Could ehealth raise public awareness of clinical conditions?

I came accross an interesting article published in BMC Medicine titled “Do citizens have minimum medical knowledge? A survey”. The authors found a “consistent and dramatic lack of knowledge in the general public about the typical signs and risk factors of relevant clinical conditions”. What surprised me was that this finding seemed to apply to those with and without medical backgrounds. Okay, granted the study was conducted in Switzerland and the authors only investigated a few conditions (COPD/heart disease and HIV/AIDS), but I think that this finding could probably be replicated. Here are two examples from my family’s recent history:

A few years back, our family didn’t realize that our grandmother had a stroke. She complained of a headache and that she “wasn’t feeling well” and had trouble seeing. We noticed that she slept a bit more than usual, but figured it was because she was a) older (almost 90 years), b) wasn’t feeling well on the account of a flu or cold (it was in the winter), and c) her cataracts was getting worse. One day, she got out of bed and walked into a wall and fell because her left side felt weak. She wasn’t feeling well and so we took her to see our family physician. After some tests were run, he said that she experienced a minor stroke but that there was nothing we could do now. He said that if we had brought her in sooner, we could have done something to help her.

Looking back, our entire family felt quite guilty. We could have helped her more, but didn’t. But, was there anything that we could have done? I mean, her symptoms were so generic and could describe a flue or cold. She seemed okay – just a bit tired. We didn’t notice anything until she actually fell, as she was quite independent until then. Our physician said that in the elderly a prolonged “headache” was a warning signal since our grandmother had high-blood pressure. How come no-one told us that?

The second example is with my father. He’s usually up quite early, but one day he woke up late and seemed somewhat disoriented. He was up late the night before. That morning, he seemed to have trouble articulating words. I only noticed because he was supposed to drive me to the commuter train. He didn’t seem in any shape to drive so my sister ended-up driving me. I mentioned this to my supervisor (Alex Jadad – a physician) and he said that I should take my dad to the hospital immediately. Apparently, his symptoms suggested something called TIA or “Transient Ischemic Attack” – it’s like a temporary stroke. Again, there’s no way I would have even considered his condition serious.

Anyway, I’m wondering if greater and more widespread use of the Internet for health purposes could increase awareness of symptoms of clinical conditions. I’m involved in the health care system and am well educated and yet had no clue what to look for. If educated medical folks like paramedics have difficulty, what chance to non-medical folk have?

There are probably two things that need to be done: better education of medical conditions and better use of technology.

What if mobile phone developers or even telecommunications companies provided some services that really could be helpful? For example, could some sort of software be developed where the primary user inputs some basic data (age, sex, existing conditions) and then ever so often, you get a text message asking you a few questions about your health or some health promotion note? I know this is somewhat “pie-in-the-sky” thinking, but we should see how we can use commonly available tools to really help people. Maybe it could be targetted – like having patients who have heart disease get these messages reminding them about warning signs or to monitor certain physiological measures. It’s a thought.

I would probably argue that the greatest challenge, with or without technology, will be to get the attention of regular people (like me) to know when something is potentially dangerous or not. We probably won’t get there until we start wearing bio-medical devices like a “shirt”. Even then we probably couldn’t monitor everything.



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