Searching the internet for health information is no longer even remotely new, and indeed it is something that many of us take for granted.  In fact it is a tool that we often use merely as a support to professional medical services, for example prior or post a doctors visit.  There is also increasing use of the internet to provide lifesaving health services in less developed geographies and rural communities with inadequate physical health infrastructures.

One area however which we often do not think about is the use of the internet for health information by tourists and people in countries other than their own.  This in itself is potentially a large number of people, with a global community of over 200 million expats and over 1 billion tourists in 2012.

Being an expat myself in Switzerland I often turn to the internet for health information – largely as a result of the language issue.  Whilst I do speak and read fluent French and German I prefer to access my health information in English so I often turn to UK and US sources of information.  Many other expats however turn to the internet because they do not speak the local language and suddenly the internet becomes a lifeline to home – a lifeline to highly valuable information that would not be available to these people locally.  There is also a comfort for some in getting health information from a source from home that they feel comfortable with and trust, whereas they may not know of or trust local sources.  I myself still regularly use NHS Direct which I know is a highly reputable source whereas I do not have a preferred Swiss source of information – and to be honest as I Google health information in English anyway I rarely come across Swiss sources in the results.

For tourists who are on holiday in countries where they do not speak the language and do not know the local resources the internet really can become a life saver.  Whilst those staying in five star hotel in cities may not have issues getting access to healthcare, for those travelling in more remote or rural locations, local and reliable healthcare may be hard to get to.

Sunset in India - worth an electric shock or two

Sunset in India – worth an electric shock or two

I had the wonderful fortune of spending a month in India and Sri Lanka – but was less fortunate in getting a full-on electric shock in India and an infected knee in Sri Lanka.  In India I could not have been closer to healthcare – my brother was staying with us and he is a GP!  In Sri Lanka however I was less lucky.  I was staying in a wonderful beachside hotel thirty minutes along the coast from the wonderful fortress town of Galle. On my third day however I noticed that a mosquito bite on my knee had obviously got infected.  My first port of call was therefore the internet where I looked up what type of antibiotics I should take before getting a tuk tuk to the main private hospital in Galle.  I was slightly flummoxed as the pharmacist did not stock the antibiotic I requested (and I had not thought of looking up a fall back option) so I found myself having to pop the doctors office for a prescription.  Upon return to my hotel my first port of call was yet again the internet – this time to check up on what the side effects where, whether I could drink on the product (it was New Year’s Eve after all) and all the questions I had been unable to ask the doctor as his grasp of English had been limited.  Satisfied that it was a good product – and that it would not interrupt my New Year’s celebrations – I proceeded to take my medication as prescribed.

My next issue came five days later when I was on my last dosage of the antibiotic.  My knee by this time had swollen up and had been very painful but it appeared to be getting better – however it was now oozing with pus which was most unpleasant.  Yet again I turned to the Internet to check what I should do as it was still too painful to contemplate another tuk tuk journey unless totally necessary.  I found instructions on how to clean the oozing wound and by the next day the knee was less painful and swollen and I was able to pop back to the hospital.   There I underwent a horrifically painful dressing of the knee (a rough handed nurse trying to squeeze every last ounce of pus out of my very sore knee was not my idea of fun) and an additional prescription for more antibiotics and this time thankfully some painkillers too.  I am pleased to say my knee was fully healed by my last day of holiday!

Whilst the internet in no way saved my life it certainly provided me with greater confidence in my healthcare needs, and it also prevented the need for what would have been a painful tuk tuk ride to the hospital until my knee was slightly less inflamed.  Had I however been in an even remoter location the story may have been different, particularly if the local healthcare providers had not spoken any English at all (much maligned as Google translate is it can have its uses).

My little holiday incident though also got me thinking about access to my health records. It would have been great to have had access to these remotely – both for me and my local healthcare provider.  Instead I found myself having to update my doctor in Switzerland verbally when I got back, for her to update my records there.  I also have records in London and Suffolk with my old physicians – and no where do I have a single record all in one place which I could take with me to my next destination.

Of course I could set up an EHR myself and compile a complete record myself from the three versions that exist – but would it not be great if my European physicians at least could all communicate and share my records electronically when I move?  I actually would feel far safer with an electronic transfer than a mail transfer.  It would also be great if there was a single European EHR system that all EU physicians could access – with a patient’s consent of course.

Unfortunately as my Swiss physician still reaches for a text book when she has a query and given current EU politics and crisis I think this is still a long way off.  Even if it were here today  as I am now job hunting in the Americas and Asia this would be moot point for me anyway – as the day that American, Asian and European physicians share patient records is still some way off!

Sunrise in Sri Lanka - well worth an infected knee

Sunrise in Sri Lanka – well worth an infected knee

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