America's future doctors might like the promise of mHealth, but they'd still prefer seeing their patients in person – even for follow-up visits.
Those surprising results can be found in athenahealth's 10th annual Epocrates Future Physicians of America survey. The survey of some 1,000 medical students paints a confusing picture of just what they want out of digital health. To wit, the students generally said they don't trust mHealth just yet, but they do acknowledge that it could ease interoperability problems and give clinicians quicker and better access to the data they need.
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According to the survey, a robust 97 percent of the medical students surveyed would encourage their patients to use monitoring devices, and 41 percent now use medical apps for clinical answers (only 29 percent, in contrast, would first ask a colleague). In addition, almost three of every four medical students would be comfortable with patients sending an e-mail through a patient portal seeking treatment advice.
But when it comes to seeing patients, online just doesn't cut it. Almost all – 98 percent – prefer a face-to-face visit over a virtual visit for their first encounter. Even more surprising: 89 percent said they'd prefer the face-to-face visit for a follow-up exam as well.
Nicholas Josey, a fourth-year medical student at the Avalon University of Medicine, based on the Caribbean island of Curacao, said he's not convinced that mHealth has proven its reliability.
"To me the idea of virtual health visits still seems very science fiction," he said in an e-mail to mHealth News. "In theory, I feel that as with many other aspects of updating our healthcare system, virtual doctor visits or telemedicine could vastly increase patients' access to improved care. In reality, however, I feel like we must be careful when and where this is implemented. I feel that virtual medicine is best designed for uncomplicated patient follow-ups and in situations such as the practice of medicine in rural areas where access to specialists may not be readily available."
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"As a student, the majority of what and how I learn comes from direct patient interactions, (while) virtually I can only do so much to simulate a physical examination on a patient," he added. Face-to-face meetings, he said, "oftentimes provide me with important data which I may otherwise miss if I am not in the vicinity of the patient. I look forward to beginning my career in medicine at a time when technology continues to advance at a rapid pace but remain cautious when it comes to replacing or recreating the physician's role in direct patient care."
Despite the misgivings expressed by med students in the survey, those keeping a close eye on the market are more optimistic. Brian Anderson, MD, senior manager for clinical effectiveness with athenahealth, said mHealth should succeed "given that, historically, mobile devices in other technology markets have driven people together (and) connected users, allowing for broader exchange of ideas, content and more seamless communication."
"I believe the same holds true for mHealth and the practice of medicine leveraging mobile devices," he added. "Doctors will more easily be able to communicate with each other, and with their patients, accessing critical patient data to make clinical decisions easier and more quickly. I believe the future of mHealth is very bright, and particularly set up to address the biggest concern of interoperability that the future physicians in this survey identified."
Another problem identified in the survey that mHealth could ease is documenting at the point of care. According to the survey, more than 70 percent of third- and fourth-year students said they spend more time documenting than they do seeing patients. And a full 80 percent say they expect that trend to continue once they become physicians.
But the biggest problem identified by students is gaining access to a patient's information at the point of care no matter where that data resides.
According to the survey, 44 percent of the students surveyed said they had concerns that hospitals or medical practices could not easily and safely share patient records – and almost three-quarters didn't think it could be done between disparate health systems. That concern about interoperability was mirrored in an earlier athenahealth survey of physicians, in which 96 percent said accessing relevant data from the EHR is vital and 95 percent said they'd experienced delays are had problems delivering care because patient records weren't readily available.
The solution? A platform – preferably mobile – that could give clinicians access to all of a patient's medical information in real time, at the point of care, and on whatever device they choose to use.
"As a registered nurse, I've found it's nearly impossible to synchronize patient information obtained by different providers," Kenneth Iwuji, a fourth-year medical student at Texas Tech University's Health Sciences Center School of Medicine, said in a release provided by athenahealth. "Health systems all use a variety of vendors and none seem to talk to each other. In order to gain critical information about the patient, we are still stuck using phones and faxes, which aren't helpful in emergency situations. These barriers need to be broken down; there's no reason why information shouldn't flow freely and securely."