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Regular version of the site

Patients Go Online

Virtual self-diagnosis and its implications

© ISTOCK

Mobile and web-based applications available today allow patients to self-diagnose and self-prescribe treatment. Galina Polynskaya and Margarita Mesropyan have examined  to what extent patients and doctors trust such technology.

Easy Access to Digital Health

According to projections by  Arthur D. Little , by 2020 the digital health market will be worth $233.3 billion globally (a 1.7 increase on 2017), mainly driven by the mobile health market, which will stand at nearly $60 billion (an increase of 2.5 times on 2017).

Mobile Health (or mHealth) is a general term for the use of mobile phones and wireless technology in healthcare. In particular, mobile and web-based application have been developed and tested by pharmaceutical companies to support diagnosis and disease prevention. With more than 20,000 such applications available in the AppStore alone, mHealth is the fastest growing mobile application category for iOS and Android devices.

People today have free access to online resources which enable self-diagnosis, including:

 general state of health (tracking key health parameters, recommendations for treatment and medications);

 medical conditions based on test result interpretation;

 medical conditions based on symptoms (early detection, treatment advice);

 rare hereditary diseases (symptom monitoring).

Where Patients Seek Medical Advice and Treatment

To gain a better understanding of patient and doctor attitudes towards digital health, the study authors conducted 44 interviews with medical doctors and pharmacists and an online survey of 200 Facebook users.

They examined consumer behaviour patterns, namely, how people deal with situations in which self-prescribed medications fail to produce a positive effect. Having analysed the interviews, they identified three distinct groups: 'traditionalists' (including a subgroup of 'doubters'), 'seekers', and 'generation Y'.

Traditionalists

Traditionalists tend to trust the conventional approach and will visit a doctor, get a diagnosis and start treatment. However, some of them ('doubters'), having consulted a doctor, will still go online and read user reviews of the prescribed drugs, and if such reviews contradict the doctor's prescription, may substitute other medications based on information found online or on the advice of a pharmacist.

Seekers

These patients prefer to gain a personal understanding of their health problem and seek advice on the internet before they decide which medication to buy. If no positive effect is achieved, they eventually consult a doctor but only after double-checking the self-made diagnosis and self-prescribed medication online.

Generation Y

Gadget- and internet-savvy millennials value their time and tend to go online to learn more about their symptoms, buy medications via online pharmacies and self-diagnose using digital health resources. They can go to a brick-and-mortar pharmacy for more information or see a doctor a last resort but often question the professional’s diagnosis.

'Generation Y' prevailed among the study survey respondents (30%), followed by 'traditionalists' (24%, of whom 65% are 'doubters').

Steps taken if faced with adverse symptoms
(% of online survey respondents)
30%
will search for information online
24%
will visit a doctor
15%
will consult with friends or acquaintances
12%
will take a pain medication
10%
will go to a pharmacy
9%
not sure

Growth Despite Concerns

According to the researchers, 'Both patients and doctors are generally positive about self-diagnosis online and feel there is a future for it'.

Factors contributing to patient use of digital health resources include:

 being reluctant to visit a doctor (lack of trust, substandard service, feeling that doctors prescribe expensive or ineffective drugs);

 feeling well-informed and thus more likely to question a doctor's opinion and performance;

 availability of mobile and online health applications;

 reliance on digital technology to deal with the problem on one's own, thereby saving time and money.

However, concerns about misdiagnosis and inadequate medication shared by 35% of the survey respondents are still an important barrier to the use of digital health resources; about the same percentage are concerned about the effectiveness of self-treatment, while some 40% are worried about getting the wrong advice due to technical faults in digital health resources.

Yet such concerns do not affect the overall trend: the proportion of Gen Y members adopting these new behaviour patterns is large and growing all the time; 50% of all respondents find it useful to search information about their symptoms or self-diagnose online before visiting a doctor, and 28% use digital health applications.

IQ 

Study authors:
Galina Polynskaya, Associate Professor, HSE Faculty of Business and Management
Margarita Mesropyan, Master's Graduate, HSE Faculty of Business and Management; Doctoral Student, Financial University under the Government of the Russian Federation
Author: Svetlana Saltanova, March 21