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EHEALTH: SPAIN
Are Spanish physicians ready to
take advantage of the Internet?
SUSANA LORENZO,
FUNDACIÓN HOSPITAL ALCORCÓN, MADRID
JOSÉ J MIRA,
UNIVERSIDAD MIGUEL HERNÁNDEZ DE ELCHE
Abstract
Objective: To analyse specialist doctors’ opinions, attitudes and habits with respect to e-health, and the
repercussions of these factors on doctor/patient relations.
Methodology: Use of a survey to analyse attitudes, Internet use, habits and opinions about the advantages and
disadvantages of the Internet among 302 doctors in eight Spanish hospitals.
Results: Of the doctors surveyed, 80% have access to and use the Internet. Almost 40% use the Internet for less
than one hour a day; doctors in smaller hospitals spend more time on the Internet and men spend more time than
women. The most frequently visited websites are PubMed (11%) and Google (22%); when choosing a website,
periodical updating and prestige are important to 78% and 69%, respectively; 37% have taken a course through the
Internet; 35% consult electronic journals systematically; 16% regularly collaborate with, or write materials for
healthcare websites; 12% receive electronic mail from their patients.
Three clusters of information were generated in this study to classify the participating hospital doctors: the
different types of information the doctors consulted, the way the Internet enhances doctor/patient relations and the
aspects that the doctors consider relevant when connecting to the Internet.
Conclusions:Spanish doctors consider the Internet to be a tool that enhances doctor/patient relations. New
technologies are accelerating the substitution of a paternalistic model by ones where the patient has access to more
information and resources. There appears to be a favourable attitude towards seeking a second opinion throught
the Internet, although not towards patients’ ‘chats’.
Voir page 40 le résumé en français. En la página 41 figura un resumen en español.
The role of the citizen in developed Western society has
evolved considerably over the last decade thanks to
the advent of new technologies and we will most likely
experience even more changes in the future as others are
implemented.
Today, patients play a much more active role in health care
than in the past. Their capacity to make choices and
participate in decisions is greater than ever before 1, 2 . This has
ushered in a new model for relations between health care
professionals and patients, and health care systems and the
citizen 3, 4 . The patient has gone from being the ‘object’ of the
health care system to become the ‘subject’, from being
‘directed’ to now playing an role in deciding ‘where to go’.
However, this expanded capacity for patient’s
participation is only as good as the quality of the information
available to him/her. Generally speaking, the information
available to patients, and the patient’s capacity to make
technical judgements even after receiving care is limited,
since the patient usually does not have enough information
to form an educated opinion about the ultimate result of a
medical intervention. This handicap is due to the enormous
gap between the information available about the diagnosis,
treatment and prognosis to the person providing care and to
the service user (the concept of asymmetric information).
The shift in the roles assigned to patients and
professionals can be traced to the progressive substitution of
the paternalistic model that has traditionally characterised
the relationship between patient and health care
professional, by other models that recognise that the patient
has needs and expectations, preferences and criteria, and
that these must be incorporated into the treatment process 5 .
The new information technologies have brought about
notable changes in many aspects of our daily lives. For
health care professionals, these new technologies have
introduced very important changes in the way they conduct
their professional activities, with the adoption of electronic
clinical records and information on-line that can be accessed
from their work stations. These changes have affected both
the content, as well as the framework and channels of
doctor/patients relations: with access to vast amounts of
information, exchanges of opinions and experiences
between professionals (‘chats’), distance learning, new
educational channels, patients’ ‘chats’, consultations by
electronic mail (e-mail) and the use of the Internet to seek a
second opinion. These new options are creating an
environment where ‘e-health’ technologies are configuring
Vol. 40 No. 3 | World Hospitals and Health Services | 31