Technology, Informed Consent and Patient-

Technology, Informed Consent and Patient-Physician Collaboration

THINGS WE LIKE — BY HEALTHTAP ON MARCH 1, 2011 12:01 AM 

In the article, Uninformed Consent, which appears in the March issue of Scientific American, Deborah Franklin posits that technology can be helpful in restructuring the informed consent process, but not without the communication between physician and patient.

But how many patients truly understand the alternatives or the risks and benefits of the test or treatment they are undergoing? One of the guiding principles of modern health care is that, except in an emergency, doctors must get the patient’s permission before the start of any invasive medical procedure. That “informed consent” is supposed to be based on an earlier conversation during which physicians make sure patients understand what the procedure will and will not do, along with its benefits and risks relative to other options.

Franklin describes how the informed consent process tends to fall apart in U.S. hospitals. On the way to testing or surgery, a patient is quickly handed a clipboard to sign to indicated that they have been informed of risks and benefits. The forms are often poorly written, not understood and do not improve patient understanding or prevent malpractice suits.

Some are hoping that technology will bridge the gap. Writes Franklin:

In hopes of filling the gap, a growing number of medical centers are now turning to technology—specifically, interactive computer programs that are designed to get beyond the one-size-fits-no-one consent form. These software solutions vary widely in approach and targeted audience. Some are aimed at doctors, others at patients. Some are meant to be reviewed with a health care provider during an office visit; others can be watched with family members at home.

A hospital’s first decision when purchasing a technology-based system is whether they want it to be physician or patient focused. One system, for example, requires the patient to sit in the doctor’s office to complete an interactive, self-paced computer module about the surgery or invasive procedure. This patient-centered approach is intended to educate the patient, facilitate communication with their doctor and document the informed consent process.

A physician-centered system relies on the creation of consent form templates tailored to each patient’s needs. If more information is required, physicians can print out educational brochures. Each step is documented in the patient’s electronic medical record.

Without collaboration and communication between physician and patient, technology can become a costly, one-size-fits-no-one venture. Ultimately, access to quality health information allows patients to begin the informed consent process prior to visiting their doctor.