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!

1. E-health & Quality of Care
How can E-health support self care?
Bart Brandenburg, MD
Chief Medical Officer
October 13th 2014

2. BRANDENBURG
E-HEALTH SPECIALIST

3. This is what I believe to be true

4. Health and well being are important for
all of us

5. I am convinced that people who can take responsibility for their own health make better choices

6. Health support should be always available and accessible for everyone

7. My goal is to get healthcare into the very best hands…
…yours!

8. E-HEALTH SUPPORTS
SELF CARE

9. Over the years I tried connecting the dots and extracting the dominant factors
9

10. 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

11. This is how we try to make that happen

13. 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.

14. To solve this problem…

15. source: https://www.youtube.com/watch?v=SB_0vRnkeOk

16. To help these people…

17. …and these…

18. …and – possibly – these!

19. SCIENCE HELPS
PRACTICE

20. 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)

21. 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

22. MHP increases the accessibility of health care: > 30% of use is outside office hours
22
source: logdata MHP september 2012 to august 2013

23. 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

24. 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

25. Here are some of the things I learned

26. Filmpje Let patients help
source: http://www.ted.com/talks/dave_debronkart_meet_e_patient_dave

27. 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

28. source: www.ted.com/talks/shawn_achor_the_happy_secret_to_better_work

29. 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)

30. The possibilities of technology are almost limitless - Use them wisely!
30
source: http://www.bmj.com/content/344/bmj.e3502

31. Start small, then expand, take all stakeholders into account!
31
source: www.zelfzorgondersteund.nl

32. questions? good ideas? bart.brandenburg@medicinfo.nl +31 6 55 84 18 85 www.linkedin.com/in/bartbrandenburg