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E-Health and Consumer Health Informatics

Nursing Informatics class presentation
by

Juli Maxworthy

on 19 November 2012

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Transcript of E-Health and Consumer Health Informatics


Juli Maxworthy, DNP, MSN, MBA, RN, CNL, CPHQ, CPPS eHealth and Consumer Health Informatics Broad area of study
Term coined in 2000 What is eHealth? Part of specified branch of eHealth divided into:
Electronic patient decision aids
Clinician-patient communication tools
Web-based consumer information
“Virtual” health communities
Access and equity challenges Internet-Based Consumer
Informatics Products Patient Decision Aids Clinician-Patient Communication Web-based Health Information Virtual Health Communities Conclusion http://epilepsyfoundation.ning.com/profiles/blogs/epilepsyblogger-s-let-s-talk-epilepsy-youth-online-support-group http://glutenfreeeasily.com/gfe-virtual-support-group-march-2012/ http://www.hiitch.com/main/general/hiitch-use-for-support-groups/ Welbourne, et al (2009)
Studied two infertility virtual communites and their effects on sense of virtual community (SOVC), perceived stress, and physical health symptoms Virtual Health Communities (cont.) Interaction via technology vs. face-to-face

Texting, email, social networking websites, wikis, blogs, instant messaging, or chat rooms

Group members post topics, make comments, share health information, ask questions, or share stories

Source of information and crucial support for patients, families, caregivers, or any consumer who wants to participate Emerging Uses:







Virtual clinic
Piloted with Blue Cross and Blue Shield employees
10 minute consultations between patients and doctors
$10 copay for Blue Cross and Blue Shield members Virtual Health Communities (cont.) Welbourne, J., Blanchard, A., & Boughton, M. (2009, June) Supportive Communication, Sense of Virtual Community and Health Outcomes in Online Fertility Groups. Communities and Technologies. 31-40. Retrieved from: http://dl.acm.org/citation.cfm?id=1556466 (Lerner, M., 2009) Access and Equity Issues E-health usage is dependent upon internet access

Digital Divide:
Divide between those who have access to, use of, or knowledge of the technology (West, D. & Miller, E., 2006) (National Prescribing Centre, 2011) Enables patients to be involved in decision making
Evidence-based estimates of the benefits and risks
Personalized so patients can make individualized choices What are PDAs? Compliment, rather than replace, counseling from health professionals
Augment discussion of treatment options How are they used? (O’Connor, et al., 1999) Dissemination of patient information is easier
Health information more readily available to less literate patients
Patients of lower socioeconomic status who may have limited or no access to healthcare can access PDAs on the Internet Impact of the Internet on PDAs (Stacey et al., 2011) Patients who used decision aids:
Improved their knowledge of the options
Have more accurate expectations for possible benefits and harm
Choose options more consistent with their informed values
Were more active in decision making
Were enthusiastic about using the tools Benefits of PDAs (O’Connor et al., 2007); (Watson, Thomson, & Murtagh, 2008) Physician and Nurse training is necessary to facilitate effective use
Nurses are typically very committed to shared decision making Implications for Practice (Triple Helix Online, 2012) Enhanced with Internet technology
Patients have more active role in medical decision making
Potential to alter clinician-patient communication
Should not replace healthcare providers as professional guides Clinician-Patient Communication Tools (Pagliari et al., 2005) Proximal
Remote
Mixed Categories of Clinician-Patient Communication Tools http://alignmap.com/2007/05/30/patients-tool-improves-treatment-decisions-adherence/ Doctor communicates clinical information in a way the patient understands Proximal Clinician-Patient Communication Tools (Stacey, et al., 2011) One example is an Internet disease management tool
Heart Failure Internet Communication Tool
Benefits:
Increased patient satisfaction levels
Improved quality of life
Obstacles:
Adherence
Lack of perceived benefit
Lack of interest
No Internet access
Privacy issues
Requires a daily time commitment Remote Clinician-Patient Communication Tools http://teachinghighschoolpsychology.blogspot.com/2010/10/depression-awareness-month.html (Houston, et al., 2001) Example of the usefulness of mixed tools is online depression screening
Benefits:
Immediate, anonymous feedback about depression status
Identifies patients with depression
Fosters patient responsibility and empowerment Mixed Clinician-Patient Communication Tools 80% of Americans use the Internet to access health information.

Majority of searches are for specific disease or treatment information and information on medical professionals and medical facilities. Pew Research Center's Internet and American Life Project ... small Interactive Health Tutorials Health Education through Video Games Self-Management Tools http://trainingwithdrellen.com/wp-content/uploads/2012/06/Decision-making-3.png http://e-patients.net/u/2012/07/psa-globe001.jpg E-health and consumer health informatics are complex and rapidly changing

As Internet accessibility increases, the benefits will continue to expand

Increased need for media literacy and patient education Questions? Benefits Drawbacks Self-education and self-management
Reinforce face-to-face patient education
Compliance Quality of information Media Literacy
Education My Health Counts! (Pagliari, et al, 2005) This author would like to acknowledge Mary Caroll for her inital Prezi presentation on which this was modified
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