1. Bruce Madge Professor Alan Gillies
An Introduction to Consumer Health Informatics and New Methods of Delivering Information to Patients
Bruce Madge
Professor Alan Gillies

2. bmadge@bma.org.uk professor@alangillies.com
Outline
The UK context: drivers and policies
National Case Study: NHS Direct
Local case study
Discussion

3. Information for Health
5.12 People need information about health and healthcare in many different circumstances.
5.13 The development of new media such as Internet and digital television offer enormous opportunities to widen access by the public to information about health and health services. Through these media an unprecedented range of information, services and facilities will be available.
NHS Information Authority, NHS Executive, (1998), Information for Health: An Information Strategy for the Modern NHS

4. The national UK context: the NHS Plan
“The NHS will provide open access to information about services, treatment and performance” (Core principle 10)
“ Each week will see millions of hits on the NHS Direct Internet site” (1.9).
“Patients will be helped to navigate the maze of health information through the development of NHS Direct Online, digital TV and NHS Direct information points in public places” (10.2) The NHS Plan July 2000

5. bmadge@bma.org.uk professor@alangillies.com
Patient Choice
Building on the best: Choice, responsiveness and equity in the NHS - Dec 2004
Consultation said:
All of us – not just some among the affluent middle classes – want the opportunity to share in decisions about our health and health care;
We want the right information, at the right time, as well suited to our personal needs as possible;
Our health needs are personal, and we would like services to be shaped around our needs.

6. bmadge@bma.org.uk professor@alangillies.com
Patient Choice
Building on the best: Choice, responsiveness and equity in the NHS - Dec 2004
Divided into:
Areas for change
Information for All
Quality signposting
personalised information
supporting change
A clear way forward
Information for the promotion of health

7. National case study: NHS Direct Online
Introduction
NHS’s main health advice and information website
Launched by the Prime Minister in December 1999
Receives 0.6 million visitors each month
Winner of one of the European Commission’s first ever eHealth awards in 2003
NHS Direct Online is the NHS’s main health advice and information website for patients and the public. The NHS Plan sees NHS Direct Online helping patients ‘navigate the maze of health information’ on the internet, by providing quality assured, evidence based content from a trusted source.
Usage has increased significantly since it was launched, from around 1½ million visits a year in 2000/1 to 6½ million visits a year in 2003/4
The website currently receives around 0.6 million visits every month.
In 2003, the website was awarded one of the first ever eEurope awards for eHealth by the European Commission for ‘Empowering Citizens in Management of Health and Wellbeing’

8. bmadge@bma.org.uk professor@alangillies.com
NHS Direct Online
What does it offer?
Interactive self-help guide
Health encyclopaedia
‘Best Treatments’ information
Frequently asked questions
Access to nhs.uk’s database of local health services e.g. hospitals, doctors’ surgeries, pharmacists
Hot topics on latest health issues
Health information enquiry service
‘HealthSpace’ personal health organiser
NHS Direct Online provides:
An interactive self-help guide to treating common health problems at home. The guide uses an algorithmic approach, one of the end-points being to call the NHS Direct telephone service
An encyclopaedia covering hundreds of illnesses and conditions with links to other accredited third-party websites.
‘Best Treatments’ information on the most common elective surgery procedures, including an explanation of the pros and cons, details of other treatments available, and advice on pre-and post-operative care. It also offers information on the choice of possible treatments for 60 conditions. ranking them according to effectiveness and highlighting the risks and benefits of each. Best Treatments’ is based on BMJ’s 'Clinical Evidence’, a website used by health professionals, but it has been written from a patient patient perspective, using clear, jargon-free language.
‘Frequently asked questions’ based on data from both the telephone service and the online enquiry service about what the public is asking about.
Access to the directory of local health services such as GP’s, dentists, pharmacists etc, provided by nhs.uk
Hot topics on current health issues
An online enquiry service for requesting health information – more on this in a moment
HealthSpace – a personal health organiser in which users can store key health information about themselves, such as blood group, weight, allergies and medication.

9. bmadge@bma.org.uk professor@alangillies.com
NHS Direct Online
Health information enquiry service
Introduced in November 2001 in response to user feedback
Responds to health information enquiries only
Handles around 3,900 enquiries per month
Replies sent within 5 working days, usually 1 or 2 days
Over half of users are aged years
64% of enquiries from females
Most enquired about topics include gynaecology, dermatology and medicines
NHS Direct Online provides:
An interactive self-help guide to treating common health problems at home. The guide uses an algorithmic approach, one of the end-points being to call the NHS Direct telephone service
An encyclopaedia covering hundreds of illnesses and conditions with links to other accredited third-party websites.
‘Best Treatments’ information on the most common elective surgery procedures, including an explanation of the pros and cons, details of other treatments available, and advice on pre-and post-operative care. It also offers information on the choice of possible treatments for 60 conditions. ranking them according to effectiveness and highlighting the risks and benefits of each. Best Treatments’ is based on BMJ’s 'Clinical Evidence’, a website used by health professionals, but it has been written from a patient patient perspective, using clear, jargon-free language.
‘Frequently asked questions’ based on data from both the telephone service and the online enquiry service about what the public is asking about.
Access to the directory of local health services such as GP’s, dentists, pharmacists etc, provided by nhs.uk
Hot topics on current health issues
An online enquiry service for requesting health information – more on this in a moment
HealthSpace – a personal health organiser in which users can store key health information about themselves, such as blood group, weight, allergies and medication.

10. bmadge@bma.org.uk professor@alangillies.com
NHS Direct Digital TV
What is it?
An interactive health information service – the largest on digital TV
Able to deliver text based information, supported by images and some video content
Allows the user to select information on particular health topics of interest to them
Not a ‘linear’ TV channel, which can only broadcast programmes on one subject at a time

11. bmadge@bma.org.uk professor@alangillies.com
Here’s an example of how you would navigate through the menus to look at a topic in the health encyclopaedia.
As you can see, a page of content on the digital TV service looks quite different to a page on our website. One of the main differences is that all the text on digital TV has to be a minimum font size of 18, because the user sits at a distance from the TV. Also, the user has a remote control, rather than a keyboard and a mouse to navigate with. Therefore, the layout needs to be much simpler, relying on the cursor keys and coloured buttons on the remote control, to move around the service.
Over 100 users, of different ages, gender, ethnicity and socio-economic groups have been involved in the development and testing of the service. The reaction so far has been very positive. In addition, we have worked with six charities, including the Royal National Institute for the Blind and the Royal National Institute for the Deaf, to ensure that the service is accessible as possible to as many people as possible.

12. bmadge@bma.org.uk professor@alangillies.com
NHS Direct Digital TV
What will it offer?
Introduction to NHS Direct Digital TV
Health encyclopaedia
Advice on looking after yourself
NHS services directory – GP’s, dentists, pharmacists etc.
Information about using the NHS e.g. how to register with a GP etc
Hot topics on current health issues

13. NHS Direct Self-help guide
What is it?
Easy to use guide to treating common health problems at home
Launched in 1999
2 million copies in circulation
New partnership with Thomson Local Directories
From April 2004, the guide is being included in the Thomson Local directory
By April 2005, the guide will be in 18 million households

14. bmadge@bma.org.uk professor@alangillies.com
Local case study
On-line resource
Designed to make skills available to patients to find information and knowledge
Designed to make skills available to patients to judge the information and knowledge they find
Case material based upon earlier work for North Yorkshire Health Informatics Service and ADITUS (NHS North West Library Service)

15. bmadge@bma.org.uk professor@alangillies.com