By Lawrence Eichenfield, MD, and Eric L. Simpson, MD
We’re tired of seeing articles that refer to a “silver lining” among the tragedies that befell health care patients and providers in the past year, but the truth is that we learned some things that will ultimately be helpful to us and the practice of medicine.
Long before the Covid-19 pandemic changed how physicians practice under current conditions, healthcare was moving toward participatory medicine, a movement in which patients and caregivers are more actively engaged in care and treatment. But clinicians’ inability to readily connect in person with patients this year, coupled with greater familiarity about how technology can help increase wellness, shifted participatory medicine into the express lane.
One condition for which participatory medicine can be particularly valuable and where great strides have recently been made is care of eczema, which more than 31 million Americans have. It is complex, affects each person differently, and there is currently no cure. Diet, weather, sleep, stress and topical contact with items like fabrics or metals can all influence how a patient will react. This can be daunting for patients or caregivers who manage a loved one’s condition to track for themselves, much less summarize for their clinicians.
Providing patients and caregivers with reliable information and tools that guide them is critical for participatory medicine, which is why we were excited to test a new app called EczemaWise. Developed with physician and patient input by the National Eczema Association, this app uses a simple smartphone interface that helps patients and caregivers accurately track symptoms, treatments, and triggers over time using validated measures. It also provides a quick reference PDF summary that patients can share with providers.
Like regular monitoring for people with diabetes, the app helps patients understand and communicate a much broader story of their disease, which helps us tailor their treatment plan accordingly. A bonus: EczemaWise also connects patients with educational information they can trust.
While there is no doubt patients can and should serve an active role in their care, the process isn’t always smooth. Some physicians regrettably resist patients’ efforts to become informed and contribute to their care, ignoring important insights or context; likewise, patients can misinterpret or fall victim to dubious information. EczemaWise seeks to bridge this gap.
There are countless examples of strong patient-physician collaborations that work well, improving care and outcomes and fostering strong relationships. Typical ten minute visits with a doctor are not enough to gain a full picture of the patient’s condition and any comorbidities — especially for complex and highly individualized conditions like eczema — and understanding what goes on outside the clinic is arguably most important. Gaining a complete and thorough view of the patient’s status helps doctors understand what course of action is appropriate, if a treatment plan is working and open our eyes to what patients’ daily lives are like. These cases tap into what originally motivated many of us to enter medicine in the first place.
After years of stalled progress, the last few have brought an incredible revolution of eczema therapies that provide better control with fewer adverse effects. Looking to the future, the aggregated data collected by the app fills an urgent gap which can help advance research toward better treatments — and perhaps eventually a cure.
Lawrence Eichenfield, MD, FAAD, FAAP, is chief of pediatric and adolescent dermatology at Rady Children’s Hospital-San Diego and professor of dermatology and pediatrics and vice-chair of the department of dermatology at University of California San Diego School of Medicine.
Eric L. Simpson, MD, MCR, is a professor of dermatology and director of clinical research in the Department of Dermatology at Oregon Health & Science University.
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