The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review

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Abstract

Background

The internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors.

Objective

This study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship.

Methods

Literature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021.

Results

We selected 53 target papers (42 [79%] English papers and 11 [21%] Chinese papers) that met the inclusion criteria. Of these, 31 (58%) papers believe that patients’ OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11%) papers show that OHI reduces Chinese patients’ trust in doctors.

Conclusions

Our main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China’s internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship.

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Most cited references 80

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Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review

Sharon Swee-Lin Tan, Nadee Goonawardene (2017)

Background With online health information becoming increasingly popular among patients, concerns have been raised about the impact of patients’ Internet health information-seeking behavior on their relationship with physicians. Therefore, it is pertinent to understand the influence of online health information on the patient-physician relationship. Objective Our objective was to systematically review existing research on patients’ Internet health information seeking and its influence on the patient-physician relationship. Methods We systematically searched PubMed and key medical informatics, information systems, and communication science journals covering the period of 2000 to 2015. Empirical articles that were in English were included. We analyzed the content covering themes in 2 broad categories: factors affecting patients’ discussion of online findings during consultations and implications for the patient-physician relationship. Results We identified 18 articles that met the inclusion criteria and the quality requirement for the review. The articles revealed barriers, facilitators, and demographic factors that influence patients’ disclosure of online health information during consultations and the different mechanisms patients use to reveal these findings. Our review also showed the mechanisms in which online information could influence patients’ relationship with their physicians. Conclusions Results of this review contribute to the understanding of the patient-physician relationship of Internet-informed patients. Our main findings show that Internet health information seeking can improve the patient-physician relationship depending on whether the patient discusses the information with the physician and on their prior relationship. As patients have better access to health information through the Internet and expect to be more engaged in health decision making, traditional models of the patient-provider relationship and communication strategies must be revisited to adapt to this changing demographic.

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Untangling the Web--the impact of Internet use on health care and the physician-patient relationship.

Hedy Wald, Catherine Dubé, David C. Anthony (2007)

The use of Web (i.e. Internet)-derived health information within the health care encounter is rapidly increasing. In this article, an extensive review of the complex effects and sometimes contradictory roles of the Web in regard to health care delivery and the physician-patient relationship is presented. A review of relevant literature was conducted, with key points integrated into a physician guide for effective interaction with Web-activated patients. An emerging consumerist model with "triangulation" of patient-Web-physician can be expected to significantly impact dynamics of the physician-patient relationship. Potential advantages of Web-acquired information include helping patients make informed health care choices (with potential to decrease health care disparities), shared decision-making with a collaborative, teamwork approach, more efficient use of clinical time, augmenting of physician-provided information, online support groups, and/or access to patients' own health information. Alternatively, factors such as misinformation due to highly variable quality of Web information, possible exacerbation of socioeconomic health disparities, and shifting of conventional notions of the physician-patient relationship ("traditional" medical authority) present their own set of challenges for the health care provider. A tangible guide to the integration of patients' use of the Web within a medical practice is thus offered with recommended communication skills. The "net-friendly" clinician can be effective by engendering a genuine partnership with patients, thus contributing to quality health care.

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Patients using the Internet to obtain health information: how this affects the patient-health professional relationship.

Stephen M McMullan (2006)

Health information is one of the most frequently sought topics on the Internet. A review of the literature was carried out to determine the use of the Internet for health information by the patient and how this could affect the patient-health professional relationship. This study is a literature review, summarizing multiple empirical studies on a single subject and is not intended to be a meta-analysis. The review showed that the majority of health related Internet searches by patients are for specific medical conditions. They are carried out by the patient: (1) before the clinical encounter to seek information to manage their own healthcare independently and/or to decide whether they need professional help; (2) after the clinical encounter for reassurance or because of dissatisfaction with the amount of detailed information provided by the health professional during the encounter. There has been a shift in the role of the patient from passive recipient to active consumer of health information. Health professionals are responding to the more 'Internet informed' patient in one or more of three ways: (1) the health professional feels threatened by the information the patient brings and responds defensively by asserting their 'expert opinion' (health professional-centred relationship). (2) The health professional and patient collaborate in obtaining and analysing the information (patient-centred relationship). (3) The health professional will guide patients to reliable health information websites (Internet prescription). It is important that health professionals acknowledge patients' search for knowledge, that they discuss the information offered by patients and guide them to reliable and accurate health websites. It is recommended that courses, such as 'patient informatics' are integrated in health professionals' education.

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Author and article information

Contributors

Wenzhao Xie:

ORCID: https://orcid.org/0000-0001-8685-3255

Key Laboratory of Medical Information ResearchThe Third Xiangya HospitalCentral South UniversityNo.138 Tongzipo RoadChangsha, 410013China86 0731 8861 8316xie_wenzhao@126.com

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: February 2022

Publication date (Electronic): 10 February 2022

Volume: 24

Issue: 2

Electronic Location Identifier: e23354

Affiliations

[1 ] The Second Xiangya Hospital Central South University Changsha China

[2 ] Key Laboratory of Medical Information Research The Third Xiangya Hospital Central South University Changsha China

[3 ] School of Life Sciences Central South University Changsha China

[4 ] Department of Pharmacy The Third Xiangya Hospital Central South University Changsha China

Author notes

Corresponding Author: Wenzhao Xie xie_wenzhao@ 123456126.com

Author information

Aijing Luo https://orcid.org/0000-0001-5890-3470

Lu Qin https://orcid.org/0000-0003-0460-7013

Yifeng Yuan https://orcid.org/0000-0002-2787-0458

Zhengzijin Yang https://orcid.org/0000-0001-9193-5781

Fei Liu https://orcid.org/0000-0001-8036-3255

Panhao Huang https://orcid.org/0000-0002-5180-4004

Wenzhao Xie https://orcid.org/0000-0001-8685-3255

Article

Publisher ID: v24i2e23354

DOI: 10.2196/23354

PMC ID: 8874798

PubMed ID: 35142620

SO-VID: e4cf84c2-1acd-4bb9-8dd6-3232892a0d4f

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 10 August 2020

Date revision requested : 21 October 2020

Date revision received : 24 October 2021

Date accepted : 17 November 2021

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