1. DUOWAP Patients’ use of and preferences for a practice homepage – how to improve service and access?

2. DUOWAP Patients’ use of and preferences for a practice homepage – how to improve service and access?

3. DUOWAP Objectives Quality development project concerning improvement of web-based services in general practice Quality development project concerning improvement of web-based services in general practice Present use of the homepage and the internet? Present use of the homepage and the internet? The patients needs and wishes for a practice homepage? The patients needs and wishes for a practice homepage?  Identification and description of new ways to use a practice homepage.

4. DUOWAP Methods Questionnaire Questionnaire 300 consecutive patients Two focus group interviews Two focus group interviews Selected patients

5. DUOWAP Questionnaire Patient related info Patient related info Present use of the homepage and the internet Present use of the homepage and the internet Interest in future initiatives Interest in future initiatives

6. DUOWAP Patient related data 64% women 44% on daily medication 39% with chronic disease 13% keep a health record at home ~50 % had < 5 annual contacts

7. DUOWAP Present use of the homepage and internet 66% had visited the present homepage 66% had visited the present homepage What had they used it for? What had they used it for?  Email consultation42%,  Prescription renewal23,5%  Appointment scheduling31%  Seeking practice information49,5%  Seeking health information 16%

8. DUOWAP1) Janne Rasmussen et al, 2009 Where do patients seek health information? > 50 % consider the internet to be an important or very important source of health information 1 Primarily used to decide whether to contact GP 1

9. DUOWAP Seeking health information on the Internet 14 % of all the patients in the waiting room had used the Internet searching for health information prior to consultation that day. Did they find what they were looking for?

10. DUOWAP Where do the patients seek health information on the Internet

11. DUOWAP Interest in future initiatives: Forms? 88 % were interested in filling in forms via the homepage as a part of preparation for a consultation 88 % were interested in filling in forms via the homepage as a part of preparation for a consultation  Certificate for drivers license  Pregnancy check-up  Record of symptoms (e.g. head-ache, urination, pain, anxiety)

12. DUOWAP Interest in future initaitives: A Personal Health Record? 87% were interested in the possibility of a safe ”archive” for personal health information via the homepage accessible only for patient and doctor: 87% were interested in the possibility of a safe ”archive” for personal health information via the homepage accessible only for patient and doctor:  A Personal Health Record

13. DUOWAP Interests in future initaitives: Discussion group? 38 % were interested in the possibility to share thoughts and experiences with others from the local area via the homepage 38 % were interested in the possibility to share thoughts and experiences with others from the local area via the homepage (chat room, forum) (chat room, forum)

14. 1: Lober et al, 2: Ralston et al, 2007 Background knowledge Increasing use of a Personal Health Record   Barriers?   Disabilities, computer literacy or anxiety 1   Providers? High satisfaction with web-based   Medical refills, messaging, test results 2

15. DUOWAP Focus group interviews Qualitative investigation of the questionnaire results Qualitative investigation of the questionnaire results Selected patients from the practice Selected patients from the practice by direct doctor – patient contact Divided into a spontaneus patient driven part and a guided part Divided into a spontaneus patient driven part and a guided part

16. DUOWAP Wishes for a practice homepage: A personal page – a personal health record A personal page – a personal health record  Access for both patient and doctor  Patient generated data and automatically generated data from the record  Diary/calendar for symptom or data recording  Access to record and test results

17. DUOWAP Wishes for a practice homepage: Flexible and flawless basic functions: Flexible and flawless basic functions:  Email, prescription request, scheduling Quality links Quality links Possibility for signing up for newsmails divided into topics. Possibility for signing up for newsmails divided into topics. Contact with other patients via the homepage. Contact with other patients via the homepage.  Prior face-to-face contact in e.g. a motivation group or educational utility

18. DUOWAP Wishes for a practice homepage: Profiled and personal homepage Profiled and personal homepage  Who is ”my doctor”?  Presentation, subspecialized? Comments on topic in the media Comments on topic in the media Knowledge sharing (e.g. clinical guidelines for chronic diseases) Knowledge sharing (e.g. clinical guidelines for chronic diseases) Information about collaborators Information about collaborators

19. DUOWAP Conclusion The accessible basic functions are important The accessible basic functions are important A wish and potential for a homepage that is: A wish and potential for a homepage that is:  Personal  Flexible  Interactive

20. Interpretation of results User driven innovation Recognition of potential for the homepage among the patients Commited and involved patients wanting knowledge sharing

21. DUOWAP Potentials and advantages by the possible initiatives Improved knowledge sharing Improved knowledge sharing Well-prepared patient and doctor Well-prepared patient and doctor Time saving Time saving Open communication Open communication Improved self-care? Improved self-care? Empowerment Empowerment

22. DUOWAP Questions? ????????????????????????????????????