What is 'history taking'? Why are we neglecting it?

History taking is the science and art of collecting relevant information from the patient about his complaints and symptoms to be able to figure out what could be the cause of those symptoms, what could be the diagnosis and decide on further actions or management based on the information collected.

It is such a crucial step. Good history taking requires intelligence, experience and of-course a lot of knowledge about the subject.

Good history can reveal a lot of information. It is like a detective taking an interview to finding clues and missing links. Good history can guide a good treatment regime further. Missed details in history can lead to misdiagnosis, bad referrals, and a lot of cost burden or agony for the patient.

Today i see a lot of #TeleMedicine platforms.

And most of them are using some kind of chatbot for collecting patient 'History'. But even in the most branded solutions i see the 'History taking' bot is just a decision tree to select options. It is not intelligent and it is not thorough at all.

The sole purpose of such bots is to redirect and convert as many people as possible into an appointment and make money.

The doctor that you connect with is also mostly going to give you 2 to 5 minutes (MAXIMUM) in which the history is usually not completely taken. Many patients feel they were not properly heard. They couldn't tell everything. The same problems existed offline in face to face dealings and now it just moved online to TeleConsultations.

And nobody seems to care about the gravity of the situation here. You were not able to express yourself means you didn't get a psychological pacification. The doctor didn't ask everything means you are prone to Medical negligence and errors. His experience may make him very accurate but still, due process was not followed.

Without the right information, how can we have good clinical decision making and patient management further?

Average time given per patient in India is 2 minutes 20 seconds (WHO Study). In Bangladesh it is 48 seconds. While in European nations this is approximately 10+ minutes to 20 minutes. Recommended time is 20 minutes.

Why are we neglecting proper history taking? If we are to use technology to make sure all 'histories' are properly recorded, then why not use some quality history taking bots, with some regulations in place rather than using a simple Question Asking system that anyone can build.

Or are we deciding to neglect the importance of a 'Good history' and prefer going towards costly testing and unnecessary investigations with a lot of referrals and delays, just to fill pockets of Corporate Hospitals, Labs and Big players in the market.

Is 'history taking' dead?

Seeking your views!

Thank you for reading.