This chapter is a brief survey on some e-medicine resources and international definitions focused on the three main subjects of the healthcare quality – the patient, the costs and the evidence for quality. The patients can find in e-medicine everything that they need, but often without data on the supporting evidence. The medical professionals can learn where to find e-information on cost, quality and patient safety, and, more importantly, how to distinguish claims from evidence by applying the principles of evidence based medicine. The goal is to spread and popularize the knowledge in this field with an emphasis on how one can find, assess and utilize the best present evidence for more effective healthcare. The sites discussed below could assist in the retrieval of information about methods for obtaining evidence along with the ways of measuring evidence strength and limitations. These sites also provide information on implementing the ultimate evidence-based product – clinical guidelines for better medical practice and health service.
TopThe Customer
Most of us have been, are, or will be patients. The patient, a suffering human being, becomes “customer”, one of the numerous external and internal customers of the healthcare system (other patients, suppliers, institutions, factories, agencies, hospitals, doctors, nurses, pharmacists, technicians, and all other staff engaged in healthcare). As a customer, the patient is told that his/her welfare is paramount for the healthcare system. Thus, the patient-customer expects the best quality of help or, in other words, service. Being a customer and receiving service, the patient obtains the opportunity to actively assist the medical staff regarding his/her personal health. The result, however, is that the customer evaluates the health service rather than his/her health behavior.
However, customer’s “satisfaction” with the quality of health service might be far away from the “evidence for quality”. Satisfaction is very subjective and cannot be objectively measured hence it is not the best end point for healthcare evaluation. Most patients today are well informed, but some prefer illusions in place of reality. People are not always able to make a clear distinction between personal satisfaction and healthy life style.
The best health strategy for the society is not be the best approach for a single person. Any healthcare system needs money and can be easily destroyed by growing expectations of uncertain nature in an environment of limited and often badly managed resources. An organized group of active, even aggressive, patients might politically impose disproportional distribution of funds that otherwise might be spent more effectively for the advantage of more patients. Attractive new technologies, diagnostic instruments, tools and devices, new curative approaches and therapeutic drugs are often subject of commercial rather than medical interest.