Idle thoughts
Everybody knows that Jerome K Jerome wrote Three men in a boat. Not so
many people, however, know that he also wrote Three men on the bummel,
a book about a cycle tour of the Black Forest, which is much funnier. And,
like AA Milne, he also wrote essays. It is from an essay in his collection
Idle thoughts of an idle fellow, that I take my text for this issue,
because it epitomises the problem of writing editorials. “‘I will write one
piece about something altogether new,’ I said to myself, ‘something that
nobody else has ever written or talked about before: and then I can have it
all my own way.’ And I went about for days trying to think of something of
this kind; and I couldn’t.’”(1)
Today, however, we can think of something new. In this edition of the
Journal, we look at the concept of involving patients to a much greater
degree than ever before in their own healthcare. This is an idea that is
currently very much in vogue. In an age when demands on the healthcare
system are infinitely greater than ever before, partly because of advances
in medical science, partly because of the inexorable rise of public
expectation, and partly because of the tidal wave of information that is
available on the Internet, the patient is, in one sense, more on his or her
own than ever before.
NHS Direct attracts thousands of calls each day from people seeking
advice. The Internet offers a bewildering array of data on every possible
medical condition and many others besides. So bewildering is that plethora
of data (not all substantiated!) that the patient cannot be anything but
confused. That is where patient choice begins to look not quite as
attractive as the political theorists make out — and that is where the
medical profession will always play a crucial and indispensable role,
guiding the patient through the maze on the basis of professional expertise.
There is, however, one valuable new element: the realisation of the
degree to which patients can support each other and, through accredited
websites, ask those questions which they had felt unable, or had forgotten,
to ask face to face in the consultation.
In our first article, Sheila Wilson, Patient Informatics Specialist from
the Wirral Health Informatics Service, describes just such a process and the
recurrent themes occurring in an evidence base to provide information for
cancer patients and their relatives.
In our June issue, we published an article by Dr Vinod Joshi — a winner
in the 2005 Healthcare IT Effectiveness Awards — describing his work in
creating a website and online support group for patients with mouth cancer.(2)
The findings of the Wirral survey on what kinds of information are wanted by
patients follow very similar themes: the need for honest (that is, not
euphemistic) information that can be absorbed at leisure, the comfort to be
derived from learning of the positive experience of others and the very real
support that can come from discussion. All these show both real needs of
patients and ways in which those needs can be met.
In their article, Elias Koury and Callum Faris describe another new
approach: helping the patient to save NHS money. Failure to attend at booked
outpatient appointments is a major source of waste in the NHS, and the
authors conducted a trial using SMS messaging to remind patients of their
imminent appointments. Coupled with a pre-existing postal reminder system,
the trial showed positive results. It demonstrated not only the efficiencies
to be gained from using text messaging to remind patients of their
appointments, but also the potential for using messaging for other forms of
dialogue within healthcare — for example, between clinician and patient in
self-administered clinical testing and treatments.
As information technology permeates more and more aspects of healthcare,
either directly in the treatment process, or indirectly in the delivery of
that process, so we may expect to see more and more opportunities to benefit
the patient, in ways both big and small. When Jerome K Jerome complained
that he could find nothing new about which to write, in desperation he
finally wrote about the weather. We have been more fortunate: the weather is
not bad as a topic (especially during the recent Fifth Test Match), but the
potential to help the patient is rather more rewarding.
Michael Fairey
References
1. Jerome JK. On the weather. In: Idle thoughts of an
idle fellow. London: Field and Tuer, The Leadenhall Press, 1886.
2. Joshi V. Creation of a mouth-cancer website and online
support group. Br J Healthcare Comput Info Manage 2005; 22(5): 17–19. |
