INFO 648 – Healthcare Informatics ,Fall 2009 – M. Rogers, PhD

Team 3Johari Crews

Andrea Kyer

Titus Moolathara

Gabriel Sirlopu

Consumer Health Informatics and Telehealth

D R E X E L U N I V E R S I T Y

Contents•Telehealth

• Definitions• Real World Systems• Bridging the Distance

•Consumer Health InformationChanging Roles for Health Professionals• How Can We Make Health Information ‘Consumer Friendly’?

•Conceptual Framework for CHIS• Information Quality Control• Research Methods

•Challenges: Economics and Privacy•The Future…

Complexity and Collaboration

●Complexity: the increasing need to understand health and disease

●Collaboration: active participation between providers, patients, family members and society.

Definition of TelemedicineTelemedicine involves the use of modern

information technology, especially two-way interactive audio/video communications, computers and telemetry to deliver health services to remote patients ad to facilitate information exchange between primary care physicians and specialist at some distance from each other. (Bashshur, et al., 1997)

Telehealth: a broad term

•Excellent collaboration method

•Capture data at one site and interpret at another

•video-conferencing between patients and providers

•Focuses on management rather than diagnosis

Remote Monitoring Telemedicin

e: Telepresenc

e

Remote Interpretati

on

Remote MonitoringSubset of telehealthCommon practice in home health careCaptures clinically relevant data in the

patient’s homeFocuses on management rather than

diagnosis

Remote InterpretationCapture of medical data at one site and

transfer to another for interpretationRadiographsPhotographsWave Form

Advancement in technology increases the availability of these services.

Multi-media, real time interaction…

Video-based TelehealthMode of synchronized video-conferencingThree categories:

TelepsychiatryCorrectional TelehealthHome Telehealth

TelepresenceView situations and act on themExcellent collaboration method

Using the telephone again:

25% of all primary care encounters occur by telephone

Improve cost control. Some insurance providers are reimbursing

for email and text messaging.Reimbursing for telephone contact?

page 513 Figure 14.1ways to bridge the distance between patients and provider

page 513 Figure 14.1ways to bridge the distance between patients and provider

Consumer Health Informatics

Modern consumers of healthcare experience an increased demand to participate in their care.

Reflects a shift in paradigm from the patient being a silent recipient to active collaborator.

The patient is now a case manager.

Inexpensive access to information on health promotion, disease prevention and disease management.

Changing roles for Health Professionals

Medical professionals have the following responsibilities to the field of Consumer Health InformaticsServe as sources for contentProvide important guidance in moderating

public electronic discussion groups and responding to patient’s electronic messages

Act as an information broker and interpreter for patients

How do we present health-related information in a way that is easily understood by the average person?

Can existing decision support systems be adapted for use by consumers, or do we need to build a new system from scratch?

Challenges

 NLM –Conceptual framework for consumer health information seeking

 Consumer

Information Source

Channel

Outcome

Environment

Information Quality: Who is watching the internet?

Credentialing represents one approach to ensuring the quality of health information available to consumers.

Three disadvantages:The challenge to ensure that every information

element is tested and evaluated fully exceeds the resources available to do so.

Leaves control of the authority for healthcare information in the hands of traditional care providers.

Credentialing alone is inherently contradictory to healthcare consumerism.

How are consumers interacting with health information?

Online Search BehaviorReadabilityConsumer Health Vocabulary aCross-language information retrieval

Research Methods in Use by the NLM

More seniorsMore chronic illnessGreater need for healthcare

$

With so many retirees, the national income decreases because there are fewer people working and earning.

The not-too-distant future…

Long term disease monitoring of patients at home currently represents the most promising application of telehealth technology for delivering cost effective quality care.

Telehealth can reduce healthcare costs

Challenges: Economics

Licensure and Economics in TelehealthLicensure is frequently cited as the single

biggest problem facing telemedicineMedical licensure is state-based

ReimbursementMedicare: synchronous video is reimbursed only

for rural patientsMedicaid: 19 states provide coverage for sync

videoFew insurers: electronic messaging and online

consultationOnly services provided directly by humans are

currently reimbursed by insurance

Challenges: Security

Using the Internet for Consumer Health and Telehealth Applications will mean…Resources are widely availableData freely transmitted over the Internet raises

security concernsThe industry faces the challenge to ensure

integrity and quality of the medical data transmitted over the Internet

Better Primary Care decisions

More accurate secondary referrals

Un-necessary spending is reduced!

On the bright side…

The Future…

Wealth of public health information and provider-oriented information resources are available through the InternetPatients are now researching medical data

Clinicians need to ensure to be prepared to answer all the patient’s questions based on their research

Telehealth technology continues to grow due to the rapid advancement of technology

Facilitating productive collaboration between patients, their caregivers, biomedical scientists, and information technology experts.

Has the use of Consumer Health Informatics helped the consumer or has it made health care more difficult to understand?

Health information on the internet is too plentiful for anyone to realistically keep track of. Experiment by googling – try heavily advertised drugs as your search term; try searching a symptom or something overly broad like ‘healthy diet’. Share and discuss on the board.

How can HIT professionals facilitate productive collaborations between patients, their caregivers, biomedical scientists, and information technology experts?

“Be careful about reading heath books. You may die of misprint.“- Mark Twain 

 Is it worthwhile to put records (general health information) into the hands of the consumer?

Think about this as you read…

Baker, L. and Gollop, C., Initials. (2004). Medical textbooks: can laypeople read and understand them?. Library Trends, 53(2),

Eysenbach, G. (2000). Recent advances: consumer health informatics. BMJ, doi: 10.1135/bmj.320.7251.1713

Pare, G. Jaana, M. and Sicotte, C. (2007). Systematic review of home telemonitoring for chronic diseases: the evidence base.Journal of the American Medical Informatics Association, 14(3), doi: 10.1197/jamia.M2270.

Consumer Health Informatics & Telehealth –p.511-535 in Shortliffe, E. H. (2006). Biomedical Informatics. Health Informatics. [New York]: Springer Science+Business Media, LLC.

Sullivan, F. and Wyatt, J., Initials. (2005). How Informatics tools help deal with patient problems. BMJ, doi: 10.1136/bmj.331.7522.955

Tse,T. Gemoets, D. and Rosemblat, G. (2004). Consumer health information seeking: a report to the board of scientific counselors. The Lister Hill National Center for Biomedical Communications, doi: LHNCBC-TR-2004-03

References