e-health & quality of care - business research and practice - medicinfo & twente university

E-health &

Quality of

Care

How can

E-health

support

self care?

Bart Brandenburg, MD

Chief Medical Officer

October 13th 2014

BRANDENBURG E-HEALTH SPECIALIST

This is what I believe to be true

Health and well being

are important for

all of us

I am convinced that people who can

take responsibility for their own

health make better choices

Health support should be always available

and accessible for everyone

My goal is to get healthcare into the very

best hands…

…yours!

E-HEALTH SUPPORTS SELF CARE

Over the years I tried connecting the dots

and extracting the dominant factors

9

Dominant factors of e-health

encouragement empowerment equity

entertaining easy to use engaging

Equally important!

Source: Eysenbach G, J Med Internet Res 2001;3(2):e20

This is how we try to make that happen

We try to use the eHealth Road Map

developed at CeHRes

13

Source: Van Gemert-Pijnen et al. A holistic framework to improve

the uptake and impact of eHealth technologies.

J Med Internet Res. 2011 Dec 5;13(4):e111.

To solve this problem…

source: https://www.youtube.com/watch?v=SB_0vRnkeOk

To help these people…

…and these…

…and – possibly – these!

SCIENCE

HELPS PRACTICE

At Medicinfo PhD and master students do

e-health research in health care practice

“E-health enables people to better self

manage their health and health care”

• Does IT work?

• Does IT help?

• Does IT pay?

20 Source: Research plan My HealthPlatform (2013)

My Health Platform is a comprehensive

blended ePortal for self management

21 Sources: www.mijngezondheidsplatform.info & www.gezondheidpagina.com/

• Personal Health Record

• Individualized Care Plan

• Monitoring of Results

• Secure Communication

• Online coaching

• Personalized health info

• Operational since 2012

• Mainly in Primary Care

MHP increases the accessibility of health

care: > 30% of use is outside office hours

22

source: logdata MHP september 2012 to august 2013

Interviews & user tests (patients & HCW)

“Does MHP support self monitoring?”

23 Source: preliminary data MHP research 2013

System Content Persuasive triggers

System logic Order of steps not logical

Time consuming Adding of data

Lack of integration my health, my lifestyle,

my measurements, my.

Goal setting SMART

Better able to

prepare F2F visits

Lack of support

to understand why, when

and where self monitoring

information should be

added

Reminders &

smileys Positive feedback

Graphs Show your progress

Interviews & user tests (patients & HCW)

“Are online life style coaches helpful?”

24 Source: preliminary data MHP research 2013

System Content Persuasive triggers

Lack of F2F

support After completion of intake

Time consuming Intake too long, drop outs

Lack of integration Between coaches and

Personal Health Record

Intake relevant

Weekly e-mails

Exercises

Well thought out

Guidance Logical steps after intake

Graphs To visualize progress

Feedback & tips

Here are some of the things I learned

Filmpje Let patients help

source: http://www.ted.com/talks/dave_debronkart_meet_e_patient_dave

We should look at health in a holistic

and positive way

27

“The ability to adapt

and self manage in the

face of social, physical,

and emotional

challenges” Source: Huber et al, BMJ 2011;

343:d4163

“A state of complete

physical, mental and

social well-being and

not merely the absence

of disease or infirmity” Source: World Health Organization,

1948

source: www.ted.com/talks/shawn_achor_the_happy_secret_to_better_work

Try to understand human behaviour,

motivation, ability, persuasion

29

sources: www.dsd.me ; http://www.behaviourchangewheel.com/

http://captology.stanford.edu/about/what-is-captology.html

https://www.authentichappiness.sas.upenn.edu/

“If you do something different, you get something different

(Fletcher)

Behaviour = Motivation + Ability + Trigger (Fogg)

Behaviour = Capability + Opportunity + Motivation (Michie)

Positive Psychology = PERMA = Positive attitude + Engagement +

Relations + Meaning + Accomplishment (Seligman)

The possibilities of technology are

almost limitless - Use them wisely!

30 source: http://www.bmj.com/content/344/bmj.e3502

Start small, then expand, take all

stakeholders into account!

31

source: www.zelfzorgondersteund.nl

questions? good ideas?

bart.brandenburg@medicinfo.nl

+31 6 55 84 18 85 www.linkedin.com/in/bartbrandenburg