Do people seek information from HCPs online or do they prefer online support from fellow patients?
Over recent years there has been a steady increase in the availability of patient-focused websites offering health information and support across a wide range of conditions. A survey of c7,000 patients carried out by the Nuffield Trust, found that 50% of people in the UK self-diagnose online long before they make a doctor’s appointment.
When it comes to discussion around their condition, it’s interesting to see where patients go online. Do they seek information from HCPs online or do they prefer online support and personal experience-based information from fellow patients?
It’s certainly not a one-size-fits-all scenario, and from experience it would seem patients do both; the real life, open and honest views of others carry much weight as patients feel normalised by hearing that others are experiencing similar issues. Yet at the same time, there are increasing numbers of patients seeking help and guidance online from healthcare professionals. With the growth of relatively affordable online doctor services, instant access to HCPs is made increasingly possible.
There is a plethora of patient health communities to choose from including forums, Facebook groups, Google Hangouts, Twitter Chats etc where patients can talk and share information freely amongst like-minded individuals. In a 2016 talkhealth survey, patients were asked what they specifically liked about the taklhealth website and other related sites. Just over half said they visit the site specifically to talk with others in the online forums, with 58% awarding online forums 4 or 5 out of 5. There is a clear desire for patient communities where people can talk and share their experiences. Patients can remain largely anonymous, protecting their identity yet having exposure to large groups of people with relevant knowledge and experience.
In contrast, online doctor services have been slower to develop. Lagging the growth of patient communities, pharmacies were some of the first to provide online services, with a pharmacy-based doctor writing prescriptions for contraception, erectile dysfunction and weight loss medication for example. However, in recent years there has been significant growth in private online doctors offering a much more comprehensive service. These subscription-based services have attracted time-poor patients who can afford to pay and want instant access, usually within a few hours from the comfort of their own home or office. Several healthcare insurers and corporate companies are now adding this type of doctor service to their policies. With increasing waiting times to see an NHS GP and patients wanting information, diagnosis and treatment quickly, the online doctor is here to stay. Currently these services are the private alternative to the NHS doctor. But this could be about to change.
Orbital Media and the University of Essex are undertaking a 30-month project they believe could save the NHS millions. A platform incorporating machine learning principles is being developed, meaning it can be trained with user data to align its responses to natural language questions and queries. The patient can type a question and ask a virtual GP a question via their smartphone or computer. A pre-recorded video of a GP answering the question is played to the patient. Initially, the platform will focus on minor illnesses like colds and coughs, but this in itself will provide quick and easy access for patients and a potential saving to the NHS of c£20 million a year. As technology evolves and projects like this prove successful, the outlook for an increasingly sophisticated online NHS doctor service seems more realistic.
Alongside such services, several health websites offer doctor Q&A services. An extension of magazine based Q&As, patients email their questions and the doctor provides an answer, usually published on the website.
Similarly, talkhealth has run monthly Online Clinics for the past 6 years. These are forum-based, in collaboration with a panel of medical experts and relevant charities on a specific topic each month. Patients, once registered, can log into the Clinic and post their question. Experts provide timely responses for each patient, mainly focused around guidance, and recommendations around what the patient might need to do next, including questions they can ask their GP. In the 2016 survey, 61% rated the clinics very good with 69% rating the guidance provided by experts as very good.
Evidence across the Internet demonstrates the value of both peer to peer support and professional medical advice. As patient need and preference differs from person to person, there is tangible value in talking with others who really understand the highs and lows of living with a specific health issue, particularly from an emotional perspective. Yet there is also value in the ease of access to some of the doctor services already discussed. It will be interesting to watch how both types of support develop over the next 5-10 years, and how such services can be translated into the NHS for the benefit of all, not just for the most Internet savvy or those who can afford to pay.
Deborah Wyatt is the Founding Director of talkhealth, providing support and information for patients living with chronic health conditions.