Patient Engagement and Health Information Technology

Angela Coulter and Ben Mearns

Applications of E-health Technologies

• Self-care advice and routine transactions• Self-management of long-term

conditions• Enabling people to remain at home

Implementation Challenges

• Policy support for e-health technologies• Availability of relevant technologies• Evidence of beneficial effects• Patients willing to use them• Clinicians willing to use them

Internet Activities by Age Group, UK 2013

Reading news Social networking Travel services Internet banking Health information0

10

20

30

40

50

60

70

80

90

100

Source: Office of National Statistics

16-24 25-34 35-44 45-54 55-64 65+

Access to Primary Care

• 25% of GP patients reported problems booking appointments by phone

• Only 6% booked appointments online• Only 10% ordered prescriptions online• Only 0.5% accessed their medical record

online• 12% of GP consultations carried out by

phone• 10% of those who cannot get a convenient

GP appointment go to A&E departments

Clinicians’ Concerns

Finding Reliable Information

Policy Availability Evidence Patients Clinicians

Multi-Channel Access

• Policy • Availability • Evidence • Patients • Clinicians

Access to Medical Records

• % general practices offering record access in 2014 = 32%• % general practices offering

record access in 2015 = 97%

• Policy • Availability • Evidence • Patients • Clinicians

Online Feedback

• Policy • Availability • Evidence • Patients • Clinicians

Patient Decision Aids

• Policy • Availability • Evidence • Patients • Clinicians

Technologies for Personalised Care Planning

• Policy • Availability • Evidence • Patients • Clinicians

Health Coaching for Self-Management

• Policy • Availability • Evidence • Patients • Clinicians

Remote Monitoring

• Policy • Availability • Evidence • Patients • Clinicians

Policy Gaps

• Shared decision making• Health coaching

Technology Gaps

• Involving users in design, testing and implementation• Telephone consultation systems• Patient decision aids incorporated into EMRs• IT systems to record patients’ self-management goals• Self-management support

Evidence gaps

• Measuring outcomes that matter• Effects of health information• Multi-channel access to primary care – impact on demand• Record access – patient use and impact• Feedback for quality improvement• Implementation of shared decision making• Effects of personalised care planning• Effects of health coaching• Effects of telehealth

Promoting Use by Patients

• Multi-channel access to primary care• Access to medical records

Promoting Use by Clinicians

• Signposting health information to patients• Supporting multi-channel access to primary care• Patient access to medical records• Responding to patient feedback• Patient decision aids• Personalised care planning• Health coaching• Telehealth• Support for innovation