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THE DOCTOR-PATIENT RELATIONSHIP IN THE ERA OF E-HEALTH

Yıl 2023, , 220 - 229, 31.05.2023
https://doi.org/10.35232/estudamhsd.1239685

Öz

The doctor-patient relationship is one of the most complex interpersonal relationships in that it involves individuals who are not on the same level, it has not been sought by both individuals, it is emotionally loaded, and it requires close mutual cooperation towards a shared goal. The digital revolution will have a profound impact on how physicians and healthcare delivery organizations interact with patients and the community at large. In the following years, personal contact between patients and doctors will become increasingly rare, and exchanges between consumers and providers will be progressively mediated by electronic devices, from which trust will suffer continually. Unfortunately, this progress has also had a negative impact on physician-patient relations, data protection, and the role of physicians. The main goals of this commentary are to describe the influence of digitalization in the form of eHealth on the doctor-patient relationship. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that healthcare systems around the globe can adapt, adopt, and embrace these rapidly evolving digital technologies.

Kaynakça

  • Gopal G, Suter-Crazzolara C, Toldo L, Eberhardt W. Digital transformation in healthcare – architectures of present and future information technologies. Clinical Chemistry and Laboratory Medicine (CCLM). 2019;57(3):328-35.
  • Eysenbach G. What is E-Health? J Med Internet Res. 2001;3(2):e20. DOI:10.2196/jmir.3.2.e20.
  • Tonsaker T, Bartlett G, Trpkov C. Health information on the Internet: gold mine or minefield? Can Fam Physician. 2014;60(5):407-8.
  • Murray E, Lo B, Pollack L, et al. The Impact of Health Information on the Internet on the Physician-Patient Relationship: Patient Perceptions. Arch Intern Med. 2003;163(14):1727–34. DOI:10.1001/archinte.163.14.1727.
  • Bundesministerium für Gesundheit. Definition von E-Health. [Internet]. [cited 2023 Apr 19]. Available from: https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/e/e-health.html
  • Schachinger A. Der digitale Patient. Analyse eines neuen Phänomens der partizipativen Vernetzung und Kollaboration von Patienten im Internet. 1st ed. 2014. ISBN print: 978-3-8487- 0961-8, ISBN online: 978-3-8452-5096-0. doi:10.5771/978 3845250960.
  • Lovejoy JF, Read M. History, and evolution of telemedicine. In: Telemedicine in Orthopedic Surgery and Sports Medicine: Development and Implementation in Practice. 1st ed. 2021. p. 3-10.
  • Monteiro AMV, Lima CMAO, Santos AAS. Global Teleradiology services and education: Brazilian projects to improve service and education. In: Feijó RA, Ziviani, Blanco PJ. Scientific Computting Applied to Medicine and Healthcare. Current State and Future Trends at the INCT-MACC the Brazilian National Institute of Science and Technology in Medicine Assisted by Scientific Computing. Petropólis, RJ: LNCC/MCTI; 2012. p. 373-390.
  • Mjøs OJ, Moe H, Sundet VS. The functions of buzzwords: A comparison of ‘Web 2.0’and ‘telematics’. First Monday. 2014;19(4).
  • Wootton R, Craig J, Patterson V. Introduction to telemedicine. CRC Press; 2017.
  • World Health Organization. mHealth: New Horizons for health through mobile technologies. Geneva; 2011:6.
  • Cirillo F. The Impact of e-Health on Privacy and Fundamental Rights: From Confidentiality to Data Protection Regulation. Eur J Privacy L & Tech. 2019;95.
  • Martenstein I, Wienke A. Aktuelle Gesetzgebung I'm Gesundheitswesen 2015/2016. Der Pneumologe. 2016; 13(3):203-8.
  • Loubichi S. General data protection regulation (GDPR) of the European Union. What had to be considered until 25 May 2018. Atw Internationale Zeitschrift fuer Kernenergie. 2018;63(5):289-94.
  • Klein M. Definition-Was ist eHealth? In: eGovernment Computing [Internet]. Jan 2017. [cited 2023 Apr 19]. Available from: https://www.egovernment-computing.de/was-ist-ehealth-a-570980/
  • Peters T, Klenke B. eHealth und mHealth in der Gesundheitsförderung. In: Ghadiri A, Ternès A, Peters T (eds) Trends I'm Betrieblichen Gesundheitsmanagement. Springer Gabler, Wiesbaden; 2016. p.123-33.
  • Evsan I, Wunderlich A. Eine Übersicht zum Thema E-Health und Digital Health [Internet]. [cited 2023 Apr 19]. Available from: https://ehealthblog.de/ehealth/
  • apoView II/2016: 360-Grad-Studie zur Digitalisierung I'm Gesundheitsmarkt [Internet]. May 2016 [cited 2023 Apr 19]. Available from: https://newsroom.apobank.de/documents/apoview-ii-strich -2016-360-grad-studie-zur-digitalisierung-im-gesundheitsmarkt-69465
  • Albrecht M, Sander M, Temizdemir E, Otten M. PraxisBarometer Digitalisierung 2020.
  • Bittner A. Gesundheitsmonitor - Informierte Patienten und unzureichend vorbereitete Ärzte [Internet]. 2016 [cited 2023 Apr 19]. Available from: https://www.bertelsmannstiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/GeMo-NL_2016-2_VV.pdf
  • Irving G, Neves AL, Dambha-Miller H, Oishi A, Tagashira H, Verho A, et al. International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open. 2017;7:e017902. DOI: 10.1136/bmjopen-2017-017902. PubMed PMID:28928173.
  • Doctor F, Karyotis C, Iqbal R, James A. An intelligent framework for emotion aware e-healthcare support systems. In:2016 IEEE Symposium Series on Computational Intelligence (SSCI). IEEE; 2016. p. 1-8.
  • Nuance/HIMSS Europe. Following the time thieves in hospitals: the real burden of documentation in German acute care hospitals is underestimated [Internet]. HIMSS Europe; 2015 [cited 2023 Apr 19]. Available from: https://www.dragonspea- king.de/download/HIMSS-Europe-Studie.pdf?m=1434964003&
  • Van Husen G. Dr. Google will soon replace the family doctor [Internet]. Die Welt. 2017 May 18 [cited 2023 Apr 19]. Available from: https://www.welt.de/wirtschaft/bilanz/article164689392/Dr-G oogle-wird-bald-den-Hausarzt-ersetzen.html
  • Shutzberg M. The doctor as parent, partner, provider… or comrade? Distribution of power in past and present models of the doctor–patient relationship. Health Care Analysis. 2021 Sep;29(3):231-48.
  • Peck BM, Conner S. Talking with me or
  • talking at me? The impact of status characteristics on doctor-patient interaction. Sociological Perspectives. 2011;54(4):547-67.
  • Siegrist J. The changing role of physicians. Bundesgesundheitsblatt. 2012;55:1100-1105. DOI: 10.1007/ s00103-012-1527-y.
  • Katz J. The silent world of doctor and patient. Baltimore: Johns Hopkins University Press; 2002.
  • Barbosa C, Pereira AD. E-health and the doctor-patient relationship: remote healthcare: consent and data protection-challenges of a new paradigm. E-health and the doctor-patient relationship: remote healthcare: consent and data protection-challenges of a new paradigm. 2021:89-113.
  • Robinson E. E-health and the Internet: Factors that Influence Doctors' Mediation Behaviors with Patients. 2008.
  • Ćirković A. Evaluation of Four Artificial Intelligence–Assisted Self-Diagnosis Apps on Three Diagnoses: Two-Year Follow-Up Study. J Med Internet Res. 2020;22(12):e18097. DOI: 10.2196/18097.
  • Schäfer K. E-Health – die Digitalisierung des Gesundheitswesens [Internet]. Devicemed. 2019 Dec 2 [cited 2023 Apr 19]. Available from: https://www.devicemed.de/e-health-die-di-gitalisierung-des-gesundheitswesens-a-888162/
  • Friends of Europe. A Highly Desirable Revolution in Digital Health [Internet]. Friends of Europe. [cited 2023 Apr 19]. Available from: https://www.friendsofeurope.org/insights/a-highly-desirable-revolution-in-digital-health/
  • Garg S, Gangadharan N, Bhatnagar N, Singh M, Raina S, Galwankar S. Telemedicine: Embracing virtual care during COVID-19 pandemic. J Fam Med Prim Care. 2020;9(9):4516–20. doi:10.4103/jfmpc.jfmpc_1118_20. PMID:33154231; PMCID: PMC7657802.
  • Bhaskar S, Bradley S, Chattu VK, Adisesh A, Nurtazina A, Kyrykbayeva S, et al. Telemedicine Across the Globe-Position Paper From the COVID-19 Pandemic Health System Resilience PROGRAM (REPROGRAM) International Consortium (Part 1). Front Public Health. 2020 Oct 29;8:556720. doi:10.3389/fpubh.2020.556720. PMID:33195347; PMCID: PMC7646014.
  • Gomez T, Anaya YB, Shih JA, Frankel RM, American Board of Family Medicine. A qualitative study of primary care physicians’ experiences with telemedicine during COVID-19. J Am Board Fam Med. 2021 Jul-Aug;34(Supplement):S61–S70. doi:10.3122/jabfm.2021.S1.210101. PMID:34244751.
  • Schachinger A. Digitalisierungsreport 2019 - Studie im Auftrag von DAK-Gesundheit und Ärzte Zeitung [Internet]. DAK-Gesundheit. 2019 [cited 2023 Apr 19]. Available from: https://www.dak.de/dak/download/digitalisierungsreport-2019-ergebnisse-2220222.pdf
  • Schachinger A. Digitalisierungsreport 2019 - Studie im Auftrag von DAK-Gesundheit und Ärzte Zeitung [Internet]. DAK-Gesundheit. 2019 [cited 2023 Apr 19]. Available from: https://www.dak.de/dak/download/digitalisierungsreport-2019-ergebnisse-2220222.pdf
  • Meinzer D. Einleitung. In: Die Arzt Patient Beziehung in einer digitalisierten Welt. Medien • Kultur • Kommunikation. Springer VS; 2019. p. 1–8.

E-SAĞLIK ÇAĞINDA DOKTOR-HASTA İLİŞKİSİ

Yıl 2023, , 220 - 229, 31.05.2023
https://doi.org/10.35232/estudamhsd.1239685

Öz

Doktor hasta ilişkisi, aynı seviyede bulunmayan kişileri bir araya getiren, her iki tarafça da aranmamış olan, duygusal açıdan yüklü bulunan ve paylaşılan bir hedefe doğru karşılıklı işbirliği içerisinde hareket edilmesini gerektiren, en karmaşık kişilerarası ilişkilerden biridir. Dijital devrimin, doktorlar ve sağlık hizmeti sunan kurumların, hastalar ve daha büyük ölçekte, toplum ile etkileşim kurma biçimleri üzerinde büyük bir etkisi olacaktır. Önümüzdeki yıllarda, hastalar ve doktorlar arasındaki kişisel ilişki, gittikçe artan oranda azalacak, tüketiciler ile hizmet sağlayıcılar arasındaki alışverişler, artan biçimde elektronik cihazlar yoluyla sağlanacak ve böylelikle güven ilişkisi, sürekli bir şekilde bundan zarar görecektir. Maalesef, bu sürecin aynı zamanda doktor hasta ilişkileri, veri koruması ve doktorların rolü üzerinde de olumsuz bir rolü olmuştur. Bu yorumun temel amacı, e-Sağlık biçimindeki dijitalleşmenin, doktor hasta ilişkisi üzerindeki etkisini açıklamaktır. Klinik uzmanlar, yöneticiler, politika yapıcılar ve araştırmacıların bu trendi daha kapsamlı bir şekilde anlamaları, dünya genelindeki sağlık sistemlerinin hızlı gelişen dijital teknolojilere kendilerini uyarlayıp bunları benimseyebilmeleri açısından kritik öneme sahip olacaktır.

Kaynakça

  • Gopal G, Suter-Crazzolara C, Toldo L, Eberhardt W. Digital transformation in healthcare – architectures of present and future information technologies. Clinical Chemistry and Laboratory Medicine (CCLM). 2019;57(3):328-35.
  • Eysenbach G. What is E-Health? J Med Internet Res. 2001;3(2):e20. DOI:10.2196/jmir.3.2.e20.
  • Tonsaker T, Bartlett G, Trpkov C. Health information on the Internet: gold mine or minefield? Can Fam Physician. 2014;60(5):407-8.
  • Murray E, Lo B, Pollack L, et al. The Impact of Health Information on the Internet on the Physician-Patient Relationship: Patient Perceptions. Arch Intern Med. 2003;163(14):1727–34. DOI:10.1001/archinte.163.14.1727.
  • Bundesministerium für Gesundheit. Definition von E-Health. [Internet]. [cited 2023 Apr 19]. Available from: https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/e/e-health.html
  • Schachinger A. Der digitale Patient. Analyse eines neuen Phänomens der partizipativen Vernetzung und Kollaboration von Patienten im Internet. 1st ed. 2014. ISBN print: 978-3-8487- 0961-8, ISBN online: 978-3-8452-5096-0. doi:10.5771/978 3845250960.
  • Lovejoy JF, Read M. History, and evolution of telemedicine. In: Telemedicine in Orthopedic Surgery and Sports Medicine: Development and Implementation in Practice. 1st ed. 2021. p. 3-10.
  • Monteiro AMV, Lima CMAO, Santos AAS. Global Teleradiology services and education: Brazilian projects to improve service and education. In: Feijó RA, Ziviani, Blanco PJ. Scientific Computting Applied to Medicine and Healthcare. Current State and Future Trends at the INCT-MACC the Brazilian National Institute of Science and Technology in Medicine Assisted by Scientific Computing. Petropólis, RJ: LNCC/MCTI; 2012. p. 373-390.
  • Mjøs OJ, Moe H, Sundet VS. The functions of buzzwords: A comparison of ‘Web 2.0’and ‘telematics’. First Monday. 2014;19(4).
  • Wootton R, Craig J, Patterson V. Introduction to telemedicine. CRC Press; 2017.
  • World Health Organization. mHealth: New Horizons for health through mobile technologies. Geneva; 2011:6.
  • Cirillo F. The Impact of e-Health on Privacy and Fundamental Rights: From Confidentiality to Data Protection Regulation. Eur J Privacy L & Tech. 2019;95.
  • Martenstein I, Wienke A. Aktuelle Gesetzgebung I'm Gesundheitswesen 2015/2016. Der Pneumologe. 2016; 13(3):203-8.
  • Loubichi S. General data protection regulation (GDPR) of the European Union. What had to be considered until 25 May 2018. Atw Internationale Zeitschrift fuer Kernenergie. 2018;63(5):289-94.
  • Klein M. Definition-Was ist eHealth? In: eGovernment Computing [Internet]. Jan 2017. [cited 2023 Apr 19]. Available from: https://www.egovernment-computing.de/was-ist-ehealth-a-570980/
  • Peters T, Klenke B. eHealth und mHealth in der Gesundheitsförderung. In: Ghadiri A, Ternès A, Peters T (eds) Trends I'm Betrieblichen Gesundheitsmanagement. Springer Gabler, Wiesbaden; 2016. p.123-33.
  • Evsan I, Wunderlich A. Eine Übersicht zum Thema E-Health und Digital Health [Internet]. [cited 2023 Apr 19]. Available from: https://ehealthblog.de/ehealth/
  • apoView II/2016: 360-Grad-Studie zur Digitalisierung I'm Gesundheitsmarkt [Internet]. May 2016 [cited 2023 Apr 19]. Available from: https://newsroom.apobank.de/documents/apoview-ii-strich -2016-360-grad-studie-zur-digitalisierung-im-gesundheitsmarkt-69465
  • Albrecht M, Sander M, Temizdemir E, Otten M. PraxisBarometer Digitalisierung 2020.
  • Bittner A. Gesundheitsmonitor - Informierte Patienten und unzureichend vorbereitete Ärzte [Internet]. 2016 [cited 2023 Apr 19]. Available from: https://www.bertelsmannstiftung.de/fileadmin/files/BSt/Publikationen/GrauePublikationen/GeMo-NL_2016-2_VV.pdf
  • Irving G, Neves AL, Dambha-Miller H, Oishi A, Tagashira H, Verho A, et al. International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open. 2017;7:e017902. DOI: 10.1136/bmjopen-2017-017902. PubMed PMID:28928173.
  • Doctor F, Karyotis C, Iqbal R, James A. An intelligent framework for emotion aware e-healthcare support systems. In:2016 IEEE Symposium Series on Computational Intelligence (SSCI). IEEE; 2016. p. 1-8.
  • Nuance/HIMSS Europe. Following the time thieves in hospitals: the real burden of documentation in German acute care hospitals is underestimated [Internet]. HIMSS Europe; 2015 [cited 2023 Apr 19]. Available from: https://www.dragonspea- king.de/download/HIMSS-Europe-Studie.pdf?m=1434964003&
  • Van Husen G. Dr. Google will soon replace the family doctor [Internet]. Die Welt. 2017 May 18 [cited 2023 Apr 19]. Available from: https://www.welt.de/wirtschaft/bilanz/article164689392/Dr-G oogle-wird-bald-den-Hausarzt-ersetzen.html
  • Shutzberg M. The doctor as parent, partner, provider… or comrade? Distribution of power in past and present models of the doctor–patient relationship. Health Care Analysis. 2021 Sep;29(3):231-48.
  • Peck BM, Conner S. Talking with me or
  • talking at me? The impact of status characteristics on doctor-patient interaction. Sociological Perspectives. 2011;54(4):547-67.
  • Siegrist J. The changing role of physicians. Bundesgesundheitsblatt. 2012;55:1100-1105. DOI: 10.1007/ s00103-012-1527-y.
  • Katz J. The silent world of doctor and patient. Baltimore: Johns Hopkins University Press; 2002.
  • Barbosa C, Pereira AD. E-health and the doctor-patient relationship: remote healthcare: consent and data protection-challenges of a new paradigm. E-health and the doctor-patient relationship: remote healthcare: consent and data protection-challenges of a new paradigm. 2021:89-113.
  • Robinson E. E-health and the Internet: Factors that Influence Doctors' Mediation Behaviors with Patients. 2008.
  • Ćirković A. Evaluation of Four Artificial Intelligence–Assisted Self-Diagnosis Apps on Three Diagnoses: Two-Year Follow-Up Study. J Med Internet Res. 2020;22(12):e18097. DOI: 10.2196/18097.
  • Schäfer K. E-Health – die Digitalisierung des Gesundheitswesens [Internet]. Devicemed. 2019 Dec 2 [cited 2023 Apr 19]. Available from: https://www.devicemed.de/e-health-die-di-gitalisierung-des-gesundheitswesens-a-888162/
  • Friends of Europe. A Highly Desirable Revolution in Digital Health [Internet]. Friends of Europe. [cited 2023 Apr 19]. Available from: https://www.friendsofeurope.org/insights/a-highly-desirable-revolution-in-digital-health/
  • Garg S, Gangadharan N, Bhatnagar N, Singh M, Raina S, Galwankar S. Telemedicine: Embracing virtual care during COVID-19 pandemic. J Fam Med Prim Care. 2020;9(9):4516–20. doi:10.4103/jfmpc.jfmpc_1118_20. PMID:33154231; PMCID: PMC7657802.
  • Bhaskar S, Bradley S, Chattu VK, Adisesh A, Nurtazina A, Kyrykbayeva S, et al. Telemedicine Across the Globe-Position Paper From the COVID-19 Pandemic Health System Resilience PROGRAM (REPROGRAM) International Consortium (Part 1). Front Public Health. 2020 Oct 29;8:556720. doi:10.3389/fpubh.2020.556720. PMID:33195347; PMCID: PMC7646014.
  • Gomez T, Anaya YB, Shih JA, Frankel RM, American Board of Family Medicine. A qualitative study of primary care physicians’ experiences with telemedicine during COVID-19. J Am Board Fam Med. 2021 Jul-Aug;34(Supplement):S61–S70. doi:10.3122/jabfm.2021.S1.210101. PMID:34244751.
  • Schachinger A. Digitalisierungsreport 2019 - Studie im Auftrag von DAK-Gesundheit und Ärzte Zeitung [Internet]. DAK-Gesundheit. 2019 [cited 2023 Apr 19]. Available from: https://www.dak.de/dak/download/digitalisierungsreport-2019-ergebnisse-2220222.pdf
  • Schachinger A. Digitalisierungsreport 2019 - Studie im Auftrag von DAK-Gesundheit und Ärzte Zeitung [Internet]. DAK-Gesundheit. 2019 [cited 2023 Apr 19]. Available from: https://www.dak.de/dak/download/digitalisierungsreport-2019-ergebnisse-2220222.pdf
  • Meinzer D. Einleitung. In: Die Arzt Patient Beziehung in einer digitalisierten Welt. Medien • Kultur • Kommunikation. Springer VS; 2019. p. 1–8.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Halk Sağlığı, Çevre Sağlığı
Bölüm Derlemeler
Yazarlar

Bahar Graefen 0000-0002-6407-2949

Yayımlanma Tarihi 31 Mayıs 2023
Gönderilme Tarihi 20 Ocak 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

Vancouver Graefen B. THE DOCTOR-PATIENT RELATIONSHIP IN THE ERA OF E-HEALTH. ESTÜDAM Halk Sağlığı Dergisi. 2023;8(2):220-9.

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