Navigating the Mental Health Internet

Lesson 3.5 Medical Information

Introduction

Mental health professionals often work with clients who present with medical conditions as as issue in their treatment, such as coping with new physical symptoms, lifestyle changes demanded by their illness, or life threatening diseases. Surveys show that 60% of Internet users have sought health information online. Consumer access to medical information is changing the practice of health care. As patients become more knowledgeable, treatment decisions are being negotiated or even initiated by patients.

This is true of mental health treatment as well. While working as a psychologist at the San Francisco VA, a patient brought in a print out of sites on PTSD, and another asked about herbs for depression she learned about from a web site. This phenomenon has become known as the Consumer Health Informatics movement. Tom Ferguson, M.D., who heads the Consumer Healthcare Informatics area at Harvard Medical School, is one of its main proponents. He describes the movement:

As health information flow becomes widely available to all, we are beginning to see the medical equivalent of the toppling of the "Berlin Wall" that once separated lay healthcare from professional medicine. Some of our widely held assumptions are now questionable. We have assumed, for instance, that ...medicine is something only doctors can know about.
Ferguson Report

Consumer health informatics provides citizens with the tools, skills, information, and support they need in the emerging new healthcare system. These changes will also require a change in thinking for health professionals in that consumers will now increasingly be seen not only bring in their problems but also as resources.  Healthcare providers have habitually overlooked (and often actively discouraged the use of) the biggest health resource of all: people's ability as informed layfolk and experienced self-helpers to prevent and manage their own health problems. He sees this and other shifts as we move from Industrial Age Medicine to Information Age Healthcare.
Self-Care in the Information Age by Tom Ferguson, M.D.

Evaluating Online Information

Since anyone can publish on the web, it is important to develop skills in evaluating online information. A number of training modules and guidelines are available through the Michigan Electronic Library:

Evaluating Health Information on the Internet

Typical suggested critieria include:

Credibility
Bias
Accuracy
Currency
Relevance
Significance
Intended Audience
Usability

It is usually reasonable to assume that a site maintained by a unversity or a professional organization is providing credible information, but a virtue of the Internet is ready access to other sites and databases such as Medline which can be used to cross-validate claims.

Disease Sites

There are over 30,000 medical sites available on the Internet. Most are specialized for a certain condition or problem. Some are maintained by medical schools and professional organizations. The United States government also sponsors many health-related sites. Others are personal home pages. Yet others are commercial sites which make unsubstantiated claims for their products or therapies. Thus the quality of medical information varies widely.A model medical site which has won many awards is

Oncolink
This comprehensive site from the University of Pennsylvania is designed for both consumers and health professionals. It contains information on specific types of cancer (e.g., breast cancer, lymphoma), medical specialties that deal with cancer (e.g., radiation oncology, gynecologic oncology, chemotherapy, bone marrow transplant), psychosocial support and personal experiences, cancer causes, screening and prevention, clinical trials, financial issues for patients, and exhibitions of art by people whose lives have been touched by cancer.

Thousands of disease-focused sites can be found on
Yahoo: Diseases and Conditions

Medical Directories

The sites listed below are 3 reputable, comprehensive, and easy to use sites containing medical information.

Medical Matrix
Well-designed and extensive site for accessing medical information on diseases, medical specialists, online documents, and medical computing. A search engine is available. You will have to register first, but use of the site is free.

Medscape
Contains over 7000 full-text, peer-reviewed clinical medicine articles. Articles are linked to Medscape's Clinical Discussions, other Internet resources, and related specialty areas on Medscape. A search engine is available.You will have to register first, but use of the site is free.

Health Finder
Consumer health and human services information web site developed by the U.S. Department of Health and Human Services. Includes online publications, clearinghouses, databases, web sites, and support and self-help groups, as well as government agencies and not-for-profit resources.