Questionnaires will be included in the medical history – Picture of the Day – Kommersant

Service “Action Medicine” asked Russian doctors how they feel about the idea of ​​digital survey of patients before visiting a doctor. This is expected to reduce the burden on doctors. However, only about 7% of respondents supported such a survey. Doctors fear that then they will cut even more time for seeing patients, which is still lacking now. Experts note that doctors have traditionally resisted everything new, but they acknowledge that fears about a possible reduction in the time of admission are not unfounded.

At the end of August, Vladimir Putin instructed the government and the Agency for Strategic Initiatives to work out the possibility of digital questioning of patients before visiting a doctor. The document spoke about “the experience of conducting an online survey of patients who made an appointment with a doctor about health complaints, as well as processing the information received and placing it in an electronic medical record.” It was assumed that this would reduce the administrative burden on the medical staff, the head of state was supposed to report on the results by September 15.

Experts from Action Medicine (an expert support service for specialists from medical organizations, part of the Action group), together with the Doctors of the Russian Federation community, interviewed medical workers – how they feel about this innovation. 1966 doctors took part in the survey, 71% of them were women and 29% were men. A large proportion of respondents (77.8%) work in state medical organizations, 11.7% are part-time workers, and 10.5% work in private clinics.

According to the results of the survey, 82% of doctors answered that now their medical organization does not conduct patient surveys before admission. The fact that such a practice exists was reported by 16% of the respondents.

Moreover, for 13%, the survey is carried out manually on a special form, and for 3% – electronically.

A third of specialists believe that most of their patients (70%) do not even know what complaints they came with: such people “answer questions for a long time”. Another 31% of respondents have the opposite point of view: in their opinion, 70% of patients know exactly what they came with and answer questions without delay. Another 21.9% of doctors claim that half of the patients prepare in advance and give answers quickly. 10.6% are sure that no one can immediately name complaints or symptoms. At the same time, doctors in state clinics more often than specialists in private medical institutions answered that the majority of their patients did not know what they came to the appointment with (34.1% versus 28.5%).

Respondents believe that men (39.9%) and elderly patients (38.7%) most often call relatives to answer questions about complaints, chronic diseases, and medications they take. When asked whether patients often “exchange” stories about symptoms and complaints in the queue or in the ward, the majority of doctors (33.8%) answered that periodically one or two active patients “infect” others with their symptoms, after which people also begin to tell about them to doctors. 25.4% of specialists believe that patients “frequently exchange” symptoms and this negatively affects diagnosis and treatment.

40.3% of the doctors surveyed were against the electronic questioning of patients, since, in their opinion, not everyone will be able to fill out the questionnaire correctly.

In particular, among therapists, 39.7% of respondents think so, among pediatricians – 36.9%, among neurologists – 43.4%, among gynecologists – 41.2%, among cardiologists – 46.6%, among psychiatrists, narcologists, psychotherapists – 42.1%. Another 11.34% of the surveyed specialists of all directions are against the survey, since they still do not have electronic cards in the medical organization. 31.5% were in favor if all the data of the questionnaire would immediately be included in the card and they would not have to enter them themselves. Unconditionally supported the questionnaire before admission, only about 7%.

Physicians were also asked if they agreed to reduce the time of admission in the event of the introduction of electronic questionnaires. More than half (61.9%) answered that they already do not have enough time “for normal interaction with the patient and filling out medical documentation.” Another 23.5% believe that patients will not fill out questionnaires. 7.17% agree to reduce the time of admission, as “they will be able to see all patients without delay”, and 2.29% – because “they will go home earlier.”

Commenting on the reluctance to introduce questionnaires before admission, doctors explained that in this way they would receive “double work”. “Read, analyze, clarify, and so on. Reception should be increased for live communication, and not reduced, ”says one doctor. “There is a catastrophic lack of time for a full examination and collection of anamnesis due to a shortage of personnel. Most patients, especially the elderly, will not be able to complete the questionnaire on their own. Many patients report those complaints that they consider related to the disease, which is not always true. Time is needed to detail the complaints, ”comments another.

Natalya Zhuravleva, the leading expert of Aktion Medicine, considers the fears of doctors that after the introduction of questionnaires they will cut down on the short time for an appointment are “not unfounded”. At the same time, Ms. Zhuravleva adds that in Western countries, the benefits of electronic questionnaires have been discussed since the 1990s. According to her, now electronic questionnaires are common among doctors who deal with chronic diseases (asthma, some cardiovascular diseases, diabetes, oncopathology). They can be passed through the application or on a special tablet in the clinic. For example, in the United States, a primary survey can be conducted by a nurse who has more rights and powers than a Russian one: she is considered an individual specialist with the right to make decisions and, in mild cases, even prescribe treatment. The doctor already receives the results of such a survey in the patient’s record and, based on this, continues the examination.

Aleksey Remez, CEO of medical company Reztom, specialist in digital medicine, notes that the concept of taking an anamnesis before coming to the doctor is not new in Russia either. She, according to Mr. Remez, has existed for “two decades”, and all this time the professional community has been arguing about its effectiveness. “In my opinion, the mechanism itself can be effective, but it depends on important aspects. How this mechanism is implemented from a technical point of view, is the information structured, does it contain any tips and guidelines so that the patient can express what worries him more structured. And secondly, is the doctor’s specialization taken into account,” says Aleksey Remez. Commenting on the results of the survey, he notes that people within a narrow professional community “inherently resist everything new.” However, whether this will increase the effectiveness of medical services, in his opinion, can be shown not by a survey, but by a study – the introduction of this approach, and with a certain design, for a certain audience and specialization.

Natalia Kostarnova