Thursday, June 14, 2007
Before joining Google, I was a full-time primary care doctor. My time working with patients every day, hearing their stories and trying to help make them better, is an experience I will cherish forever. And about once a week, I still practice as an urgent care doctor at a county hospital. Based on these experiences, I have witnessed the problems patients face. One of the biggest ones I see is the difficulty patients have getting answers to the most basic questions, such as 'What tests and treatments should I know about if I have type 2 diabetes? Is the care I am getting on par with what most experts recommend?'
Many patients are comfortable letting their doctors worry about these questions for them. But I think patients get better care when they are more informed about generally accepted standards of care, and know more when talking to their doctors. Of course, I don't recommend that patients treat themselves. They can't simply do searches on the Internet, self-diagnose and treat. While there is an endless amount of information available online, it's difficult to know what is quality information and what is not. Patients need to see their doctors to get the right medical care. But better-informed patients recover faster, manage chronic illnesses better and may even avoid some illnesses altogether. And patients should feel in control of their situation.
I was recently reminded of these issues when I was hospitalized. I wanted to know more about the best treatment options for my situation, so I called a few doctor friends and got all the information I needed. Because of that, I think I recovered faster, and I certainly felt better as a more active participant in my own care. But most people don't have this kind of access to medical expertise.
In addition to my medical training, I studied medical informatics before coming to Google. I learned about computer systems that are designed to remind doctors about tests and treatments that their patients should have. I can say from personal experience that it is difficult to remember everything I should be doing for my patients, or to read every new article on the latest test or drug. These systems help doctors get the information they need to deliver quality care.
I believe patients should also have access to these kinds of systems so that they can help make sure they are getting the best care. If you search online to learn more about diabetes, it should be easy to find out what the generally recommended treatments and tests are.
Now I'm part of the team here working on health and we're trying to do something about this problem. Adam Bosworth, who is leading our team, has alluded to this in previous posts such as this one as well as in some speeches he has made at healthcare conferences.
We have been talking to many medical experts to understand what the best guidelines are, and how we can determine which ones apply in different circumstances. If such guidelines were more available to patients, they might be able to, by inputting information such as age, gender or medications, learn about recommended screening tests and other preventive measures, or about harmful drug interactions. (The problem of drug interactions is reason enough to work on this: in the U.S. alone, it is estimated that over 770,000 people are injured or die each year in hospitals from adverse drug events. Many of these medical errors could be prevented if patients or doctors checked for drug interactions.)
As we work on this project, we are of course paying very close attention to privacy. If such a tool were available, you should be able to enter as much or as little information as you want -- and it's important that you be allowed to access this kind of information without entering your name, insurance number or other personal information. We also think that if you want to save this information, you should have that choice so you can access it later or share it with your doctor.
When I help my loved ones navigate an illness or get up to date with screening tests, I wonder how those who don't have a doctor in the family manage their health. When a patient comes to see me with a pretty good understanding of their treatment options, I find that refreshing. But really, I wish it were just easier for patients to get the information they're looking for. While we don't expect to develop the perfect solution, I hope that some day we'll be able to offer something that is a step in the right direction.