Many doctors are unfamiliar with the concept of shared decision making in medicine. Too often, they expect their patients to follow their instructions and not ask any questions related to their medical advice. But patients want to play a more active role in the management of their diseases. They want to be engaged, empowered and educated. This is what prompted the founders of PatientsLikeMe to create an online community for patients like their brother, who had Amyotrophic lateral sclerosis (ALS) but did not have a way to connect with other people living with ALS.
For similar reasons, Sean Ahrens, a patient with Crohn's disease, created an online community called Crohnology, a patient-centered information sharing network for people with the same condition. This type of information can empower patients to make better medical decisions, but it can also confuse patients and potentially cause harm if people lack the proper guidance as they sift through all this information. Crowdsourcing is a great way to gather general information, but it may not be the best approach to make a personal medical decision.
Eventually, we will see a greater level of personalization in the shared decision-making process. Patients and healthcare providers will have access to genomic profiles that will reveal how a patient will respond to certain treatments. Our genetic makeup determines how our bodies will react to medications, which is why people who have identical conditions may receive different sets of treatments.
Scientists and medical researchers are collecting data about our genetic makeup to predict how our bodies will react to therapies and our predisposition to certain medical conditions. Right now, we have all this data, but the information remains disconnected. Patients lack access to much of their own health data, so even if they wanted to build a platform that analyzes and integrates their information with other sources of data, it would not be possible.
We are seeing the application of personalized genomic medicine in the world of cancer treatment. The cancer doctors at New York City-based Memorial Sloan-Kettering Cancer Center are studying how artificial intelligence systems like IBM's Watson may help medical professionals choose the best diagnostic and treatment plans for individual cancer patients by processing data from medical literature and the patient's genomic profile. Soon we will be applying big data analytics when we treat the common cold or when we choose over-the-counter vitamins to stay healthy. Companies like 23andMe provide genetic makeup reports, which may help individuals understand their health risks. Their DNA kit is only $99 and gives specific health recommendations based on the individual's genetic profile.
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Physicians and nurses are using clinical decision support technology to guide them in their clinical decision-making process. These tools are being integrated into EHR and computerized physician order-entry systems. Patients are reaching out to peers and gathering information from social networking communities like PatientsLikeMe and Crohnology. Some are even connecting with patients on open communities like Facebook and Twitter.
The current concept of shared decision making involves the healthcare provider team, the patient and family members. Doctors and patients may consult a computer, but computers do not have an active voice in the decision-making process. Soon, we will see technology, artificial intelligence and predictive data analytics getting included as part of the decision-making team. Shared decision making will involve more supercomputing horsepower than human brains can generate.
As physicians are discussing treatment options with the patient, the computer's voice may also audibly chime in and provide additional data and insights. The computer may even respond to some of the patient's questions. Physicians may not like the idea of this, but technology is quickly moving in this direction. We will see some form of this within the next few decades. In the future, when you go to the doctor and hear his computer speaking, be prepared to ask if you are speaking with Dr. Watson or Dr. Google.
About the author:
Joseph Kim is a physician technologist who has a passion for leveraging health IT to improve public health. Dr. Kim is the founder of NonClinicalJobs.com and is an active social media specialist.
This was first published in October 2013