The Uses of Second Life in Doctor-Patient Relationships

I must first say my experience with Second Life is limited to a health informatics class I am currently 

taking : The Internet and the Future of Patient Care.  Learning the uses of Second Life is one part of the class.  As required for the class, I opened a Second Life account and created an avatar (animated character). Since I am female, I chose a female avatar.  You may be thinking "duh, of course you would choose a female avatar".   Not so fast.  You can choose to be whatever you want and apparently many are selecting to be the "not so obvious".  I was given maybe a handful of female avatars to select from.  All of the female "default"avatars have sexual undertones (for example bulging breasts and/or unprofessional attire). My brief attempt to change my outfit when I went "shopping" for new clothes resulted in several "party attire" outfits to choose from.  Maybe there were more to choose from but I did not find any professional attire readily available.  I will admit that I like contemporary stylish clothes but I believe you have to carefully select when and where to wear them.  My account is free and perhaps if I was willing to pay, I would have had more female avatars and clothes to select from (hopefully more professional appearing).

 I do not consider myself a computer geek but I think I do a pretty good job of using a computer in my everyday life.  In order for a patient or physician to effectively use Second Life, s/he must both be intuitive with a natural affinity for computer/software technology and its uses, aka computer geek.  I did not find Second Life to be intuitive.  Second Life requires patience as you learn to move your avatar in and around Second Life.  

My knee-jerk reaction to Second Life as a whole is that it is a great place to escape from reality. That said and from a psychosocial standpoint, I think it could be difficult forming an effective patient-doctor relationship.  If I'm walking around big-breasted while communicating with my physician who may look like someone from Star Wars wearing a cowboy hat or boots, how could we each be taken seriously?  On the other hand, most individuals are more apt to "speak out" when not face-to-face and therefore may be more forthcoming with their psychosocial issues.  If this is the case, then I do see some benefit although this same benefit could be achieved with "good old-fashioned" e-mail and without the fancy work of manipulating avatars.  In an ideal world, we are all open-minded individuals and therefore it does not matter what you like but unfortunately this is not the case.  We are quick to judge by what we see.  As the old saying goes, "first impression is the last impression".  If I decided right now to establish a Second Life relationship with one of my patients, I would not feel comfortable with my avatar.  I do not like how I am represented.  I think face-to face on the internet via telemedicine and/or e-mail is the way to go for now.  You can upload patient education videos for patients to review without the need for avatars.  Again, I am someone speaking with very limited Second Life experience.  

Health-Related Issues Currently In The News

Innovation is key to healthcare reform. The Council on Technology and Innovation (CTI) at the Centers for Medicare and Medicaid Services (CMS) is "developing the capacity to better prepare for new kinds of medical innovations.  Sharing knowledge with industry and other agencies already engaged in identifying and tracking innovative healthcare solutions will enable CMS to better anticipate and accommodate new technology to assure a more orderly, timely, and appropriate coverage process.  ..........The goal is to promote the adoption of more targeted approaches to care that can increase quality and avoid unnecessary health care costs."  New software applications are being developed to encourage Patient Self-Monitoring.  This means patients will take an active role in managing their healthcare.  In order to implement patient self-monitoring, technology is needed that will allow the patient to remain at home.  Ideally this will result in fewer office visits with healthcare professionals and could also mean that patients needing skilled nursing care will be able to remain at home instead of going to a facility.  This is both a cost and time-saving means of delivering innovative healthcare without sacrificing quality.  The Wall Street Journal provided an excellent overview in The Journal Report March 28, 2011 entitled Innovations: Health Care.  The WSJ gave several examples of innovative care using Mobile-Health Technology to monitor from afar.  There are mobile tools that "allow physicians to monitor vital signs, note changes in activity levels and verify that medications have been taken, without ever seeing a patient face to face".  This is an exciting time for biotechnology firms to research and develop mobile clinical technology.  My personal experience with mobile monitoring is with my mom who has a cardiac pacemaker.  In lieu of traveling to see her cardiologist and/or his staff for interrogation of her pacemaker, she has a portable device at home that allows this to be done and send results electronically to her cardiologist.  If there are concerns, the cardiologist will notify her with treatment recommendations.  My mom is a layperson and this form of monitoring requires she "hook up" to the device for the monitoring to occur.  Although this particular process is simple (as it should be), this is an example of patients taking an active role in their healthcare.  Another example is when patients take the initiative to e-mail their healthcare providers regarding health concerns.  Getting patients involved in their care and helping them to understand their treatment plan will hopefully, along with mobile technology, result in better outcomes.  What does innovation, mobile-health technology, and patient self-monitoring have in common? HEALTH CARE REFORM.  These are the new keys to delivering low-cost, high quality health care mandated by the federal government.