Building common ground for communication between patients and community pharmacists with an internet medicine cabinet Jean-Pierre Calabretto 1,2 , Jim Warren 3* , Kathy Darzanos 3 , Benjamin Fry 3 1 Pharmacy Department, Adelaide Women’s and Children’s Hospital, 2 School of Pharmaceutical, Molecular and Biomedical Sciences, University of South Australia 3 Advanced Computing Research Centre, University of South Australia Email: warren@cs.unisa.edu.au Abstract Increased levels of patient satisfaction and compliance are found when they assertively participate in clinical conversations. The Internet may be able to aid communication between the patient and the community pharmacist, particularly if the patient is in control of their record. We propose an Internet Medicine Cabinet that affords this aid by providing “common ground” for conversations. This should provide concrete objects for patient-pharmacist communication and allow online storage of current medication details, recording of problems / issues related to medication, and online education facilities. These first two functions have been implemented in a prototype service called Winston. In collaboration with the Adelaide Women's and Children's Hospital, oncology and asthma patients are being enrolled in a trial wherein they maintain their own online records to share with their community pharmacists. We report the rationale, architecture, usability testing results and future plans for Winston. 1. Introduction 1.1. Internet-enabled partnerships The Internet provides opportunity to build partnerships between patients and health providers [1]. Increased levels of patient satisfaction and compliance are found when patients more assertively participate in clinical conversations [2]. Establishing partnerships with patients is also seen as vital for the future community pharmacist’s role [3]. Although not as thoroughly studied as doctor- patient communication problems, pharmacists and patients have different perceptions of therapies that may confound communication [4]. Patient satisfaction with pharmacists has been shown to correlate with social interaction, although not necessarily with the level of care [5]. However, pharmaceutical care has been shown to increase patient awareness of medication side effects [6]. Community pharmacists provide a useful advisory role for minor ailments, thus avoiding unnecessary visits to general practitioners; and community pharmacists can also act as referrers in cases that merit General Practitioner (GP) consultation [7]. The key to greater consumer participation in health care decision-making is better information [8]. Informed consumers would be in a better position to approach the consumer-provider relationship as more of a partnership of shared decision- making [9]. While some consumers may want to continue to leave all decisions to the provider, those who want to take a more active role in their health can only do so effectively if they are in a position to make informed decisions [8]. For that matter, there is serious doubt that providers themselves are in possession of all information at the point of care that they would want in order to do best for their patients [8]. The proliferation of health information and self-help communication facilities now commonly accessible on the Internet has been hailed as a transformation in health care [10]; however, it has also raised concerns about the quality of on-line information [11]. The Internet need not take consumers away from traditional sources of quality information; for instance, doctor-patient communication by e-mail has technical benefits in facilitating clarification of previous advice and including links to Internet sources of further information [12]. 1.2. Complementary and over-the-counter medicines Information that is often lacking at the point of care is that relating to Complementary Medicines (CM) or Over- the Counter (OTC) medications [13]. The popularity of CM is increasing based on the perception of being ‘safer’ than conventional medicines [14-15]. Within one year in Australia, almost half of a representative sample of consumers had used at least one non-medical complementary remedy and at least one in five had Proceedings of the 35th Hawaii International Conference on System Sciences - 2002 0-7695-1435-9/02 $17.00 (c) 2002 IEEE 1