Health in the Information Age Rita Espanha  and  Gustavo Cardoso
< Answer>
Why Health and Information ?
< answer>
What does the Internet say to us?
A  research on YouTube
9s of Dr. House
Sounds familiar ?
the notion that Internet doesn’t really help us with nothing important ?
A few minutes of Google
the people in this audience ?
The same testimonials …
but not in English ?
The answer may also lie in the media, but it’s not enough.
Why?
Because we have to look at...
< People >
Doctors
Nurses
Pharmacists
Patients
</ people >
< Institutions >
Hospitals
Public and Private
Medical Centers
Primary Care Institutions
Pharmacies
</ Institutions>
< Content>
Internet Pages
Blogs
Search Engines
</ Content >
It’s of all these things that this study is about
< Health in the Information Age>
goal
To analyze in what way Information and Communication Technologies are appropriated in the health field :
by users and professionals, in the context of the network society, in Portugal
to question
(1)
How can Internet be used in communication and to provide health information ?
(2)
What tell us the experiences of consumption and information technologies use by health professionals?
(3)
Which is the value and impact of Internet in the public health campaigns?
(4)
Which other communication technologies are valued and used?
 
Health   Professionals
1000  Doctors by postal survey
1000  Nurses by postal survey
160  Pharmacists by online survey
Internet use   77% of Doctors 63.7% of Nurses
Internet use in professional practice 92,4% of Doctors 80,9% of Nurses
< doctor >
diagnose evaluation with Internet resource   52,3%
prescription of therapeutic measures 46,4%
prognosis evaluation 32,7%
therapeutic measures execution 19,5%
36,1% ( yes frequently + yes sometimes ) Recommend Internet websites to patients
the online consulting of information may lead to questioning the doctors knowledge ? Very  much:24,9% Quite:49,5%
I agree with a single patient record accessible by me through the Internet   53% ( totally agree )
interaction remuneration with clinical purposes Email (45,5%) ;Telephone (39,5%) Cell phone (38,2%); SMS (31,8%) Chat (23,...
</ doctor >
< nurse >
usefulness for professional practice Very   useful : 55,3% Useful : 40,4%
Internet information, improves autonomy and quality of life > 80%  of opinions
I  agree with a single patient record accessible by me through the Internet   54,3% ( totally agree )
</ nurse >
< pharmacist >
would you use, in your professional practice, if it was possible… Reception of prescriptions by email: 81,4%
would you use, in your professional practice, if it was possible… Reception of users direct requests: 71%
would you use, in your professional practice, if it was possible… Sending SMS to remind to take the medicines: 87,6%
importance of Internet contents in the health field Portuguese : 61,7% English : 90,5% ( relevant and very relevant)
</ pharmacist>
 
Patients and Health
2000 users by presencial survey
< users >
< perceptions and uses of the National Health System >
Where to go with a non urgent health problem ? Doctor of the National Health System: 71,5% Pharmacist: 18,2% Doctor (priva...
… and with an urgent health problem? Public hospital Emergency service: 48,7 Health emergency center : 46,4% Doctor: 2,4% ...
</ perceptions and uses of the National Health System >
procura de informação na Internet Source: INE/UMIC, Survey to the Use of Information and Communication Technologies by Fam...
Would you like to use online medical services 9,5% ( doctors appointments, tests appointments, occasional doubts, medical ...
telephone support (help lines) 95,8%  never used (who did use…pediatric questions 73,2%)
stating that the doctor never dissuaded them from looking for information online 96%
when dissuaded … Risk of self-diagnose: 40,9% Lack of knowledge: 30,8%
8,4% Percentage of those that got their doctors cell phone number
60,8%  used 54,1% got an answer 6,2% were contacted after leaving a message
</ users >
Professionals Users
(1) mediation arrive to the health field
(2) is part of professionals and users routines
(3) but is not part of…
(3) public health policies
(3) health field science teaching integration
(3) protocols of professional practice in the relation user/health professional
What has changed supremacy of network morphology over action
what is still to be changed? structural practices of the actors
 
 
 
Health contents on-line: Google, www and Blogs
80 general websites about health in Portuguese
Information fundamentally institutional
formal contents are more frequent (institutional, descriptive, functional)
than contents about “health” and “illness”
We find sites with health related information and content
<ul><li>but with no communication processes or services with a higher interaction level </li></ul>
<ul><li>Contrary to what happens in Catalonia </li></ul>
where the interactivity levels are quite higher compared with the Portuguese experience
but where the presence of institutional websites is lower
55  Health blogs in Portuguese
They are built from the selection and comment to a given event or news
proceeding from other sources and standing out only a part of this information
General information blogs and diaries prevail
“ Online practices” through blogs are practically non existent
In spite of...
The majority of blogs being kept by health professionals  (78,2%)
And amongst these, the majority being kept by doctors  (45,5%)
The interactivity is very limited
In “Hans Oh’s Health Blog” http://blog.hansoh.com/2005/04/26
 
Health Care Institutions and Information Technologies: Organizational Changes and Autonomy
6  case studies
Different information systems and different uses
70 Interviews
Institutions in several regions of the country
6  different stories
The medicine   circuit and patients computer management
Intranet and institutional websites
External electronic prescriptions and Local Health Units
Telematic Health Network (THN)
SONHO, SINUS, SAM and SAPE  and RisPac (names of several informational systems at use in the National Health System, for a...
A reading proposal…
OIT Model (Organization, Impacts and Technology )
There are many variables guiding in a positive and negative way
the Information Systems implementation processes
which determinate simultaneously
changes in the organization forms of the institutions
and in the autonomy processes of users and professionals
Some common features
(1)
Growing use of ICT’s applied to health
(2)
Tendency to an implementation  and need of applications and information systems
which will optimize care processes given to the community
Whether clinical care or administrative quickening
(3)
Non existence of a generalized network concept in the National Health System
Programs and projects disruption
(4)
Doctors are the most resistant group
To the use of information applications/systems
Some General Conclusions
The analysis of health information systems
Sends us to 3 analysis units
(1)
Organizations and their management models
(2)
Health care professionals
(3)
Information and software physical and technological networks
leading to The need to articulate the 3 analysis units in a way that we have
Network Organizations, i.e.
More flexible and adaptable to change
And professionals who will increasingly value ICT’s
Leaving the expectation that these values will be more expressive in the future
In a global context where:
Internet is rising as an alternative
to more traditional methods of obtaining health information
Constant flows of information
encourage citizens to be more responsible for their own and their families health
In a context of generalized health information
the use of communication and information technologies is fundamental
To the promotion of individual autonomy in the health field
The incentive of Internet use in this context
Depends actively
(1)
On the type of available contents
(2)
the quality and credibility of contents
(3)
The ease in using and understanding available contents and resources
Which gives a central role to the health care professional
And health care institutions
In developing the concept of “informed citizen”
Even because :
</ answer >
< more questioning >
In November 2005, at the Royal Society of Medicine, Prof. Andrew Webster was discussing…
The promise
tertiary 1m hospital admissions secondary  - over 11m hospital  admissions primary – 360m GP consultations self care –  90...
Information age health care INDIVIDUAL SELF-CARE CARE BY FAMILY AND FRIENDS CARE BY SELF-HELP COMMUNITY HEALTH PROFESSIONA...
Doubts
(1)
Limits of e-health: what is possible to be ‘offered’ in e-health?
(2)
What implies e-health – in particular for health care professionals?
(3)
Implications of the future e-health services offer: new segmentation and new exclusions?
</ doubts >
?
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Health in the Information Age - Portugal by Rita Espanha and Gustavo Cardoso

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Transcript of "Health in the Information Age - Portugal by Rita Espanha and Gustavo Cardoso "

  1. 1. Health in the Information Age Rita Espanha and Gustavo Cardoso
  2. 2. < Answer>
  3. 3. Why Health and Information ?
  4. 4. < answer>
  5. 5. What does the Internet say to us?
  6. 6. A research on YouTube
  7. 7. 9s of Dr. House
  8. 8. Sounds familiar ?
  9. 9. the notion that Internet doesn’t really help us with nothing important ?
  10. 10. A few minutes of Google
  11. 11. the people in this audience ?
  12. 12. The same testimonials …
  13. 13. but not in English ?
  14. 14. The answer may also lie in the media, but it’s not enough.
  15. 15. Why?
  16. 16. Because we have to look at...
  17. 17. < People >
  18. 18. Doctors
  19. 19. Nurses
  20. 20. Pharmacists
  21. 21. Patients
  22. 22. </ people >
  23. 23. < Institutions >
  24. 24. Hospitals
  25. 25. Public and Private
  26. 26. Medical Centers
  27. 27. Primary Care Institutions
  28. 28. Pharmacies
  29. 29. </ Institutions>
  30. 30. < Content>
  31. 31. Internet Pages
  32. 32. Blogs
  33. 33. Search Engines
  34. 34. </ Content >
  35. 35. It’s of all these things that this study is about
  36. 36. < Health in the Information Age>
  37. 37. goal
  38. 38. To analyze in what way Information and Communication Technologies are appropriated in the health field :
  39. 39. by users and professionals, in the context of the network society, in Portugal
  40. 40. to question
  41. 41. (1)
  42. 42. How can Internet be used in communication and to provide health information ?
  43. 43. (2)
  44. 44. What tell us the experiences of consumption and information technologies use by health professionals?
  45. 45. (3)
  46. 46. Which is the value and impact of Internet in the public health campaigns?
  47. 47. (4)
  48. 48. Which other communication technologies are valued and used?
  49. 50. Health Professionals
  50. 51. 1000 Doctors by postal survey
  51. 52. 1000 Nurses by postal survey
  52. 53. 160 Pharmacists by online survey
  53. 54. Internet use 77% of Doctors 63.7% of Nurses
  54. 55. Internet use in professional practice 92,4% of Doctors 80,9% of Nurses
  55. 56. < doctor >
  56. 57. diagnose evaluation with Internet resource 52,3%
  57. 58. prescription of therapeutic measures 46,4%
  58. 59. prognosis evaluation 32,7%
  59. 60. therapeutic measures execution 19,5%
  60. 61. 36,1% ( yes frequently + yes sometimes ) Recommend Internet websites to patients
  61. 62. the online consulting of information may lead to questioning the doctors knowledge ? Very much:24,9% Quite:49,5%
  62. 63. I agree with a single patient record accessible by me through the Internet 53% ( totally agree )
  63. 64. interaction remuneration with clinical purposes Email (45,5%) ;Telephone (39,5%) Cell phone (38,2%); SMS (31,8%) Chat (23,3%)
  64. 65. </ doctor >
  65. 66. < nurse >
  66. 67. usefulness for professional practice Very useful : 55,3% Useful : 40,4%
  67. 68. Internet information, improves autonomy and quality of life > 80% of opinions
  68. 69. I agree with a single patient record accessible by me through the Internet 54,3% ( totally agree )
  69. 70. </ nurse >
  70. 71. < pharmacist >
  71. 72. would you use, in your professional practice, if it was possible… Reception of prescriptions by email: 81,4%
  72. 73. would you use, in your professional practice, if it was possible… Reception of users direct requests: 71%
  73. 74. would you use, in your professional practice, if it was possible… Sending SMS to remind to take the medicines: 87,6%
  74. 75. importance of Internet contents in the health field Portuguese : 61,7% English : 90,5% ( relevant and very relevant)
  75. 76. </ pharmacist>
  76. 78. Patients and Health
  77. 79. 2000 users by presencial survey
  78. 80. < users >
  79. 81. < perceptions and uses of the National Health System >
  80. 82. Where to go with a non urgent health problem ? Doctor of the National Health System: 71,5% Pharmacist: 18,2% Doctor (private system): 3,5%
  81. 83. … and with an urgent health problem? Public hospital Emergency service: 48,7 Health emergency center : 46,4% Doctor: 2,4% Private hospital emergency service: 1,4%
  82. 84. </ perceptions and uses of the National Health System >
  83. 85. procura de informação na Internet Source: INE/UMIC, Survey to the Use of Information and Communication Technologies by Families 2002 - 2007. * Individuals between 16 and 74 years old which have used the Internet in the first trimester of the year. Search in the Internet about health
  84. 86. Would you like to use online medical services 9,5% ( doctors appointments, tests appointments, occasional doubts, medical prescriptions )
  85. 87. telephone support (help lines) 95,8% never used (who did use…pediatric questions 73,2%)
  86. 88. stating that the doctor never dissuaded them from looking for information online 96%
  87. 89. when dissuaded … Risk of self-diagnose: 40,9% Lack of knowledge: 30,8%
  88. 90. 8,4% Percentage of those that got their doctors cell phone number
  89. 91. 60,8% used 54,1% got an answer 6,2% were contacted after leaving a message
  90. 92. </ users >
  91. 93. Professionals Users
  92. 94. (1) mediation arrive to the health field
  93. 95. (2) is part of professionals and users routines
  94. 96. (3) but is not part of…
  95. 97. (3) public health policies
  96. 98. (3) health field science teaching integration
  97. 99. (3) protocols of professional practice in the relation user/health professional
  98. 100. What has changed supremacy of network morphology over action
  99. 101. what is still to be changed? structural practices of the actors
  100. 105. Health contents on-line: Google, www and Blogs
  101. 106. 80 general websites about health in Portuguese
  102. 107. Information fundamentally institutional
  103. 108. formal contents are more frequent (institutional, descriptive, functional)
  104. 109. than contents about “health” and “illness”
  105. 110. We find sites with health related information and content
  106. 111. <ul><li>but with no communication processes or services with a higher interaction level </li></ul>
  107. 112. <ul><li>Contrary to what happens in Catalonia </li></ul>
  108. 113. where the interactivity levels are quite higher compared with the Portuguese experience
  109. 114. but where the presence of institutional websites is lower
  110. 115. 55 Health blogs in Portuguese
  111. 116. They are built from the selection and comment to a given event or news
  112. 117. proceeding from other sources and standing out only a part of this information
  113. 118. General information blogs and diaries prevail
  114. 119. “ Online practices” through blogs are practically non existent
  115. 120. In spite of...
  116. 121. The majority of blogs being kept by health professionals (78,2%)
  117. 122. And amongst these, the majority being kept by doctors (45,5%)
  118. 123. The interactivity is very limited
  119. 124. In “Hans Oh’s Health Blog” http://blog.hansoh.com/2005/04/26
  120. 126. Health Care Institutions and Information Technologies: Organizational Changes and Autonomy
  121. 127. 6 case studies
  122. 128. Different information systems and different uses
  123. 129. 70 Interviews
  124. 130. Institutions in several regions of the country
  125. 131. 6 different stories
  126. 132. The medicine circuit and patients computer management
  127. 133. Intranet and institutional websites
  128. 134. External electronic prescriptions and Local Health Units
  129. 135. Telematic Health Network (THN)
  130. 136. SONHO, SINUS, SAM and SAPE and RisPac (names of several informational systems at use in the National Health System, for administrative and clinic purposes)
  131. 137. A reading proposal…
  132. 138. OIT Model (Organization, Impacts and Technology )
  133. 139. There are many variables guiding in a positive and negative way
  134. 140. the Information Systems implementation processes
  135. 141. which determinate simultaneously
  136. 142. changes in the organization forms of the institutions
  137. 143. and in the autonomy processes of users and professionals
  138. 144. Some common features
  139. 145. (1)
  140. 146. Growing use of ICT’s applied to health
  141. 147. (2)
  142. 148. Tendency to an implementation and need of applications and information systems
  143. 149. which will optimize care processes given to the community
  144. 150. Whether clinical care or administrative quickening
  145. 151. (3)
  146. 152. Non existence of a generalized network concept in the National Health System
  147. 153. Programs and projects disruption
  148. 154. (4)
  149. 155. Doctors are the most resistant group
  150. 156. To the use of information applications/systems
  151. 157. Some General Conclusions
  152. 158. The analysis of health information systems
  153. 159. Sends us to 3 analysis units
  154. 160. (1)
  155. 161. Organizations and their management models
  156. 162. (2)
  157. 163. Health care professionals
  158. 164. (3)
  159. 165. Information and software physical and technological networks
  160. 166. leading to The need to articulate the 3 analysis units in a way that we have
  161. 167. Network Organizations, i.e.
  162. 168. More flexible and adaptable to change
  163. 169. And professionals who will increasingly value ICT’s
  164. 170. Leaving the expectation that these values will be more expressive in the future
  165. 171. In a global context where:
  166. 172. Internet is rising as an alternative
  167. 173. to more traditional methods of obtaining health information
  168. 174. Constant flows of information
  169. 175. encourage citizens to be more responsible for their own and their families health
  170. 176. In a context of generalized health information
  171. 177. the use of communication and information technologies is fundamental
  172. 178. To the promotion of individual autonomy in the health field
  173. 179. The incentive of Internet use in this context
  174. 180. Depends actively
  175. 181. (1)
  176. 182. On the type of available contents
  177. 183. (2)
  178. 184. the quality and credibility of contents
  179. 185. (3)
  180. 186. The ease in using and understanding available contents and resources
  181. 187. Which gives a central role to the health care professional
  182. 188. And health care institutions
  183. 189. In developing the concept of “informed citizen”
  184. 190. Even because :
  185. 191. </ answer >
  186. 192. < more questioning >
  187. 193. In November 2005, at the Royal Society of Medicine, Prof. Andrew Webster was discussing…
  188. 194. The promise
  189. 195. tertiary 1m hospital admissions secondary - over 11m hospital admissions primary – 360m GP consultations self care – 90% of health care events FAST, ACCESSIBLE INFORMATION E-TRANSACTIONS TELECARE
  190. 196. Information age health care INDIVIDUAL SELF-CARE CARE BY FAMILY AND FRIENDS CARE BY SELF-HELP COMMUNITY HEALTH PROFESSIONALS AS FACILITATORS HEALTH PROFESSIONALS AS PARTNERS HEALTH PROFESSIONALS AS AUTHORITIES
  191. 197. Doubts
  192. 198. (1)
  193. 199. Limits of e-health: what is possible to be ‘offered’ in e-health?
  194. 200. (2)
  195. 201. What implies e-health – in particular for health care professionals?
  196. 202. (3)
  197. 203. Implications of the future e-health services offer: new segmentation and new exclusions?
  198. 204. </ doubts >
  199. 205. ?

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