All innovation begins with hypotheses and theories, which, when taken together, sway the risk-benefit ratio toward allowing the initial step into the darkness of that venture. Some of these theories prove to be true and are incorporated into future iterations, while others are proven false and are discarded.
There is another type of theory that, while unproven, seems to persist and grow, either through intuition, fear, emotional response or other unidentified reason to become a myth and sometimes even an urban legend. This other type of theory can unnecessarily interfere with and sometimes even arrest the progress of innovation, even if that innovation has been proven extremely useful and/or desirable.
Digital health is changing how clinicians and patients interact with health information and their providers. More and more Canadians are able to view their personal health history online, connect with their care provider through a virtual setting and e-book medical appointments, leading to changes in clinician workflows as well as some uncertainty and anxiety. Canada Health Infoway, established in 2001, is an independent, not-for-profit organization funded by the federal government. The deputy ministers of health for the 10 provinces, three territories and the federal government make up the members of the corporation. Infoway’s stated goal is to “improve the health of Canadians by working with partners to accelerate the development, adoption and effective use of digital health across Canada.”
Infoway identified, researched, then published several digital health myths here in an attempt to reduce the negative effect that these myths may have on the progress of digital health in Canada. I highlight a few of these, but I encourage the reader to explore the entire collection, including references, for themselves.
Myth: Patient-doctor relationships suffer when there is a computer screen in the exam room.
Fact: Technology does not impact the quality of the interaction. Electronic records provide complete patient information and historical information at the point of care. Almost two-thirds of physicians who used electronic records (65%) reported better or much better quality of care since implementation.
Myth: Patients don’t want to see their health information and won’t find the information useful.
Fact: 69% of Canadians who don’t currently have online access to their medical records would like access. Furthermore, Canadians who do have access find it beneficial. In one study, 94% of patients who use portals said they valued viewing their health information online. Another 74% of Canadians with access to digital health say it helps them have more informed discussions with their doctor.
Myth: If patients are able to view lab test results online before talking to their doctors, they will be overly anxious.
Fact: Patients who view their results online are no more anxious than those who wait to learn about them in person. A study showed 93% of patients who accessed their lab results online said they had more informed discussions with their doctor. Additionally, patients with one or more chronic conditions were less likely to report being anxious.
Myth: Doctors will be flooded with calls if patients have access to their lab results online.
Fact: Patients who have access to their lab results online are less likely to call their physicians while waiting for results and they’re less likely to have an in-person visit related to their results. Additionally, patients who have access to their health information through a patient portal are less likely to call or make requests for information, with one Ontario study finding a 61% decrease in requests for information when a patient portal became available.
Myth: The introduction of virtual visits means I won’t see my doctor anymore.
Fact: Face-to-face visits will remain a cornerstone of primary care, but sometimes an in-person visit isn’t required. According to research, patients who opt for virtual visits do so to save time, gain faster access to care and avoid a work absence. Virtual visits can also enable continuity of care for those in remote communities because it requires less travel.
Myth: The quality of care offered in a virtual visit is not as good as the care in a face-to-face visit.
Fact: While in-person visits are essential in some cases, in many scenarios virtual visits can provide the same standard of care. A BC study found 79% of patients who had a virtual visit said the quality of care was the same as in an in-person visit. 91% said the online visit helped them with the health issue for which they needed the appointment.
Myth: Digital health is only for the young and tech savvy.
Fact: Canadians are very connected, including seniors. 88.5% of Canadian households have Internet access. Digital health offers important opportunities for advancing care for seniors through programs such as telehomecare. In a study where the average age of respondents was 75 to 84, 98.3% of telehomecare patients were satisfied with the program. Additionally, growth in the availability of digital health services for Canadians more than doubled between 2014 and 2016.
In Alberta, the patient health record will soon be a reality, giving Albertans unprecedented access to their own health information. Evidence from other jurisdictions has shown this as a significant step forward in patient satisfaction and reduced risk without increased workload to physicians. I would encourage the reader to review all of the Infoway myths to take an evidence-based approach to digital health innovations in our province and country.