Using Technology to Maximize the Clinician's Role

I recently had the misfortune of having to explain to a patient why we were performing a nuclear medicine bone scan on her. She was admitted to the hospital with a presumptive diagnosis of ovarian cancer and we were performing this test to see if the cancer had invaded her bones. 

Her symptoms started when she noticed that her abdomen had grown over the course of the last two months, at which point she had been told by her doctor to lose weight. Her current provider believed that she may have ovarian cancer because ovarian cancer causes a large amount of fluid to accumulate within the abdomen and pelvis. This is known as a peritoneal effusion, which can be sampled for cancer by drainage and sending it for pathological diagnosis. Ovarian cancer is the third most deadly cancer among female patients because of this insidious pattern of presentation.

This experience elucidated two points for me: First, I felt really good about being able explain a complex situation to her because she seemed very upset that she didn't know what was going on with her body. When I asked her why she was so distraught, she said that it was because she had been looking information up on the computer and that none of her providers could explain why she was having this "big belly."

I call this situation mismanaged elements of patient interaction. For example, this happens when a patient tells her doctor that she is having a headache and he then suggests an incorrect diagnosis because he didn't remember to ask her when the headache began. In this case her initial provider failed to identify her symptoms and later her providers failed to address her need for information.

Secondly, this situation addressed the need for better use of technology to provide patients with information. I couldn't help but thinking, “If only I had my iPad, I would have been able to provide her with a visual representation of her presumed diagnosis in addition to the verbal explanation.” The iPad and other mobile devices are able to provide access to an enormous amount of information quickly. When combined with the knowledge and expertise of a skilled professional such as a doctor, these tools are amplified in their efficiency. With an iPad, every physician can become an instant library, theater, and in the case of this patient, assistant.

Modern hospitals are currently under tremendous budgetary constraints with the future possibly even more abysmal; however, with tools that increase the quality of interactions between patients and their providers, I believe we will save money and time in the long run. By helping patients to understand their bodies and illnesses better physicians provide an invaluable service. This is something that the Internet cannot provide a patient alone.

The use of technology such as the iPad can help physicians maximize their impact with visual aids and quick access to information. When combined, the efficient use of technology along with a better understanding of a patient's concerns can lead to a better informed, compliant patient. Additionally, I believe that this will also lead to more rewarding patient encounters for providers.

Luther B. Adair II, MD, is a senior radiology resident at Long Island College Hospital. He will begin an abdominal imaging fellowship at Thomas Jefferson University Hospital in Philadelphia in June.