Practical Pearls: Getting the e-Patient Equipped and Engaged

Patients often search the internet for medical answers and solutions before talking to their healthcare provider (HCP). This article provides practice pearls for conversing with an e-patient.

We live in a world in which information is at our fingertips and finding the answers to almost any question, including one about our own health, is just a web search away. All of us at some point likely will be a patient or have a family member or friend with a condition that we will research online. The Institute of Medicine estimates that more than 80% of U.S. internet users have looked online for health information and approximately 1 in 4 follow online an individual’s health experience.(1,2) Google, Web MD, Wikipedia, Facebook, Twitter and personal blogs often are used to find information on specific diseases and treatments. A study by the New Health Union found that 73% of internet users claim online health information has impacted their decisions regarding medical management.(3) The most commonly searched conditions in 2017 were diabetes, depression and anxiety.(4)

The concern about consulting “Doctor Google” rather than your HCP is that online, media-based information can a business or product. Healthcare information should not come via Facebook, magazines at the checkout line or celebrities seeking financial gain. This type of information often is not supported by research data but by personal opinion. For example, consider the lipidologist or clinical lipid specialist trying to start statin use for a patient who recently read a blog from an anonymous person saying that statins had crippled him. These publicized claims can be challenging for clinicians who are trying to provide individualized, evidence-based care for their patients.

Unfortunately, the patient’s level of healthcare literacy may preclude them from understanding the validity – or lack thereof – of the data. The information provided by legitimate sources sometimes may be too technical for patients to understand. Specific statements supported by research data need to be promoted by reputable organizations and individuals,

with caution taken toward those who may make false claims and state their personal opinions. Healthy People 2020 health initiatives recommend that health professionals address e-health literacy through continual patient-provider feedback, productive interactions and access to evidence on the effectiveness of treatments and interventions.(4) This will help change the way patients receive, process and evaluate health information and increase their e-health literacy.

The e-Patient:

Obtaining information online that enables a patient to better care for themselves can be beneficial, and there is some evidence that this has led to positive changes in health care.(6) Actively engaging in their medical decision-making and seeking out information to make better decisions can help patients achieve better outcomes. Increased access to health information has been a driver in healthcare reform, changing from a volume-based approach to a value-based approach.(6) Empowering the healthcare consumer by making health resources available can be traced back to a “medical self-care” movement started in 1976 by Tom Ferguson, a medical student at Yale.(7) Ferguson envisioned HCPs and their patients as equal partners, coining the term “e-patient.”(6) In today’s digital age, an “e-word” usually represents an electronic format, but an e-patient is not defined as one who is electronically connected. The “e” in e-patient stands for the patient who is equipped, engaged, empowered and enabled.

The e-Patient:

The late Dr. Warner Slack, electronic medical records pioneer and advocate for empowering patients, is quoted as saying, “The most underutilized resource in all of healthcare is the patient.”(8) As HCPs, we want our patients to play an active role in their care and to make wise decisions as healthcare consumers.

Listed below are ways HCPs can “EQUIP” patients when accessing healthcare information online:

E — Engage. Find out what they are reading and take time to answer patients’ questions.
Q — Quality. Refer them to quality sources – such as reputable professional organizations like the American Heart Association, American College of Cardiology, National Lipid Association or Preventive Cardiovascular Nurses Association – that will provide accurate information.
U — Understand. Use terms and language they understand. Make sure that all information is at the appropriate learning level, nothing higher than a fourth-grade level. Consider using bullets points to make pertinent points clear. I — Interdisciplinary approach. Utilize all the members of the healthcare team, including medical assistants, pharmacists, dietitians, nurse practitioners and physician assistants.
P — Provide. Be the source of their information.

As HCPs, we can encourage our patients to ENGAGE as an active participant in their healthcare:

E — Educate yourself about your condition or treatment.
N — Need to stay away from unreliable sources of education or advice. G — Guard against false statements and be aware of those whose “information” brings them financial gain.
A — Ask questions of your healthcare team, including physicians, nurses and your local pharmacist.
G — Greatest asset in the healthcare team is YOU. Learn to trust yourself.
E — Engage in educated decisions for healthcare.

1. We hope that, through EQUIP and ENGAGE, your patients will gain the appropriate tools and data to manage and treat their condition alongside their healthcare provider.