Canada's e-health journey and HIMSS Analytics' Canada Information and Communications Technology Study (2009 - Healthc Q.) NoFull Text
In spring 2007, HIMSS Analytics began developing its first Canada Information and Communications Technology (ICT) Study. Less than one year later, 38 RHAs, DHAs and HAs are already on board, with some 20 more scheduled to participate by year's end. Why are so many Canadian provincial healthcare delivery organizations now participating in HIMSS Analytics' Canada ICT Study? The answer is tied to the character of the HIMSS study, the value offered to all participants and specific Canadian healthcare issues that are addressed by the study.

US: Interoperable electronic prescribing in the United States: a progress report. (April 2009 - Health Affaires)
Although the vast majority of U.S. physicians still handwrite prescriptions, adoption of electronic prescribing is slowly growing. Major barriers to adoption remain, including the inability to electronically submit prescriptions for controlled substances and confusion about standards for data exchange. Federal and state governments and private insurers are using payment and policy incentives to boost e-prescribing because they still believe in its promise for improving the quality and efficiency of health care. However, additional efforts and further investments are needed to reap the benefits of e-prescribing on a national scale.

Health information technology: dispatches from the revolution. (April 2009 - Health Affairs)
Countries around the world are increasingly employing health information technology (IT). These tools hold the promise of powerful health system breakthroughs from Johannesburg to Jakarta. While implementers multiply, a global e-health consensus framework is beginning to take shape among donors, governments, industries, researchers, and policymakers. As plans are formulated in the United States for substantial new federal investments in health IT, this paper details common threads in national and global health IT discourse. Among them are the need for strong stakeholder engagement, workable policy solutions, funding and donor coordination, and the imperative for adequately addressing standards and interoperability.

Exploring antecedents of consumer satisfaction and repeated search behavior on e-health information (2009 - J Health Commun.)::
E-health information has become an important resource for people seeking health information. Even though many studies have been conducted to examine the quality of e-health information, only a few studies have explored the effects of the information seekers' motivations on the perceived quality of e-health information

User information seeking behaviour: Perceptions and reality. An evaluation of the WHO Labresources Internet portal (2009 - Inform Health Soc Care.)
This article discusses the evaluation of a WHO Internet portal: the Labresources website. The evaluation investigates user satisfaction with the resource, usability, demographic information about users and how well they could complete specific tasks using the website and compared this with the actual online behaviour revealing a number of discrepancies

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NHS Direct (United Kingdom) has recently launched an online Contraception Checker to help take the agony out of what to do next. It is designed to deal with enquiries about emergency contraception, missed contraceptive pills, dislodged contraceptive devices, interactions with other medicines or failed contraceptives.

So far 34,700 have used the online checker and 409 have had web chats with others The new tool takes the protocols - used by NHS Direct call centre nurses to assess patients’ concerns over the telephone - and adapted them for the website.

A series of questions are asked and the advice given naturally depends on the information given.¹ At all times the user remains anonymous which enables NHS Direct to reach those who may be less comfortable using the telephone or talking face to face.

Depending on the data provided by the user, the system may suggest a number of options including: a conversation with a nurse advisor; a visit to the family planning service or GP to get a prescription for a contraceptive pill or a visit to the nearest pharmacy to buy over the counter emergency contraception.

An anonymous web chat service is also offered if further assessment is advised. Web chat advisors are available 8am to 8pm Monday to Friday and 9am to 5pm on Saturday and Sunday.

Anne Joshua, associate director of pharmacy at NHS Direct says: “Sexual health is one of the major public health challenges and unplanned pregnancy is the most problematic². The Contraception Checker is ideal for anyone in urgent need of information about what to do if they have had unprotected sex but who also wishes to remain anonymous. The user is advised about the next steps to take according to the tried and tested protocols NHS Direct has developed to support telephone calls. In some cases users may be advised to seek professional advice about taking the emergency hormonal contraceptive pill.

“The emergency hormonal contraceptive pill is most effective within 24 hours of sex and is recommended for use up to 72 hours after sex – the self assessment tool caters for this urgency. Emergency hormonal contraception however is not a replacement for regular contraception and it is important that women of child-bearing age seek professional advice to ensure they have the best form of contraception for them.”

To help users experience a seamless ‘journey’ NHS Direct is planning to introduce a call back from NHS Direct with the facility to arrange a specific call back from a nurse advisor at a time to suit. This is already in operation for the cold and flu Symptom Checker launched in December 08.

Useful facts about NHS Direct

• Medicine information enquiries are one of the top three reasons people phone the service and emergency contraception makes up the largest percentage of those calls.

• So far there have been 34,700 unique visits to the new online Contraception Checker and of those 409 engaged in anonymous web chats – 3% of those were from men.

• Emergency hormonal contraception is not intended to be used as a regular form of contraception. One dose of the Emergency Hormonal Contraceptive pill (Levonorgestrel 1500 micrograms, Levonelle®) doesn’t protect you against pregnancy during the rest of a menstrual cycle if you continue to have uprotected sex.

• Taking a dose of the emergency contraceptive pill does not protect you against sexually transmitted infections. A condom does.

• NHS Direct handles over 22,000 calls a day. That’s over 8 million calls a year.

• The NHS Direct Online website (www.nhsdirect.nhs.uk) receives around 21 million visits a year.

Notes:

• ¹The advice given is only suitable if you are aged 13 or over. If you are under the age of 13 orif this enquiry is for someone under the age of 13, call NHS Direct on 0845 4647.

• ² Bailey JV et al. Interactive computer-based interventions for sexual health promotion (Protocol). 1-12.2007

eHealth 2.0 is focused on “promoting conversation” and user-generated content via websites and intranets to promote community networks and collaboration:

• Promoting networks of relationships

• Transforming users into publishers

• Discussing, sharing & collaborating

• From one to many -> many to many

Web 2.0 collaboration is best categorized into seven over-arching categories of tools and technology:

• Conversation platforms

  • Blogs, podcasts, ePinions.com

• Collaboration platforms

  • Wikipedia, MyStarbucksIdea, CarePages

• Social networks

  • Facebook, LinkedIn, MySpace

• Social bookmarking

  • Delic.io.us, Digg, Reddit

• Micro-blogging or Presence

  • Twitter, YouAre, Yammer

• Content sharing sites

  • YouTube, Flickr,

• Virtual networking platforms

  • Second Life, There.com

(credit to Shel Holtz, www.Holtz.com, for the original version of the above list)

The new social media tools represented by eHealth 2.0 reveals an evolution from mainstream communication technology to new generation collaboration:

eHealth 1.0             > eHealth 2.0

Hospital news         > Care Pages

Executives speech   > Executive blog

Taxonomy              > Folksonomy

Quick poll               > Discussion forums

Generic report         > Regular podcasts

Wellness information > Patient sharing sites

Content management > Wikis

Directories (A-Z)      > Tagging

Sticky content         > RSS

Some leading eHealth 2.0 websites and tools include:

• MedHelp discussion forums

• Wiki Public Health

• WebMD Health Blogs

• Running A Hospital (blog)

• Codeblog: Tales of a Nurse (blog)

• National Institute of Health podcasts

• HealthyCanada.com – Health podcasts

• CarePages

• OrganizedWisdom

• PatientsLikeMe

• RateMDs.com

For more information on how to transform you website or intranet into the next generation eHealth 2.0 website or intranet, please contact Prescient Digital Media at (416.926.8800).

Microsoft recently released the results of a study it conducted on cyberchondria.  This of course is the condition in which people assume the worse conclusions about what ails them while researching online. 

Cyberchondria is not a new term and much has been speculated about the condition but according to Microsoft, this is the first study to systematically study cyberchondria.  The study analyzed health-related Web searched on popular search engines and a survey of 515 Microsoft employees. 

It seems that many of us treat search engines as an expert that can exercise medical judgement.  Searches of innocuous and common symptoms often lead to further searches of serious conditions.  Also, web search results for common symptoms like chest pain were just as likely to lead people to pages about heart attacks as indigestion, although heart attacks were much less likely.

Some interesting results also emerged from the survey:

 “Three in four survey respondents have at least once interpreted the ranking of Web search results as indicating the likelihood of the illnesses, with more likely diseases appearing higher up on the results page."

 “One in five survey respondents were convinced to seek medical attention based on the review of online medical content.”

o   “only one in four of the respondents that sought medical attention had a medical condition that warranted doing so.”

All in all an interesting study which details some of the user's predispositions.  The authors hope to use the results to improve the search experience for users and try to lower the chance that search results will lead to unfounded escalations.

Download the full study, Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search.

Web 2.0 is the buzzword on everyone’s minds, but how is it changing the game for health care?

The Internet is rapidly evolving from an environment where static pages exist for people to search and read information (a.k.a. Web 1.0) to one where users from all walks of life can create and share content online. 

Patients now have the potential to go beyond just researching health facts on the web to actively sharing their experiences with each other – not only for emotional support but also to benefit from collective intelligence and gain clinical knowledge from each other.  They increasingly have the ability to take greater control and play a larger role in the management of their own health.

Not surprisingly, a recent survey showed that patients are starting to consult Internet-based resources, including social media, more than they consult their physicians.

59% resort to Internet-based resources (including Web sites, search engines, online advertisements, blogs, forums, and social networks) for health- and wellness-related information (versus 55%  who ask their physician)

Source: iCrossing

Physicians themselves are starting to utilize Web 2.0 as well.  Sermo.com is an example of a social networking site exclusively for doctors which enables members to come together to share their knowledge in order to “accelerating the emergence of trends and new insights on medications, devices and treatments.”   

Here is a small sample of the many health-related Web 2.0 resources out there:

Wikis	AskDrWiki, FluWiki, Clinical Informatics Wiki, WiserWiki
Blogs	Kevin M.D., DiabetesMine, Running a Hospital, Clinical Cases and Images
Social Networks	Sermo, Patientslikeme, MyCancerPlace, DailyStrength
Video Sharing	ICYou
Online Forums	Google Health Groups, Revolution Health Groups, HealthyCanada
Podcasts	Johns Hopkins Medicine Podcasts, NIH Podcasts, CDC Travelers Health Podcasts, dLife

It is clear that Web 2.0’s popularity will start to change the way in which patients, physicians and researchers collaborate and learn about illnesses and therapies, and manage patient health. 

Web 2.0 holds great potential for both health care professionals and patients alike, but it remains to be seen how issues surrounding privacy and security, which are especially heightened in the health care space, will be overcome.

Read my full article on Health 2.0.

A new study reveals that Danes beat out other leading nations in using information technology (IT) in delivering patient care.

Among the findings, Danish GPs regularly exchange clinical information over asecure network. In fact,  over 90% of clinical communications are exchange online and only 41 GPs are not connected to the network.