- Associated Press - Wednesday, November 10, 2010

CHICAGO (AP) - Learning he had prostate cancer floored John Noble. Then came the prospect of surgery and his overpowering fear of being “put under” with anesthesia.

Remarkably, he found comfort in a computer. A soothing woman’s voice explained the operation step-by-step, its risks and benefits, and even answered his questions. Noble’s phobia vanished. The operation to remove his tumor was uneventful and Noble is doing fine.

The 54-year-old Pennsylvania lawyer was aided by an interactive computer program that is part of a growing trend in health care, helping patients better understand what they are consenting for the doctor to do.

Proponents say this way of getting informed consent makes patients partners in decision-making.

Such a system “sends a message that the decisions are truly owned by the patients,” said Dr. Harlan Krumholz, a Yale University heart specialist and advocate of changing informed consent procedures.

Computer-based informed consent programs are also part of a broader push for electronic record-keeping that President Barack Obama’s administration has advocated to improve patient safety and curb medical errors.

The Emmi Solutions program that John Noble watched about prostate cancer surgery can be viewed at home, and that’s where Noble watched it.

Shortly after his diagnosis last December, while he was still grappling with shock and denial, his doctor e-mailed him the program.

“I put off watching it for a while,” he said. “Who wants to be filled in on the facts of the surgery? Ultimately I forced myself to review it when I was all alone.”

By the time he watched it, he felt better prepared mentally than when his doctor first told him he had cancer.

Noble said his biggest fear “was being knocked out. I was terribly afraid of it.”

As the interactive explained the operation, Noble could pause it and ask questions or review the information to make sure he understood it.

“It changed my perspective. It removed my fear,” he said.

Traditionally, informed consent has involved a conversation with the doctor and signing medical forms written in tough-to-decipher legalese.

It has a dual purpose: to make sure patients understand risks and benefits, and to protect hospitals from lawsuits in case something goes wrong.

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