopath Assoc 2014;114(5):368-373. doi: 10.7556/jaoa.2014.035. (Link) Mühlhauser I et al., Does WIKIPEDIA provide evidence-based health care information? A content analysis, Z. Evid. Fortbild. Qual. Gesundh. wesen (ZEFQ) doi:10.1016/j.zefq.2008.06.020 (Link) Wikipedia; Reliability of wikipedia (Link)
  15. 15. Why physicians do not recommend websites or health apps to their patients? QUESTION &ANSWER 3:
  16. 16. Because they don´t know them? 3:
  17. 17. Mostly YES. (And the commonly given answer.) 3:
  18. 18. But main (& mostly unknown)reason is: 3:
  19. 19. They can´t prescribe them!! Lack of certifications means: recommending an app is a legal grey area So they better keep hands off! 3:
  20. 20. A physician´s controversial conjective CONCLUSION OUT OF 1 – 2 – 3
  21. 21. The net and the healthcare sector are parallel universes… …WITH A LOT OF MORE OR LESS WEAK CONNECTIONS IN BETWEEN. CONTRARY TO ALL EXPECTATIONS & STATED POTENTIAL, THE NET´S OVERALL CONTRIBUTION TO HEALTHCARE PROVISION IS STILL LOW. CONTOVERSIAL CONJECTIVE:
  22. 22. Thank you! TOBIAS NEISECKE PHYSICIAN & DIGITAL HEALTH EXPERT TWITTER: @TOBIAS_NEISECKE HTTP://MEDIZIN-UND-NEUE-MEDIEN.DE

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