Patients may be eager to use internet health management systems, but they run the risk of boring their patients, being over-complicated, and potentially lacking credibility, a new study has concluded. The report, published in the Journal of Medical Internet Research, was undertaken in Denmark as part of a pilot by technology firm AstraZeneca, focussing on their software LinkMedia-Heart, and aimed to find out how such systems are received by the general public. It found that while patients and doctors alike were enthusiastic about using the software, which invites users to enter periodically details about their exercise and diet and automatically e-mails plans for a healthy lifestyle. However, interest dropped off after the initial questionnaire and survey was completed. After six months, no patients had made any improvement to their lifestyles or diet because of the system. One GP told the study: “The patients were happy when I asked them to participate in a test of a lifestyle program. When I introduced the program to them, their eyes shined and they were ready to start immediately.” However, one patient later told the researchers: "Unfortunately, I never got into the program, but I wanted to do it very much." One reason put forward by the researchers, Jacob Anhoj from AstraZeneca and Lene Nielsen from the Copenhagen Business School, is possible over-complication of the particular system tested, as over 219 initial questions were asked of the patients and they were required to update the information at regular intervals. Furthermore, patients felt that without direct human support from healthcare professionals, computer results could not be trusted, and when patients disagreed with the advice they were given, they simply ignored it. One patient told the study: "It’s the doctor who is educated and knows things. You cannot expect a computer program to know what is good for you. However, if your doctor tells you to use a computer program, it might provide extra information." The report remains hopeful about the power of the internet to improve people’s health: “The Internet appears to be an ideal medium for providing the additional support that complements the doctor’s counsel.” However, it recommends that all developers of health management sites should have an "open attitude" to the way their patients could integrate the site into their lives, and use qualitiative rather than quantative analysis of diet and exercise. Other forms of contact and encouragement, such as SMS, should be explored. Nobody at AstraZeneca was available to give E-Health Insider any further comment.
