Prescription for Change

“The health-care industry is about to undergo a global revolution driven by a force it can no longer resist: information technology.
While hospitals and other care providers have long been quick to adopt breakthrough technology in medical devices, procedures and treatments, far less attention has focused on innovations in networking and communications.”
Article
Amar Gupta, The Wallstreet Journal, 20 October 2008

Act paves way for National Information Governance Board

“The National Information Governance Board is to become a statutory body, replacing the Patient Information Advisory Group, following Royal Assent for the Health and Social Care Act 2008.”
Article
e-Health Insider, 23 July 2008

Patients turn to Internet for medical solutions

“The Internet has produced two types of patients, says Dr Joseph Kosgey, a general practitioner at the Aga Khan Hospital in Nairobi.
“Some of the patients now go to the doctor just for the prescription, since after consulting the Internet they already know what they are suffering from. The other lot of patients after being diagnosed by the doctors go the net to research on the doctor’s findings,” says Dr Kosgei.”
Article
Beatrice Gachenge, Business Daily Africa, 23 April 2008

How much can Internet-powered consumers demand?

“If information is power, then the Internet makes your power absolute. Several times, just since launching this blog, I’ve been able to shock my doctors with new knowledge. They can’t sneak stuff by me. They’re no longer the final word.
But all Internet communication is two-way. I can learn about new research, new drugs, and new devices, but the makers of these things also have new ways to reach me. Those who take fullest advantage, and scale that intimacy, can become big-name brands.”
Article
Dana Blankenhorn, ZDNet Healthcare, 22 April 2008

The Implication Of Choices

“I have heard this theory many times, but I was glad to run across an article on it.  The basic point is that too many choices have negative implications on people.  In this article from Health Day News, it discusses a study published in the Journal of Personality and Social Psychology about the effect of multiple choices.”
Article
George Van Antwerp,Patient Centric Healthcare, 18 April 2008

EMRs vs. Information Convergence

“The focus of true health care reform must be placed on information and how it enters the health care equation-how it is used, processed, managed and archived. The outcome of the patient encounter is most important and to get the proper outcome, meaningful information must be available to the health care provider at the right place and at the right time.”
Article
Scott McCabe, Advance, 7 April 2008

Home test websites giving misleading information

“Websites selling home diagnostic tests are providing misleading and confusing information which could have serious health consequences, according to a new study.
Researchers from Birmingham Women’s Hospital looked at the information provided on 168 websites marketing home diagnostic tests for conditions such as hepatitis C, HIV and prostate cancer.
They found that 55.9% of the websites complied with less than half of the criteria suggested by the authors and only one website complied with all of their criteria.”
Article
e-Health Insider Primary Care, 5 February 2008

Information Latency: Why Don’t We Change?

“I have had this note to self for a while so I am finally going to put a quick entry out here on the topic.
The issue is data latency or more appropriately information latency. The data often exists right away, but the challenge is how to you get the data into a usable form, with context, and with enough data to make decisions.”
Article
George Van Antwerp, Patient Centric Healthcare, 4 February 2008

Perceptions and behaviour of access of the Internet: A study of women attending a breast screening service in Sydney, Australia

“Objectives
To describe the perceptions and behaviour in accessing health information from the Internet by women attending a BreastScreen, New South Wales (NSW) Service in Northern Sydney.
Design
Cross-sectional study.
Setting
A BreastScreen NSW Service in Northern Sydney.
Main outcome measures
Behaviour and perceptions of accessing of the Internet for breast health and screening information and other related health information.
Participants
Four hundred and fifteen women aged ?40 years who had a screening mammogram at a BreastScreen NSW Service in Northern Sydney. Data were collected from 1 October to 22 December 2004 (study interval).
Results
Four hundred and sixty-one eligible women were invited to participate in the study and of these 415 women agreed to participate in the study (participation rate = 90%). Of the 415 women enrolled in the cohort, 80% (333/415) of women accessed the Internet in general and 62% (205/333) of the women who accessed the Internet also accessed health related information from the Internet, but only 7% of the total women accessed breast health and screening information from the Internet. Two hundred and eighty (70%) women in the cohort expressed their intention to access the Internet if they were diagnosed with breast cancer. Age (OR = 0.94; 95% CI = 0.91–0.97), marital status (OR = 2.65; 95% CI = 1.45–4.83), educational status (OR = 3.26; 95% CI = 1.77–6.02) and behavioural intention of accessing the Internet if diagnosed with breast cancer (OR = 3.31; 95% CI = 1.83–5.98) were found to be associated with access of Internet for general information. Furthermore, behavioural intention (OR = 2.43; 95% CI = 1.30–4.55), rating of computer skills as ‘average’ (OR = 0.42; 95% CI = 0.22–0.79) and ‘not good to poor’ (OR = 0.23; 95% CI = 0.11–0.49) were found to be associated with access of health related information from the Internet.
Conclusions
Information searching from the Internet is common among women having a screening mammogram. There is potential to provide guidance to women regarding accessing the BreastScreen NSW website and other reliable sources of Internet information on breast health, breast screening and cancer-related information.”
Article
Aditi Dey, Beth Reid, Robyn Godding and Andrew Campbell, International Journal of Medical Informatics
Volume 77, Issue 1, January 2008, Pages 24-32, doi:10.1016/j.ijmedinf.2006.12.002

Knowledge Navigators Combat Information Overload

“One of my greatest challenges in 2008 is information overload. 700 emails a day on my Blackberry, RSS feeds, Facebook, Instant Messaging, LinkedIn, MySpace and Second Life all create a pummeling amounts of data.”
Article
John D. Halamka, Life as a Healthcare CIO, 7 January 2007

Technology offers cost efficiency in health-care services

“The U.S. owns the distinction of having the world’s costliest health care with annual outlays surpassing $2 trillion, or roughly $7,500 per citizen. Readily available information measuring population health raises serious questions of whether we are getting our money’s worth on that investment. A quick glance at rankings that gauge Tennesseans’ health clearly suggests we are not.”
Article
Bryon Pickard, The Tennessean, 8 October 2007

Do People Experience Cognitive Biases while Searching for Information?

“To test whether individuals experience cognitive biases whilst searching using information retrieval systems. Biases investigated are anchoring, order, exposure and reinforcement.”
“People may experience anchoring, exposure and order biases while searching for information, and these biases may influence the quality of decision making during and after the use of information retrieval systems.”
Abstract
Annie Y.S. Lau and Enrico W. Coiera, J Am Med Inform Assoc. 2007;14:599-608

Health information Websites: characteristics of US users by race and ethnicity

“We conducted a national public opinion survey of adults aged 18 years or older in the continental US to determine their use of health Websites. Of the 928 individuals contacted, 868 (94%) reported their race/ethnicity. More non-Hispanic Whites reported using the Internet (34%) than African Americans (31%) and Hispanics (20%). We used logistic regression to estimate adjusted odds ratios describing the relationship between Website usage and covariates across the racial/ethnic subgroups. Whereas better perceived health was associated with greater Website use among Hispanics and Whites, stronger health literacy was associated with greater use among Hispanics. No African American or Hispanic respondent aged 65 years or older reported going online. The relationship between education and use was more than twice as strong for African Americans and Hispanics than other groups. That some minority groups are less likely to use the World Wide Web for health information may further compound existing disparities. One place where this problem may be addressed is in the nation’s schools.”
Abstract
Miller, E.A.; West, D.M.; Wasserman, M., Journal of Telemedicine and Telecare, Volume 13, Number 6

A survey of Internet use for health purposes in Poland

“We investigated the use of the Internet for health-related purposes in Poland. A telephone survey was performed of 1027 people between 15 and 80 years old who were selected from the Polish population by random sampling. The study showed that the Internet was used by 47% of the respondents (n = 483) and 37% of the respondents (n = 376) had used it at least once a week. Almost 80% of responders used the Internet to obtain information about health or illness (n = 383) and 43% of them did it at least once a month. The respondents used the Internet for health purposes mainly to read about health or illness (95%). Only 3% of them approached the family physician, specialist or other health professional over the Internet. However, when choosing a new doctor, 45% of respondents stated that the doctor’s provision of Internet-based services was of importance. At present the Internet is not used as a health communications channel but it is clear that many Polish people are interested in Internet-based health services.”
Abstract
Bujnowska-Fedak, Maria Magdalena; Staniszewski, Andrzej; Steciwko, Andrzej, Journal of Telemedicine and Telecare, Volume 13, Supplement 1

Commission unveils medical intelligence system

“The European Commission has developed a medical intelligence system that collects and sorts information from more than 1000 news and 120 public health websites in 32 languages.”
Article
Carla Moore, Digital Media Europe, 14 August 2007

Americans increasingly turn to Web for health data

“Americans turn to the Internet as a primary source for medical and health information almost as much as they rely on their personal physicians, according to a poll released Tuesday.
The 2007 Consumer Medical and Health Information poll, commissioned by search engine Ask.com and performed by Harris Interactive Inc., revealed that 70% of adults use the Internet as a primary source for health information and that 72% describe their doctor as a primary source.”
Article
Computerworld, 14 August 2007

Communication and ICT in Healthcare: Theory and Practice

Workhop Organizer:
Dr P. Toussaint, LUMC, The Netherlands

Background

If information is the lifeblood of healthcare, then communication is the heart that pumps it. Every information exchange is a communication act, whether it is the exchange that occurs between two people or two machines. Communication can be studied at the level of the interaction between individual agents, or as a set of processes that co-ordinate different health services.

Traditionally health informatics research has focussed on information system design, with an emphasis on representation and storage of information, for example in the health record. The support of communication has received little attention, despite the fact that up to 90% of the information transactions in some health services do not involve stored electronic data, but are the exchange of information between clinicians, often in face -to-face conversation.

The importance of supporting effective communication in health care is growing as the result of several well recognised trends:

• It is increasingly being recognised that health care is not always safe or effective, and the role of avoidable error in generating poor outcomes is now widely discussed. For example, it has been argued that the highly interruptive media such as the pager and the telephone, that are the main means for implementing communication between health professionals, result in a large workload for the health professionals. Communication inefficiency and failure may be a core generator of clinical error, and supporting more effective communication may have great impact on the quality and safety of health service delivery.
• The ageing of the populations of western societies inevitably will result in a greater percentage of the population requiring care for multiple illnesses. Such co-morbidity implies shared care, and shared care necessitates co-ordination of activities through communication.
• Health care organisations are increasing the number of people employed often due to the merger of smaller organisations and the fact that more people work part time hours. This development has huge implications for the role of communication in the organisation of the care process.
• The health professional/client relationship is changing, as the meek or patient receiver of care has turned into an active demander of a service. This client wants to be informed about and involved in the medical decision making process.

Health informatics has a key role in shaping our understanding of the role of communication in health care processes, and in crafting interventions to support improved communication. Information and communication technology seem to be a promising means for restructuring many communication processes, and there currently are an increasing array of communication channels, media, and devices from which communication services can be constructed. Informatics is also interested in the socio-technical aspects of health services, and understanding the impact of organisational and cultural processes on poor communication is also crucial.

Objective

In this workshop we want to approach communication and ICT in healthcare from both a theoretical and a practical perspective. Based on theoretical insights from communication science, linguistics and Computer Science we will present a framework for the analysis of communication processes, and the assessment of the effects of ICT-application. After this theoretical introduction, four practical ICT-applications that support communication are presented. In the discussion following these presentations, two questions are central:

1. What can theory contribute to the practical applications?
2. What can theory learn from the practical applications?

Workshop Schedule

• Welcome and Introduction
  J. Zwetsloot-Schonk, Clinical Informatics, Leiden University Medical Center, The Netherlands
• Contextualization, ICT and mutual understanding: possible roles of communication complexity
  D. Te’eni, Tel-Aviv University, Israel
• Communication and ICT: A Theoretical Overview
  P.J. Toussaint, Leiden University Medical Center, The Netherlands
• The Impact of Structuring Multidisciplinary Team Conferences Mediated by ICT in the Treatment of Patients with Rheumatic Diseases
  J. Verhoeff, Clinical Informatics, Department of Physical and Occupational Therapy, Department of Rheumatology, Leiden University Medical Center (LUMC), The Netherlands
  P. J. Toussaint, Clinical Informatics, Leiden University Medical Center (LUMC), The Netherlands
  T.P.M. Vliet Vlieland, Department of Rheumatology, Leiden University Medical Center (LUMC), The Netherlands
  J.H.M. Zwetsloot-Schonk, Clinical Informatics, Leiden University Medical Center (LUMC), The Netherlands
• Enhanced Communication between Care Professional and Patients with Hemophilia by Using a Web Enabled Electronic Logbook
  Dr. G. ROOSENDAAL, Ing. E.R. DRENTH, Drs. M. POERSCHKE, Ing. E.C.M. VERKERK, Dr. H.M. VAN DEN BERG, M. METSELAAR, University Medical Center Utrecht, The Netherlands
• Involving the patient: a prospective study on use, appreciation and effectiveness of an information system in head and neck cancer care
  J.L. van den Brink, Erasmus MC, The Netherlands
• Discussion
  Moderated by J.H.M. Zwetsloot-Schonk, Clinical Informatics, Leiden University Medical Center, The Netherlands