Selected Podcast

Families Did Their Research, Now What? Health Information Seeking in the Digital Age

New innovations in digital media allow for more access to more health information than ever before. Parents and teens are now taking their health information into their own hands, but what does this mean for providers?

Rupal C. Gupta, MD, explains how this new digital health innovations affect the provider-patient dynamic and what providers can do to make sure their patients are receiving accurate and helpful information.

Families Did Their Research, Now What? Health Information Seeking in the Digital Age
Featured Speaker:
Rupal C. Gupta, MD
Rupal C. Gupta, MD, is a pediatrician and Medical Director of Operation Breakthrough, which provides a safe, loving and educational environment for children in poverty and empowers their families through advocacy, emergency aid and education. She received her medical degree from the University of Pittsburgh School of Medicine and completed a residency in pediatrics at St. Christopher’s Hospital for Children in Philadelphia, Penn.

Learn more about Rupal C. Gupta, MD
Transcription:
Families Did Their Research, Now What? Health Information Seeking in the Digital Age

Dr. Michael Smith (Host): So our topic today is, “Families Did Their Research, Now What? Health Information Seeking in the Digital Age.” My guest is Dr. Rupal Gupta. She’s a pediatrician and medical director of Operation Breakthrough. Dr. Gupta, welcome to the show.

Dr. Rupal Gupta (Guest): Hi, thank you, so much, for having me Dr. Mike

Dr. Smith: We’re going to get into information-seeking in the digital age because I know that’s a challenge for a lot of practitioners, but I just wanted to hear quickly about Operation Breakthrough because this sounds really interesting. Just tell us a little bit about what you’re doing there.

Dr. Gupta: Sure, it’s a very exciting place. It is an early head start center, which is based in Kansas City Missouri. We serve around 450 children and are one of the largest daycares in Missouri. Children’s Mercy Hospital has had a presence in this center for the past 20 years, including a medical clinic, which offers full well-child care to families and also serves within the school community. I was brought in as director of this medical aspect of the facility.

Dr. Smith: That’s great. Very good, Dr. Gupta, I know you’re going to do some awesome stuff there with Operation Breakthrough. Let’s bring it back, now, to this information-seeking in the digital age because I know this is a challenge for hospitals and practitioners. What do you think are some common reasons parents and teens seek out information online?

Dr. Gupta: It’s funny because this kind of a thing affects all of us as providers almost every single day. We always have somebody who’s looked up something in google and is asking us about it, so we all know this on a very personal level. There are many reasons for which families will look up information online, and they make a lot of sense. They might have fear. They might have a concern. They may have time and just want to have information on a certain type of a symptom. Many things can drive health information-seeking behavior.

Dr. Smith: Do you find it interesting that more people are usually – it’s after the diagnosis that they go online. I know in the adult world, adult patients, when they get a symptom they hop right online, but do you see that with the kids? Do you see teenagers, for instance, after they’ve received, say, a diagnosis, that they sit down with their family and they start to go online? Is that the more common behavior?

Dr. Gupta: I would say that this behavior, just like in adults, can happen at any time. Approximately 50% of health-related searches are done on behalf of someone else. It is more common to do health-related searching if you have a loved one, such as a young child who has a disease, so certainly, that rate of search will increase once you have a diagnosis. Teenagers, for instance, may not have any kind of a diagnosis, but because of a symptom they experience, they might start exploring their social networks and the web to find out what it could mean.

Dr. Smith: Yeah. What about when a parent or even maybe a friend of the family goes online to start looking up about a diagnosis or about symptoms? Does it concern you about which sources or resources they’re looking at online?

Dr. Gupta: I mean, that’s the obvious, number one concern. When we have – in the pediatric office, the issue of vaccine hesitancy affects us increasingly. Being in Operation Breakthrough, I’ve tended to have patients who will trust and accept medical care, but I am seeing increased levels of vaccine hesitancy as information abounds, but the quality of that information can be questionable. That’s one of the first things that I discuss with families when they have a question about a certain symptom – what are their sources, and how are they evaluating them?

Dr. Smith: And so, Dr. Gupta, how do you actually approach that? We don’t want to belittle the person; we don’t want to say, “Why are you on that website?” What’s your approach to actually asking that question and evaluating that website they’re looking at?

Dr. Gupta: Of course, I think that the first thing that providers might be inclined to say is, “Get off the search engine. Don’t look up health information,” and because of the ubiquity of information-seeking, in general, online we all know that’s an unrealistic possibility, so the current model that’s often recommended is Ask, Acknowledge, Advise. Don’t be afraid to ask a question, acknowledge the family’s concern, and try to give them some concrete advice on how to evaluate those sources. Unfortunately, there’s not data to back up the use of that particular model, but I’m afraid that at this point it’s all we have. As providers, as history-takers, the more history we can take to understand our family’s decision-making and questioning, the more we can treat them personally and properly.

Dr. Smith: Yeah, it seems like if there’s some information that the parent, or even the teen, has and they’re talking about this in their doctor appointment and you know it’s not coming from a legitimate source or a source that concerns you, isn’t that just maybe a great spring-board into actually educating the family, the teen, about what’s really going on, about the symptoms. It really could be something – if we handle it right, we can make it a positive, correct?

Dr. Gupta: And certainly that can happen. I had an example of a patient who came to me concerned about their child having neck pain. The child was completely well and without symptoms otherwise, but the family had looked a topic of chronic meningitis and thought that that could be a concern. I was able to educate this family on the fact that that diagnosis isn’t really a legitimate one and helped reassure them -- your child does not have any rigidity of the neck, your child is not having fevers, you child does not have any signs of meningitis, and so you have a lot of reason here, in this particular situation, to see that your child is healthy and well and that you don’t have to be concerned about that particular symptom.

Dr. Smith: Digital health media applications are – it seems like new ones are coming out almost daily. are there any applications out there that you find helpful, and are there some digital health media applications that you find that may actually not be so great to use [LAUGHS]?

Dr. Gupta: Well, I think that because this type of information is changing, as you say, extremely rapidly, it’s astounding to me how many wonderful things are out there. The NIH digital presentation that was given in 2015, there was even discussion of a program called Night Scout in which families had actually hacked their children’s’ continuous glucose monitors to be able to track glucose and send that information to their phone. There are issues with there. There’s the benefit of being able to track a child’s glucose, and then the other side of it is that this may have some privacy implications. I think that every application can have positive and negative aspects to it, but the key is really identifying how to use sources appropriately, how one can recognize that their own privacy could be compromised by their use of those programs. Really education families on how much information they are sharing with others online and how they are being critical of whatever media they use.

Dr. Smith: Yeah, it seems clear to me that it needs to be a team approach to this, as well, right? The practitioner needs to know what some of those great applications are and some of those online resources, speak with the family about that -- create almost an online strategy for how they can learn information, so it really becomes almost part of their care, right? That way, as a physician, you would know the sites they’re going to, you would know the information that they’re pulling up. To me, it seems like it should be a team approach. With that in mind, do you have some advice then, for practitioners in helping their patients go through a lot of that online information and applications?

Dr. Gupta: Yes, so there’s specific things that you can do in terms of evaluating a source. You want to make sure that you know what the funding sources are for whatever application it is or web program that they’re accessing because that can give you a good insight into what agendas might be desired by whoever’s creating that resource.

Find out who the sources are for the information that they’re getting. If they’re going to a particular site or using a particular app, who are their experts – who are the people who are being trusted by that application? You want to get a good idea of how privacy is protected with any of these applications especially with the rise of telemedicine. These are certain things I’ll discuss with families depending on their needs.

Dr. Smith: Do you know if there’s – speaking of online – an online resource, for instance, that already lays out a lot of that information for doctors and patients, meaning, here are some highly vetted applications online, resources – these are the good ones, these are a little bit more questionable. Is there anything like that?

Dr. Gupta: I’d probably have to go into more research myself to know that answer, but regarding certain types of media programs, like Common Sense Media is one that I will commonly discuss with families. It’s a wonderful resource that just helps you assess all kinds of digital media, so that could be related to – especially related to children’s media, so if there are children’s health-related media, that would be a wonderful place to go to.

Dr. Smith: Right, well let’s end this way, Dr. Gupta, you’re an expert in this information-seeking in the digital age. What’s your overall take on all of it? Is it good, is it bad? Where do you see it going in the future?

Dr. Gupta: I consider it good. It’s a good thing when families have questions and are engaged in their health. It may be a difficult thing to know that a family doesn’t necessarily agree or want to go by the practice that I’m suggesting being in traditional medicine, but it is absolutely a good thing for families to want to make decisions. I think that it’s absolutely a good thing for families to be looking into their healthcare and to show that they actually have a true interest and engagement in their healthcare.

One of the things we all struggle with is engaging our patients and making sure that they’re personally invested in what they’re doing, that they’re reading and that they want to make that decision shows it. It’s up to us to ask families and let them teach us about the sources that they’re using so that we can explore them.

Dr. Smith: Right, and of course we all agree, Dr. Gupta, it’s not going anywhere. The internet is going to continue to grow. The resources are going to continue to grow, and so I think it’s best that we have a strategy for dealing with that in clinical practice. Dr. Gupta, I want to thank you for the work that you’re doing at Children’s Mercy, and I want to thank you for coming on the show today. You’re listening Transformational Pediatrics with Children’s Mercy, Kansas City. For more information, you can go to ChildrensMercy.org. that’s ChildrensMercy.org. I’m Dr. Mike Smith. Thanks for listening.