e-health & quality of care - business research and practice - medicinfo & twente university
DESCRIPTION
Lecture held at Twente University, about the challenges, possibilities, lessons learned and research questions involved with developing e-health at Medicinfo. Business, research and practice put into action!TRANSCRIPT
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
