Jul 17, 2015 – A headline from NPR this week gave me pause: “Online Symptom Checkers Can’t Replace the Real-Life Doc Just yet.” How do patients use symptom checker apps and do these apps fit within the broad landscape of telemedicine?
The article discussed research about the efficacy of these applications, “Researchers tested 23 online symptom checkers and found that the correct diagnosis was provided first on a list of potential illnesses only about a third of the time. That means symptom checkers are spitting out wrong diagnoses two-thirds of the time.”
The fundamental problem with this is that the researchers (and perhaps patients as well) are mistakenly equating the notion of checking symptoms with arriving at a diagnosis – something symptom checkers were simply not designed to do. Symptom checker apps may provide helpful information to a patient, but they are not designed to provide a diagnosis or care – and they are not telemedicine.
Unlike simple symptom checkers, a virtual care (telemedicine) visit offers patients both a means to review their symptoms as well as a way to potentially receive both a diagnosis and treatment plan that is based on medical evidence and provided by a trained clinician.
A Zipnosis virtual visit starts with the patient’s concerns about what might be wrong. From there, the application leads the patient through a series of questions about symptoms and past history. The flow of questions adapts based on the information the patient provides. Once the interview is complete, a summary is reviewed by a real clinician practicing at a local health system. The key is that it is a real live clinician, not the software, who makes the diagnosis and recommends a treatment plan.
The entire process is grounded in evidence-based medicine and complies with national best-practice guidelines. If at any point the patient provides information indicating a serious illness, Zipnosis will determine that virtual care is not appropriate and direct the patient to the most appropriate level of care. For example, if a patient believes she/he has a sinus infection and also indicates a fever of 103, the Zipnosis platform will stop the virtual visit and recommend an appropriate in-person site, such as the health system’s urgent care clinic.
Symptom checkers may have their place. Like Wikipedia, they bring together a wide range of information for quick review. They may help someone make a decision to wait or to seek help from a clinician. However, as with Wikipedia, the information offered is best evaluated with a very large grain of salt.
For patients who have questions about the significance of their symptoms, virtual care visits go beyond just checking symptoms to provide real care by trusted clinicians.
Dr. Rebecca Hafner-Fogarty
Chief Medical Officer