Monday, August 29, 2011

Putting an end to "Didn't Ask Didn't Tell" Syndrome in Patients

This is a guest post from a clever medical student , Muthukar Ramanathan. If there are more like him, the future of medical practise holds a lot of promise !


How many times have you felt that you forgot to mention something important after leaving your doctor’s clinic ? Unable to ask an embarrassing question or to did not remember to discuss your recent allergy? This familiar problem of "Didn't Ask Didn't Tell" among patients is due to multiple reasons - chiefly lack of recollection, stress or even laziness. But this inability to communicate well with physicians ultimately hurts patients due to incorrect diagnosis or treatment.

As a medical student sitting as an observer in physician's office, I noticed that many times patients could not accurately provide much needed information about their symptom of chest pain . In the stressful & time challenged setting of the physician office, patients rarely had the presence of mind to ask their questions ; clarify their doubts; or confirm their diagnosis and treatment plan. These observations drove me to think there must be an easier way to help patients organize information and communicate with physicians. If patients have a more systematic approach towards recalling important information, it would allow patients to contribute to a strong physician-patient relationship and help the doctor to make the right diagnosis and offer the correct treatment.

Hence, I looked into creating a simple, logical sequence of questions that can be applied to the common medical problems most patients face. I realized that smartphones offer a perfect platform to capture information from patients through text, images and voice and smartphones are almost always easily available in the pockets. Hence, whenever a patient has a problem, he can immediately note down more details about his symptom – for example, the type of pain, its location ; what makes it better and what makes it worse; and so on, thus creating a more accurate picture of his medical problem ; and tracking its progression by comparing notes over a period of time. This is a free app called Mediari which is currently available free at iTunes store.
Download it at:

Plans in the Future

After talking to many physicians and patients, I have come to realize that Mediari can serve a critical role in improving the ability of patient to track his problems as well as to describe them better to his physician. However, some patients might prefer a short note with a brief description and questions for the doctor. This truncated short note is a feature that I am trying to incorporate in the next update.

Another idea that I am considering is from Dr. Malpani who suggested linking Mediari to web based Personal health records. This is a very interesting idea that I am exploring as well when updating my app.

At the same time, I am working on a trial with patients in a pediatric setting (Mediari allows users to track up to 5 patients and parents can track their children’s medical problems ). I am also working on improving the user interface, so it’s easier and more intuitive for patients to use this app.

I am very encouraged by the inputs and insights that I have gathered from many physicians and early adopters. I hope that Mediari can help patients to take better notes about their health, to help them get better medical care

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