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4 November 2015

Dr Google will see you now

Individuals all over the country are attempting to take control of their health by accessing readily available information in order to self-diagnose.

By Becky Slack

In August 2015, New York City experienced an outbreak of Legionnaires’ disease. The worst in the city’s history, it claimed 12 lives and affected more than 120 people. As the sickness spread through the South Bronx, more and more people wanted to know what it was and how to prevent it. The first place many turned to for information was Google. Searches for “Legionnaires’ disease” spiked over 1,000 per cent, instigating an update on information from Google in its health conditions feature.

Overall, one in 20 searches on Google is for health-related information and the website now offers information on roughly 900 different conditions, covering symptoms, treatments, prevalence and prevention. This information can be downloaded and printed in PDF form – a facility Google recently began offering in response to requests from doctors. 

In the UK, a third of the population uses search engines for health advice – the same proportion as those who contact their GP, according to recent research by the Natural Hydration Council, which surveyed attitudes among 2,000 consumers.

Meanwhile, the Picture of Health report commissioned by Philips found that 75 per cent of the British public is digesting health information from a wide range of sources, primarily health-related websites (26%), medical professionals (38%), search engines (27%) and food packaging (22%). Of those British adults who turn to social media channels for health information, many consult these channels at least once a week – Twitter attracting 69%, Facebook 68%, YouTube 56% and blogs 53%.

“As you might expect, millennials are more likely than the majority of adults to use search engines, websites and social media channels as their main information sources,” wrote the report’s author. “Having this information at their fingertips means they are more likely to consult a search engine than a health professional as a health information source – in stark contrast to older British adults, who, without question, consult the doctor most.” 

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It isn’t just websites to which the public is turning for health information. Home testing kits are also becoming increasingly popular. Pregnancy testing has of course been a form of self-diagnosis that has been around for many years, but in recent years more products have become available. It is now possible to test for diabetes, heart disease, bowel cancer and much more – all from the comfort of your own bathroom.

Meanwhile, new connected devices – such as the Philips health watch, which continuously and automatically measures a wide range of health biometrics – are becoming increasingly popular, particularly with those aged 18-24, who are “just as likely to use social and ‘connected’ outlets to assist with health management as they are to visit a professional”, according to the Picture of Health report.

If you are a slightly cynical individual, or prone to worry, you would be forgiven for raising concerns about the reliability of online or home-based health care and, indeed, the risk of mis-diagnosis. In the case of DIY health testing kits, the consumer group Which? found those it tested to be misleading, offering false reassurance or triggering false alarms. Meanwhile, websites containing certain information on symptoms and conditions do not take into account family history and social context when providing analysis and so can miss information that is vital for an accurate diagnosis.

“A large proportion of us are trusting information that can be accessed in seconds to provide answers to issues that could be fairly complex. Although there is a lot of credible information on the internet, there are also a lot of health messages out there that often have no evidence to back them up. I urge everyone to check the credibility of the advice they are seeking online,” says Dr Henderson, a senior partner in a Shropshire general practice.

However, although these concerns are valid and there are certainly risks attached to relying on information online, the public is not always as gullible as media reports insinuate.

Christine Marton, in a piece of research published in the Journal of Hospital Librarianship in May this year, found that approximately half of UK respondents checked the authorship or source of the consumer health websites they visited to determine which organisation was responsible for the content, whereas only 15 per cent viewed the website’s privacy policy to determine how it uses personal information obtained from users. Equally, the most popular site used for health information is NHS Direct, receiving 64 per cent of visits – suggesting that people are keen to ensure the information they are looking at can be trusted. 

All of this contributes to a much wider public understanding of health and health care, Christine Marton found. Almost all (93 per cent) of respondents stated that “the health information they found online had helped them to improve their understanding of an illness or injury”, and over half (57 per cent) had taken action to improve their health based on what they had learned. “Furthermore, several health outcomes resulted from searching from health information online, in particular, improving eating habits, increasing exercise, and relaxing more, especially for those who had used the NHS Direct website,” her report states.

These findings reflect those of the Philips Picture of Health report, which stated how health-care professionals observed psychological benefits among patients who track and share data. Fifty-five per cent of professionals believe that patients are more motivated to follow through with treatments and 41 per cent believe patients are more likely to observe their advice as a result of turning to digital sources for information.

Clearly there are challenges with self-diagnosis: the same Philips report also found that 41 per cent of health-care professionals said patient reliance on digital media for health and wellness information makes their job more complicated and can act as a barrier to the doctor learning about the individual. However, there are also benefits for the patient-doctor experience.

“Patients who are better prepared with their own statistics and their own health data can also prepare and help the clinician and the GP to give a better assessment and a better diagnosis,” says Neil Mesher, managing director of Philips Healthcare UK & Ireland, adding that “the other opportunity is giving patients the tools to better describe and analyse their symptoms”.

Dr Taylor, a GP from Warwickshire, agrees. “When patients come in having read about what might be wrong with them, it can help me guide my questions and get to the source of the problem much quicker.  However, if you go against their opinion you have to do so in a way that is very persuasive and explains precisely why you don’t think they have whatever condition they have researched.  Good communication skills are paramount.”

As technology improves so, too, will the quality of the information available to both patient and doctor, and the benefits of online health-care information and self-diagnosis tools will be felt more widely. We are already beginning to move towards an era of online patient records, while medical advances mean phenotype and genotype modelling is now possible, giving much greater insight into a patient’s genetic make-up and individual characteristics. Combine this information with the data contained in health tracker apps and soon it will be possible to view a holistic picture of an individual’s health profile from any PC, tablet or smartphone. The patient/professional data exchange has the potential to improve efficiency and efficacy when it comes to both prevention and treatment, thus improving health in the individual and reducing pressure on the NHS.

Of course, better access to quality information is vital to improving the nation’s health, but it is not a substitute for health care itself. As Hippocrates once said, “Science is the father of knowledge; opinion breeds ignorance.” Health-care professionals should always be consulted in the event of medical concerns.

This article is part of a thought-provoking series on living health, brought to you by the New Statesman in association with Philips, which looks at how technology, innovation and big data are helping to improve your health and our health-care system.

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