Module 5

As described by the ethics podcast, a deluge of health information can awaken one’s inner hypochondriac. The information in search engines may not be reliable and may influence consumers to make unwise decisions. Diane Rehm made a point that the public needs to know how to do research and discern whether or not it is credible. Patients who utilize general search engines for self diagnosis and directing the course of their care may consume health care dollars by insisting on a plan of diagnosis or treatment that will not allow physicians to receive reimbursement. The AHRQ website, with its mission to improve health care outcomes, is a more reliable source for consumers providing evidence based information with which consumers can use to collaborate with physicians regarding their care.
Upon reviewing information under “ Research Findings”, “Clinical Information”, and “Consumers and Patients” , the consumer will be better informed as to why a physicain may not order a battery of diagnostic testing or medications they see advertised on TV. For example, research included in AHQR supports restrictions on anti ulcer drug prescribing. Patients insisting on deviating from these recommendations could be referred to the AHQR website to be reassured that decisions made by the physicians were legitimate and supported by regulatory bodies such as Medicaid. Conversely, they could question why a test was not ordered upon researching that its inclusion in a diagnostic workup is supported by evidence as well as reimbursed by a regulatory body. AHQR research findings can also influence accrediting bodies. For example, if new evidence is revealed regarding patient safety, this could result in practice changes for practitioners and institutions.
With the vast amount of reliable health care information available, new issues may develop. “Few professionals are prepared to make the transition to a more humble provision of assistance in decision making-the communicaton of support and guidance rather than authority and control” (Curtin, 2005, p350). Careful utilization on the AHQR website makes for a well informed patient who can plan trajectory of care with a health care provider. Will this newly “empowered” patient influence the care provider with his new found knowledge to make diagnostic decisions? What new ethical issues will arise that pose a threat to medicine’s paternalistic approach? Health care workers will need to be willing to collabrate with consumers but must also be able to determine who of their patients are truly well informed. Again, the information must be interpretted accurately. Considering the design of this website, can the average consumer, assuming a lower literacy level, navigate through the AHQR website? If the culture changes so that consumers are expected to be well informed, how will this reliable information be delivered in a format that is accesible and understood by the general population? The design of this website brings up more issues. This website is open to all consumers and allows them to complete searches without logging on with a secured password. I will let my paranoia run freely from here. What if I run searches on the AHRQ website under a chronic illness or certain medications? Then I sign up to receive “disability updates”? Can I be identified using my IP address and denied insurance, or employment? Do researchers seeking participants have access to these sites and can identify me by the searches I conduct? Regardless of the reasons someone would search my electronic trail, my privacy would be compromised. Even if I had no firm diagnosis, could this information be archived somewhere so that I could be grouped into a high risk population (despite having no documented diagnosis) when I apply for mortgage or long term care insurance?