Where am I? Why am I having trouble focusing? Oh, wait a minute … that’s my hand … at least, I think that’s my hand. Why does it appear to be moving in slow motion and leaving a blurry trail in its wake? Oh, hang on, there’s my foot. It’s in a cast! Oh, now I remember … it’s all coming back to me now.
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I recently attended the annual Canadian eHealth conference, held this year for the first time at the new Ottawa Convention Centre. One of the themes that emerged during the conference, at least for me, was the role of the individual in their health and healthcare and the extent to which information and related technologies might change this role. Many speakers and participants spoke about the emergence of the Healthcare Consumer and some even suggested that their behaviour will shape future healthcare services. While I think that consumerism has a role to play in healthcare, I also believe that the traditional roles of patient and physician are not going to disappear anytime soon – nor should they.
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I have been involved in many conversations and listened to numerous presentations that use the words “consumer” and “patient” interchangeably, often in the same sentence! While I will readily admit that we can get hung up on words at the expense of getting anything done, I think that the inaccuracy in our use of language can actually impede progress. Such is the case, I suggest, with regard to the words “consumer” and “patient”.
While the debate as to whether the individual who is the subject of care is a “patient” or “consumer” may be heated, both sides of the argument seem to be focused on classifying the individual as either a “patient” or a “consumer”. I contend that “patient” and “consumer” refer to roles that we play and that we can shift between these roles depending upon the situation. I define these roles as follows:
- In the consumer role an individual will make choices of about the services that they need, when they need them and from whom they receive them. In this role, the consumer may engage service providers outside the traditional healthcare system such as a consumer health portal or consult with other individuals in on-line communities of interest.
- In the patient role an individual has made choices regarding the healthcare services that they wish to receive and are engaged with one or more healthcare providers for these services. Just as banks and courier companies are using ICT to streamline operations and engage their customers in ways and at times that are most convenient to these customers so too can healthcare providers use ICT to engage their patients.
Numerous surveys and studies confirm that Internet users have a strong interest in searching for information related to health and medicine and interacting with others who suffer from the same disease or condition. Yet, despite this strong interest in using the Internet for health related purposes, many so-called “personal health record” applications have floundered. Examining these successes and failure reveals a pattern of behavior that is best explained by categorizing the role in which the individual operated when using these applications as either “patient” or “consumer”. Applications that are designed for the role in which the individual is operating are more likely to garner an active and engaged audience.
I think it is time to better define what we mean by the words “patient” and “consumer” and to be more careful about how we use these words. The distinction is critically important to understanding how best to use IT to help people manager their health.
Neil Seeman is one of my favourite eHealth writers and, perhaps, one my favourite essayists period. I find his style quite readable and his insights nearly always thought provoking.
In a recent short essay, Neil takes on one of my favourite topics: the “patient” vs. “consumer” debate.
As you may know from earlier posts, I believe that people act in different “roles” when engaging the healthcare system, sometimes they are a patient under a physician’s care and sometimes they are a consumer seeking advice for a proposed course of treatment for a newly diagnosed disease. I contend that understanding these dual roles in critical when designing eHealth systems that involve the subject of care.
Neil takes an interesting approach to addressing this matter – ask the people to whom these words are applied what they wish to be called. While I like Neil’s approach, the examples that he cites are only ones where I believe the word “patient” is most appropriate. I suggest that we ask people searching google to learn about a medication they have been prescribed or to learn more about the cancer that their Mom was recently diagnosed to have to determine whether these people view themselves as patient or consumer.
If you are looking for well written, easy to read yet thought provoking pieces on eHealth, have a look at Neil Seeman’s work. I don’t always agree with him but I always enjoy reading what he has written.