Democratizing Health

Michael Gill, Founder of Dragon Claw


The widespread use of the internet means that availability of innovative web tools and processes (Web 2.0[1]) to assess, monitor, evaluate, collaborate and explore medical conditions by both patients and practitioners is a reality.  There are a wealth of sites and tools currently available but the level of innovation is yet to explode.  What can Web 2.0 technologies do to improve a patient’s ability to cope or contribute to their eventual health?  This short paper touches key web resources related to awareness of information, navigating the forest, key themes (like drug-drug interaction and diet), confronting the system and taking control.  There is so much more that Web 2.0 can assist with patients helping patients and patients helping doctors that is yet to be realised.  In this context democratising health is about recognising that patients are increasingly equipped to dialogue with professionals and evaluate the appropriateness of their treatment.

There is a quiet revolution going on under the noses of most medical professionals and health systems.  It is a revolution about information access, equity of access and participatory medicine.  The old adage that the ‘doctor knows best’ is being questioned, initially by those of the baby boomer generation but especially by the millenniums.  The huge increase in the incidence of complex chronic disease means that primary care practitioners simply are unable to keep up with the latest research, new modes of treatment and, in Australia, rarely participate in team based care provision.  Our primary model is one of lone practitioners providing services in sequence.

Did you know that the Internet provides opportunities to:

Many users of the Internet are typically presented with passive information display sites but these are increasingly being replaced by interactive sites supporting tools, providing chat room facilities and video like Dragon Claw.  Mobile phone based applications now number in the hundreds with many related to fitness, diet and medical calculators.  The direction of movement is to supplement facts and education with decision support and collaborative environments. The most successful of these are sites where patients exchange information, drug use and the quality of their medical care.  There are very few sites where patients together with health professions interact in real time.

All this challenges the current modus operandi of most medical care delivery outside the acute sector.  For a doctor to spend two hours with a patient exploring and evaluating their condition via Internet based tools and their own office resources questions the model of incentive payments, health insurance and medical indemnity insurance.  The practicality of simply adding these services to a General Practice is unlikely to be feasible.  Moving patient-doctor discussion and preliminary diagnosis on to the web may present a first step in developing new delivery models.  What would happen if a doctor charged $5 for an email reply to an emailed question? Can you even email your local doctor?

Yet there are medical groups who recognise the opportunities and are entering the dialogue.  Perhaps the best of these are a group of medical professionals and patients who see internet technologies as a major support for providing better health outcomes: “Participatory Medicine is a cooperative model of health care that encourages and expects active involvement by all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of care.” (Participatory Medicine) .

But what of the future?  The ability of Web 2.0 technologies and social networking sites to merge and mix health data, personal information and other types of information (commonly known as mush-ups) combined with the increasing popularity of mobile devices suggests that medical doctors, nurses , allied health professional and patients along with their carers may well be pushed down innovative ways of building new health care delivery models.  What is increasingly evident is that demand by patients and their carers for better access, for better tools and to engage in the dialogue about their own care is strong and increasing (Care Out Loud).