Do you speak doctor?
There are some professionals with whom communication is an uphill battle for the average citizen. We often hardly understand a word of what they are trying to tell us. Lawyers and civil servants are infamous for using complicated jargon. Doctors are too, which is extremely unfortunate for the affected citizen, since the topic of discussion could hardly be more important: their own health. A doctor will hold a long and complicated lecture about diagnosis, treatment options and risks – peppered with a seemingly endless list of expert terms – and ultimately present the patient with a series of forms to be signed. But how much did the patient really understand? Every day hundreds of thousands of people turn to the internet in their search for answers with good reason, a group the Latinophiles in their white coats ironically refer to as “Dr Google”.
Austrian Johannes Allesch has developed an approach that is an enormous step forward in attaining informed patient consent: His company, AniMedical, focuses on digital patient information and consent forms and develops pre-operative informational materials using 3D animation. The short films depict what happens during surgery, for example. They condense all the important elements of complicated medical procedures and depict them in a manner that is easy to understand. AniMedes is the name for the software he has developed that combines information with documentation options for doctor and patient. It has been successfully implemented in Austrian hospitals and makes it easier for both patient and doctor to prepare for the consultation that takes place prior to surgery.
Not only can a patient view 3D films with AniMedes, he or she can also use it to complete their medical history, report any possible allergies or pre-existing conditions, and prepare some questions they would like to ask the physician. In turn AniMedes offers the doctor an overview of the information accessed by the patient: What information does the patient already have, what still needs to be communicated? What questions does the patient have that need to be discussed prior to surgery? The software also offers doctors the option of documenting the consultation.
And since comprehension begins with language, AniMedes is available in a range of languages: German, English, Serbian and Turkish are the standard options, but additional languages are available upon request. The software also offers the option of switching between languages during a consultation. So doctors can prepare patient information in their own language, and then switch to the patient’s mother tongue.
How did you get the idea for AniMedes? Was there a specific catalyst?
Yes actually, there was. Because of an accident in my family, I spent a lot of time in hospitals and consultations a few years ago. That was the first time I really noticed the complete lack of good informational media. Since I have always been very interested in medicine and was studying 3D animation at FH Salzburg, it made perfect sense for me to combine the two. The AniMedes software just kind of developed naturally after we introduced the first information films in hospitals in 2009. Despite the films, we still felt a tool was missing to make consultations more effective. Just distributing the films to hospitals was alright, but ultimately not a huge help to physicians without a corresponding method of documentation.
Before a procedure or operation, a doctor meets with the patient to discuss the methods and risks of treatment so the patient can provide informed consent. What advantages does AniMedes offer compared to the classic consultation?
We are never going to replace a personal consultation. Our videos provide patients with information about surgery before they talk with their physician – which helps them understand the consultation better. Audio-visual information is generally easier to understand than texts when talking about complex medical topics that tend to be too abstract for many people. The animation enables us to boil down all the relevant details of the operation so that anyone can understand them while ensuring they are still medically correct. This means physician and patient can discuss a procedure on a higher level.
AniMedes is especially designed to help patients who have trouble reading or writing understand the procedure – whether because they are not fluent in a foreign language, have dyslexia or a similar learning disability, or simply find it difficult to focus on long texts because of advanced age. Have you tested how well your films are understood by this target group?
We have been testing the films since 2011 and the software in hospitals since 2013. We are currently conducting a clinical patient study in Salzburg and Vienna. Experience from earlier testing has shown that patients very readily accept the films as an informational medium. Our concerns that a graphic representation might increase anxiety in older people in particular or cause a patient to refuse treatment proved unfounded. Physicians report that consultations are more pleasant and more effective when patients have already absorbed the information provided in the films.
"Physicians report that consultations are more pleasant and more effective."
For what sorts of illnesses /diagnoses is material already available from AniMedes?
We have developed a range of films for urology, vascular surgery, trauma surgery/sport trauma surgery that cover a wide spectrum of the most common operations or treatments in each of these specialised areas. We are currently also focusing on developing our range for anaesthesiology and intracardiac catheter procedures.
If I as a patient want to learn about a surgical procedure – can I access AniMedes films independently or maybe watch them on YouTube?
As software, AniMedes is only accessible to hospitals and doctors since the software includes a lot of functions for documentation that would be useless to an individual user. We also offer online video platforms for the informational packets so that patients can re-watch the films at any time after the consultation. We are also currently talking to a lot of interested parties we would like to provide access to the films for as an additional service before patents are admitted to the hospital. This applies to specialists, for example, who often give patients information about surgery before referring them to hospital.
How many hospitals are already using AniMedes?
AniMedes is currently in use in 5 hospitals.
So you have already gathered a lot of practical experience. What has feedback from physicians and patients been like?
Feedback from most doctors has been very positive. The additional information we offer through audio-visual media is an obvious improvement on the often hard to understand and very long informational texts. We also get suggestions for improvement, which we are always very grateful for, often about optimising the sequences in the software and details in the films. Our goal is to ensure that patient consultations are more effective and quick, after all, and optimisation is key.
Well-informed patients could be a disadvantage for hospitals from a purely monetary point of view, since they might decide to get a second opinion or that surgery is not absolutely necessary – which could result in financial losses for a hospital. What have the largest hurdles and resistance to AniMedes been so far?
In medicine there is a general rule that patients who choose elective surgery – a procedure that is not absolutely necessary – must be better informed than those undergoing essential surgeries. For cosmetic procedures for example, patients have to meet with their physician twice and with two weeks to think about their decision in between. So for physicians, providing the patient with comprehensive, precise information is unavoidable from a purely legal standpoint. We certainly feel that it is always better to provide the patient with verified information than to leave them to their own devices and internet search skills, forcing them to become “Dr Google”.
Generally the hurdles to introducing AniMedes are that hospitals are unsure as to whether the documentation as comprehensible and suitable from a legal-medical standpoint. There is also a certain level of scepticism about providing information in digital form due to data protection and the advantages of paper forms.
What are the next steps for AniMedes?
We have some studies and tests running right now that we want to complete by the end of the year. At the moment we are working with our partner clinics on expanding our range of films to meet market need. When the necessary preparations, like medical-legal and technical testing, are complete, we will focus on marketing and selling the product, so on expanding our client list. Developing additional language versions is also on our to-do list.
Johannes was awarded with the European Youth Award in the category "Healthy Life" in 2014. The European Youth Award is a pan-European contest to select and honour "Digital Creativy for Social Good!".