"Desktop Medicine” Could Transform Medical Practice

An emerging approach to medicine shifts emphasis from diagnosing diseases and treating symptoms to identifying risk-factors for medical conditions, and intervening before they develop.

Desktop medicine, as defined in a recent commentary by Jason Karlawish, M.D., an associate professor of medicine and medical ethics at the University of Pennsylvania School of Medicine (Philadelphia, USA), involves clinicians continuously gathering risk factor information from a patient's medical history, electronic medical record (EMR), or recent office visits, and combining it with clinical studies regarding disease risk. Once the patient's risk has been assessed, the physician can provide the appropriate intervention to prevent the onset of disease, rather than treat the disease once it is fully developed.

Accordingly, physicians need to learn how to incorporate both bedside and desktop medicine into an office visit, so that long-term disease prevention is not overlooked while a short-term symptom is being addressed, and vice versa. Both physicians and their patients, both enjoying increasing access to their own medical information, will have to learn how to collaborate on the decision making process. Thus, medical and premedical education focused on epidemiology, genomics, and information sciences becomes increasingly important, while EMRs are also becoming more and more crucial, as physicians use statistical models that require large sample sizes to detect risk. The commentary was published in the November 10, 2010, issue of the Journal of the American Medical Association (JAMA).

"Desktop medicine has substantial implications for how we ought to educate, train, and practice medicine,” said Dr. Karlawish. "For example, medical training should teach how to help patients appreciate their relevant risks and manage these risks, as many patients fail to adhere to a long-term intervention intended to prevent disease.”

One of the aspects of Desktop medicine is developing new techniques to change patient behavior, such as monetary rewards for adhering to medication protocols. Accordingly, physicians will need to learn how to discuss such financial incentives with their patients.

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University of Pennsylvania School of Medicine