Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology.
- Great Britain. Parliament. House of Lords. Science and Technology Committee.
- Date:
- 1996
Licence: Open Government Licence
Credit: Information society : agenda for action in the UK : evidence received after 31 March 1996 / Select Committee on Science and Technology. Source: Wellcome Collection.
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![16 April 1996] Lord Butterworth contd.] along all the time. Some of the traditional habits will remain, such as surgery. You have got to do it somewhere. Even if you do it by some distant remote skill, it has got to be done somewhere that is safe and whoever is doing it is the right person to do it. In that sense hospitals will not disappear. The internal structure may change and certainly communication with general practice will radically change, just as in academic medicine. It has already changed beyond my belief when I started in academic medicine; we now communicate solely by computer. There will be that order of change in our communication with general practice, it will be instant communication. In that sense hospitals will change. 417. I ask because I understood that there were a number of architects and others in the States who were exploring the possibility of quite radical changes because of telemedicine. (Dr Smith) Yes, but they will still have to provide the facilities for those activities, some that Simon mentioned. There is some time when somebody has to see the patient. (Dr Macara) Revolutionary concept! Lord Butterworth] That is a comfort. Lord Haskel 418. In the introduction we heard how the information superhighway is, as you described it, Dr Macara, a change for the better. We have heard about telemedicine and prescribing and medical records. The impression that I was beginning to get is that the benefits are really for the efficicncy of the doctors. I wonder if you could tell us a little bit about how it can help the patient? (Dr Macara) That is a very good question because our anxiety is that it shall help the patient. Our basic philosophy in medicine is that our only function basically is to provide what the patient needs, not necessarily what the patient wants, that is quite different, what the patient needs. Therefore, we see no conflict of interest so long as the doctor or the other health professional is in a position—and this we will come to later I expect—to reassure the patient about their ability to protect the confidentiality of information given to them in confidence. There is that assurance required in the interest both of the patient and of all the health professionals involved. I should not really trespass on my clinical colleagues in relation to the main burden of the question. (Dr Jenkins) I think there are two broad groups of opportunity presented by the information superhighway. We have spoken about the opportunities for communication between doctors and health care professionals and now we are looking at the patient. The fact is that patients will have access to the same sources of information through the superhighway that doctors do. Some people have said: “Well does that not pose a threat to the professionalism of the doctor?”. I do not believe it does and the reason I do not believe it does is because patients have always come in to me with “new” information. At one time it used/to be just a cutting from a newspaper, then it was the radio, and then it was the television. Something they had heard on the television was new information and now on [ Continued occasions it is something they have accessed through the Internet. They present this to me as new information, as something it may well be that I was not previously aware of. This is normal practice for me and for many other general practitioners. What patients want is to understand what that information, which is new to both of us, actually means to them. It is the clinical judgments that help me, with them, to be able to put it into the appropriate perspective and also to be able to identify further sources of expertise to give them further reassurance. I do not see this ability of patients to access the same information that I can access as a threat, I see it as a new opportunity and one which will bring further interest and excitement to general practice particularly. (Dr Macara) Of course on the epidemiological side one ought to add it is obvious to us but it ought to be on the record that we are committed to what it is becoming common to call evidence based medicine. The evidence should be available so far as it is possible to make it unequivocally clear to the patients equally as to the doctors and the others caring for them. By extension, of course, there is an immense potential in health promotion in_ self-learning materials which patients can use in their own interest. I do not know whether Colin wants to add anything? (Dr Smith) A very brief addition, Simon has put it very well. The availability of information is a benefit to the profession if the people they are dealing with know what you are talking about. If they have background information already it facilitates the consultation enormously. The downside is that information available without structure or comment does not put it in perspective and it is like newsprint. People come rushing in because they interpret minimalist information in a maximum way. In other words, they associate themselves with the illness because it seems like a good idea at the time. One thing we will have to do with the information highway is to make sure that the information is adequately presented to share, not to obscure basically. One of the problems with medicine is if we perceive a threat we will try to obscure when in fact we are both saying do not obscure, make it wide open. That makes the consultation and management and helping the patient far easier. (Dr Macara) I wonder if Ross sees it the same way? (Dr Anderson) One of the things I have observed, my Lord Chairman, is that on the Internet there has been a proliferation of support groups. Some of these have acquired a certain notoriety: sexual abuse recovery for example but there are many others which are helping people who have been victims of car crashes or plane crashes or whatever and may have iocked up inside themselves some trauma that they feel reticent to talk about. Now the Internet can put people in touch with sufferers from similar complaints who are effectively anonymous because they are living in New Zealand, Hong Kong, Virginia or wherever and people have an opportunity to talk out the problems they have which just was not available before. (Dr Macara) In case you are thinking of moving on, I am just a little concerned, my Lord Chairman, that we do not overlook the value of Medline. I think](https://iiif.wellcomecollection.org/image/b32218631_0016.jp2/full/800%2C/0/default.jpg)


