Prepared by: Kristen Erika H. Pino, RN

Focus of Health Information

Gunther Eysenbach “…the branch of medical informatics that analyses consumers' needs for information; studies and implements methods of making information accessible to consumers; and models and integrates consumers' preferences into medical information systems.”

SUBFIELD OF MEDICAL INFORMATICS “…stands at the crossroads of other disciplines, such as nursing informatics, health education, and health promotion, and is perhaps the most challenging and rapidly expanding field in medical informatics.”

All persons, sick or well, who seek information and take action in accord with personal preferences, life situations, and individual health goals (Brennan & Safran, 2005).

Consumers are taking control of their health and are not satisfied being dependent on a health care provider to supply them with information.

Consumer movement of 1970s Consumer movement of 1970s – Increased demand for information – Greater participation in “medical” decision making Prominence of “self-help” phenomenon of 1980s – Huge increase in health information for lay audience Widespread use of the Internet – Increased dramatically throughout 1990s – In 2005, 78.6% of Americans “online”

113 million American have used web for health information; 8 out of 10 (2006)

Over half (53%) report that online health information had an impact on behavior or decisions

Digital Divide –i–is the term used to describe the gap between those who have and those who do not have access to online information.

Grey Gap –o–only 32 % of persons over the age of 65 have ever gone online or lived in a connected household.

Degree of Consumer Autonomy Provide information Access to personal medical information Communicate with providers Obtain education/ information/treatment Give/receive support

Patient Portal Personal Health Record

…Patient interface to clinical information systems.

Tool for collecting, tracking, and sharing important, up-to-date information about an individual’s health or the health of someone in their care Facilitates informed health care decisions Allows individual to be active partner in care

Personal Health Record

Patient role is evolving Informed patients more satisfied and better able to cope with illness Shared vs informed decision making “Different (not always better) relationships” Physician adoption of e-communication low

Quality of Web-based information Privacy and security of health information Unequal access to information technology

Most consumers (86%) and health care professionals concerned about reliability of online information Eysenbach, G, Powell, J., Kuss, O., & Sa, ER. (2002) Empoirical studies assessing the qulaity of health information for consumers on the world wide web. JAMA, 287, Fallis, D., & Fricke, M. (2002). Indicators of accuracy of consumer health information on the Internet. JAMIA, 9,

C urrent and frequently updated R eferences cited E xplicit purpose and intentions of the site D isclosure of developers and sponsors I nterests disclosed and not influencing objectivity (e.g., financial interests) B alanced content, lists advantages and disadvantages L abeled with metadata E vidence-level indicated ( Eysenbach, et.al., 2002)

HIPAA Demand for Access Masys, D., Baker, D., Butros, A., & Cowles, K.E. (2002). Giving patients access to their medical records on the Internet: the PCASSO experience. Journal of the American Medical Informatics Association, 9,

– Addresses the security and privacy of health data. – Improves efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the U.S. health care system.

Uneven accessibility across age, ethnic, and socioeconomic groups Physical and Cognitive Disabilities Digital Divide is narrowing

“Degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions.” Bohlman LN, Panzer AM, & Kindig DA. (2004). Health Literacy: A Prescription to End Confusion. Washington DC: The National Academies Press.

Patient education information stored electronically

Health promotion education classes

Promote education via pamphlet distribution, broadcasting and kiosks

Promoting health literacy in school-aged children Supporting the development of nutrition education programs as interactive computer games, video games, and cartoons

Implantable Chips

Prepared by: Kristen Erika H. Pino, RN