Introduction

Information technology has integrated with the healthcare system, and has changed the way doctors practice medicine. Practices have begun converting to electronically submitted claims, and many offices have updated to electronic medical records and a "paperless" practice. But how is advancing information technology affecting the podiatric patient? The authors conducted a survey to evaluate this specific population.

Materials and Methods

articipants consisted of patients at six different locations in the metropolitan Chicago area during April 2006. All patients and offices were a part of the senior author's (LSW, Jr.) practice. The subjects were asked to complete a 12 question survey (Image #1). The data was compiled and stratified according to age groups; Group 1: participants less than 30 years old, Group 2: participants age 30 to 49 years old, and Group 3: participants 50 years and older.

Results

Four hundred and one subjects were surveyed at six locations. Group 1(30 patients) accounted for 7.5% of the population surveyed. Group 2 (133 people) consisted of 33.2%. The majority of the surveyed population fell into the category of Group 3 (238 patients/ 59.4% of total population).

Computer Ownership and Internet Usage

The first three questions focused on computer ownership and Internet usage. Most patients reported owning a computer. (Figures #1,2,3) Likewise, a very high percentage of subjects reported using the Internet. Of those patients who use the Internet, 64% from Group 1 spent more than an hour a day online. 46% and 37% of Group 2 and 3, respectively, spent more than an hour a day online.

Online Medical Information

Questions four through seven focused on the subject's interest in gaining medical information online. Groups 1 and 2 reported that having a website was of some importance (figure #4). Among older responders, only 34% responded that it was important that their doctor have a website. One hundred and ninety-one subjects (46.4%) reported that they seek medical information on the Internet (Figure #5), with Groups 1 and 2 responding yes, 53% and 62%, respectively. The majority of subjects reported using the Internet once a month to obtain medical information. Infrequently, this population used the Internet to verify medical advice (Figures #6,7).

Figure 1:

QUESTION #1: DO YOU OWN A COMPUTER?

Figure 2:

QUESTION #2: DO YOU USE THE INTERNET?

Online Appointments

The following four questions focused on the subject's interaction with the Internet combined with appointment making. Sixty-six subjects(16.2%) reported that they preferred appointment online versus by phone. The most positive response to this question came from Group 1, at 36% (Figure #8). However, two hundred and six subjects (83.8%) stated that if available, they would use online appointment scheduling (Figure #9). Although, the majority of those surveyed stated they would prefer appointment reminders by phone versus e-mail, 43% of Group 1 and 38% of Group 2 preferred e-mail reminders (Figure #10).

Figure 3:

QUESTION #3: HOW OFTEN DO YOU USE THE INTERNET?

Figure 4:

QUESTION #4: IS IT IMPORTANT THAT YOUR DOCTOR HAS A WEBSITE?

Figure 5:

QUESTION #5: DO YOU GET YOUT MEDICAL INFORMATION ON THE INTERNET?

Figure 6:

QUESTION #6: HOW OFTEN DO YOU GO ONLINE FOR MEDICAL INFORMATION?

Figure 7:

QUESTION #7: AFTER SEEING THE DOCTOR DO YOU VERIFY MEDICAL INFORMATION ON THE INTERNET?

Figure 8:

QUESTION #8: IF GIVEN A CHOICE HOW WOULD YOU PREFER TO MAKE AN APPOINTMENT?

Online Protected Health Information and Financial Transactions

Questions #11 and #12 evaluateted the subject's willingness to trust Internet security, and willingness to participate in secure, protected health information and financial transactions over the Internet. Two hundred and twenty-seven subjects (56.6%) marked that they would use a secure website to complete medical forms prior to an office visit. However, Groups 1 and 2 were very willing to complete an online medical history, answering positively 88% and 86% respectively. Two hundred seventy-six subjects (69.9%) said that they would be willing to purchase a doctor recommended product on a secure website.

Figure 9:

QUESTION #9: IF DOCTOR HAD ONLINE APPOINTMENTING, WOULD YOU USE IT?

Discussion

The majority of the patients surveyed in this study were over 50 years of age, and reported having personal computers, used the Internet regularly, and frequently obtained medical knowledge online. It would have been interesting to have evaluated the sites that that they most frequented for medical information and evaluate those sites for content. It is also worthy of noting that nearly one in every four participants surveyed used the Internet to verify medical information that was received.

43.9% of the subjects surveyed reported that it was important that their doctor had a website. Patients under 50 years thought it was important nearly 60% of the time. When asked if they had ever visited the senior author's website, only 26.1% said yes. Understandably, having a great website alone does not translate into patients seeking information or visiting the site. This may warrant the doctor to market the site either internally or externally in order to maximize patient visits to the website.

Interestingly, the majority of subjects preferred appointment scheduling by phone; however, 51.9% of subjects said that they would use online scheduling if available. This discrepancy is difficult to explain. The majority of subjects also reported that they would be willing to complete medical record forms using the Internet prior to an office visit. This data suggests that patients might be willing to use the Internet in manners that would reduce the burdens on the front office staff and increase the efficiency by which patients were seen.

Question #12 suggests that patients are willing to purchase recommended medical equipment online. The implications of this for the doctor include dispensing of medical products and devices without the burden of storage. The patients are still able to receive the recommended device, without the need of the doctor to store the products at his or her office.

The results, when stratified and compared, display a large variation between groups, which was expected. Although, the typical podiatry practice population more likely corresponds to Group 3, the future population is represented by Groups 1 and 2. Patients younger than 50 years old appear to have greater interest in integrating the Internet with their healthcare.

Conclusion

The results of this survey suggest that the podiatric patient population in a large metropolitan setting is actively incorporating the Internet with their healthcare. There also seems to be much room for growth in this area. This survey serves to demonstrate the willingness of patients to partake in a number of methods that can reduce the burden on practices and increase efficiency and income. The results seem to indicate that future podiatric patient populations will have more interest and willingness in using the Internet in combination with their health care. It also validates the importance of modernization of the podiatric practice to keep up with the changing population.

Figure 10:

QUESTION #10: HOW WOULD YOU PREFER TO BE REMINDED ABOUT AN APPOINTMENT?

Figure 11:

QUESTION #11: IF DOCTOR HAD SECURE WEBSITE TO COMPLETE MEDICAL FORMS PRIOR TO VISIT, WOULD YOU USE IT?

Figure 12:

QUESTION #12: IF DOCTOR RECOMMENDS YOU TO PURCHASE A PRODUCT FROM ONLINE SECURE STORE, WOULD YOU USE IT?

Dr. Goldsmith graduated from Scholl College of Podiatric Medicine in 2003, and completed his residency in Podiatric Surgery at Grant Medical Center in Ohio. He is currently in private practice at the Foot & Ankle Center of Nebraska in Omaha. Dr. Goldsmith is Board Qualified in both Foot Surgery and Reconstructive Rearfoot & Ankle Surgery by the American Board of Podiatric Surgery, and is an Associate of American College of Foot & Ankle Surgeons.

 

 

 

 

 

Dr. Fridman holds an appointment at New York-Presbyterian Hospital, Columbia University Medical Center in the Department of Orthopaedics, and at Weil-Cornell Medical Center. He is also in private practice at Foot Associates of New York. He was Chief Resident at The Mt. Sinai Hospital Podiatric Surgery Residency Program, and completed a fellowship in Reconstructive Foot and Ankle Surgery & Research at the Weil Foot & Ankle Institute in Illinois. Dr. Fridman is Board Qualified in both Foot Surgery and Reconstructive Rearfoot & Ankle Surgery by the American Board of Podiatric Surgery, and is an Associate of American College of Foot & Ankle Surgeons.

 

 

 

 

 

Dr. Weil is a partner at The Weil Foot & Ankle Institute and also serves as Fellowship Director. He is Board Certified by ABPS in Foot Surgery and Reconstructive Rearfoot and Ankle Surgery. Dr. Weil is President of OurDoctorStore.com, is the Team Podiatrist for the Chicago White Sox Baseball Club, and lectures nationally and internationally.

 

 

 

 

 

 

Elizabeth Vissat is a 3rdyear podiatry student at Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science.