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Inforium® opens the internet
for shared decision making
2013 Planetree Annual Congress,
Montreal Octobre 7
Dr. M.L.Y.M. Oei, Dr. M. Vleming
MD, PhD, ENT-surgeons
Flevoziekenhuis, Almere, The Netherlands
Introduction
Contents
• Shared decision making (SDM): How can we help to choose?
• Reliable medical information in SDM: BetrouwbareBron.nl
(Reliabesource.nl)
• How do we get knowledge to our patiënts (and beat Dr. Google)?
• “How we do it” in the Flevo Hospital
• Conclusions and future developments
Shared decision making
• An approach where clinicians and patients share the best available
evidence when faced with the task of making decisions,
• and where patients are supported to consider options, to achieve
informed preferences
• Elwyn et al. 2012
How do we make choices?
• Determine your goal.
• Arrange and examine the options available to reach it.
• Determine the likelihood of each option meeting your goal.
• Choose the option with the highest likelihood of meeting it.
Shared decision making process
Information and knowledge
Doctor  Patiënt
Options and verbal
explanation
Support information
(Local
info,Betrouwbare Bron)
Inforium (paper, video,
decision aids)
Wishes and feelings
Patiënt   doctor
Verbal
Non-verbal:Reactions
and interpretation
Explanation
Process and Decide
Doctor and patient
Evaluatie the options
Shared decision
choice talk option talk decision talk
D
E
C
I
S
I
O
N
“RELIABLE SOURCE. NL”
Traditional internet method
Patiënt
Website
Organization 1
(doctor, reliable)
Content 1
Links to
organizations like
organization 3
Website 1
(commercial)
Content 2
No links
Links to other
organization
Website
Organization 3
(patiënt,reliable)
Content 3
Links to many
organizations
Website 2
(unknown)
Content 4
-Patient searching through engine
(usually Google)
-Get a selection based on popularity
instead of not reliability
-Not patiënt specific
-Sources not transparent
- often commercial
- often advertorials
-"Reliable Sources" not recognizable
-Small "Reliable Sources" difficult to
find because of small target audience
D
r
.
G
O
O
G
L
E
Doctors
governmentpatiënts
non-profit
Patiënt
BetrouwbareBron Method
• The Patient is the core for information search
• Source-accreditation rather than content-confirmation
• No new content, but bundling and transparency
• Commerce and unknown sources excluded
• “RELIABLE SOURCE.nl”
• Goals:
– To gather and bundle reliable patient information on the
internet
• Provide reliabel relevant information to patiënts
• Safe referral harbor voor doctors and health professionals
• Cross-sector and independent presentation
– Assumptions:
• Each Reliable Source is right (from their specific viewpoint)
• Every patient is unique (in disease and need for information)
What is a BetrouwbareBron (Reliablesource)?
• Nationwide
• Dutch language
• Non-commercial
• On diseases, symptoms, health care, education and prevention
• Information aimed at patients / consumers
• Approved by or part of accrediting health organization
Accreditation organizations
• Professional associations: KNMG (doctors, AMA), KNMP
(pharmacists), NMT (dentists)
• Governmental and government-linked: RIVM (CDC)
• Patient organizations: member NPCF of CG-raad patiënt
association
• Non-profit organizations
– Comprehensive criteria such as objectives, association, funding,
partners
BetrouwbareBron (Reliablesource) websites
• Collection of content striaght to the relevant subject page
• Different sources with the same subject are bundled
• Bundles manually selected by medical volunteers
• Example (click to view)
Betrouwbare Bron Base (database)
• Largest dutch database of non-profit public health information
• Since 2008
• 258 BetrouwbareBron organizations
• > 8000 relevant links
• Continuous medical maintenance
– > 30 medical volunteers
– BetrouwbareBron organizations (NPCF, ENT-surgeons, Child
and hospital foundation)
Betrouwbare Bron Base
• Available for patients
– Published on the internet www.BetrouwbareBron.nl
• Available for health professionals and institutions
– Integration in websites, portals
• Available for e-health applications
– For example “Inforium”
Start a movement (click to view)
How do we beat Dr. Google?
Why do people go to Dr. Google?
• Information in the doctors consult is:
– Too much
– Too fast
– Too difficult (words and content)
– Too little knowledge
– Too emotional
• Told only once!  Make information repeatable!
Doctor-patiënt communication
• 60 % of the information is forgotten instantly
• Of the remaining 40%,
– half the information is remembered incorrectly
Kessels, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE Volume 96 May 2003
But we have a website...
PATIENTS DO NOT VISIT YOUR WEBSITE
• Most people use Google or Yahoo for health information
• To publish information on your website is not enough
• Portals are too user unfriendly (for doctors and patients)
• The solution has to be easier than Dr. Google
KISS (Keep It Simple, Stupid) US Navy 1960
• The KISS principle states that most systems work best if they are
kept simple rather than made complex; therefore simplicity should
be a key goal in design and unnecessary complexity should be
avoided.
User friendly
• Easier for doctors
– Doctors/departments can manage the information themselves
– Doctors can choose Inforiums tailored to the patient
• Easier for managing information
– Easier content creation
– Responsibility to the proper persons
• Communication department in charge of readability, look and feel
• Doctor responsible for medical content
• Easier for patients!
What does Inforium® do?
• Collects, makes and delivers tailored
content
– Local flyers and information
– Databases (eg BetrouwbareBron)
– Multimedia (video)
– Hyperlinks, questionnaires
• Straight to patiënt mailbox
– Privacy compliant (anonymous)
– No mail addresses stored
• Easier for patients than Google !
–Tailored information in their own mailbox
–Multisource, multimedia information
–Privacy respected and environment friendly
–Information can be shared easily
–Better information for shared decision making
What did you say?
• Video (click to view)
How we do it at the Flevo hospital!
• Shared Decision Making in the ENT department with Inforium
• In the doctor’s office (click to view)
• At the reception desk (click to view)
• Example doctor screen (click to view)
Patient experiences
• Subjective: enthusiasm
• Questionnaires:
– Do you like Inforium in mail? Yes
– Do you like the content? Yes
– Easy to use? Yes
– Would you like to receive Inforiums
more often?
YES, please
Results
100%:Yes
What kind of information do you appreciate the most?
Do you understand the information?
Nomination
client award
2012
Make our own Planetree presentation Inforium
www.inforium.info
Use this code: ENG-montreal
( Dutch live Inforium: www.inforium.nl Code: FZA-SDMMOD )
Conclusions en future developments
• In Shared decision making, is reliable information a key element
• Make it easy for the patiënt and yourself
• Getting information to the patient is crucial, not making it.
• Websites get beat by Dr. Google, Inforium® beats Dr. Google
Future developments
• Share our knowledge and resources !
– Patient organizations
– Professional associations
– Health institutions
– Health websites
• Connect our knowledge
– PHR Personal health records
– EHR Electronic health records
– Health portals
Inforium opens  the internet for shared decision making  planetree congress montreal flevoziekenhuis shared db

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Inforium opens the internet for shared decision making planetree congress montreal flevoziekenhuis shared db

  • 1. Inforium® opens the internet for shared decision making 2013 Planetree Annual Congress, Montreal Octobre 7 Dr. M.L.Y.M. Oei, Dr. M. Vleming MD, PhD, ENT-surgeons Flevoziekenhuis, Almere, The Netherlands
  • 3. Contents • Shared decision making (SDM): How can we help to choose? • Reliable medical information in SDM: BetrouwbareBron.nl (Reliabesource.nl) • How do we get knowledge to our patiënts (and beat Dr. Google)? • “How we do it” in the Flevo Hospital • Conclusions and future developments
  • 4. Shared decision making • An approach where clinicians and patients share the best available evidence when faced with the task of making decisions, • and where patients are supported to consider options, to achieve informed preferences • Elwyn et al. 2012
  • 5. How do we make choices? • Determine your goal. • Arrange and examine the options available to reach it. • Determine the likelihood of each option meeting your goal. • Choose the option with the highest likelihood of meeting it.
  • 6. Shared decision making process Information and knowledge Doctor  Patiënt Options and verbal explanation Support information (Local info,Betrouwbare Bron) Inforium (paper, video, decision aids) Wishes and feelings Patiënt   doctor Verbal Non-verbal:Reactions and interpretation Explanation Process and Decide Doctor and patient Evaluatie the options Shared decision choice talk option talk decision talk D E C I S I O N
  • 8. Traditional internet method Patiënt Website Organization 1 (doctor, reliable) Content 1 Links to organizations like organization 3 Website 1 (commercial) Content 2 No links Links to other organization Website Organization 3 (patiënt,reliable) Content 3 Links to many organizations Website 2 (unknown) Content 4 -Patient searching through engine (usually Google) -Get a selection based on popularity instead of not reliability -Not patiënt specific -Sources not transparent - often commercial - often advertorials -"Reliable Sources" not recognizable -Small "Reliable Sources" difficult to find because of small target audience D r . G O O G L E
  • 9.
  • 10. Doctors governmentpatiënts non-profit Patiënt BetrouwbareBron Method • The Patient is the core for information search • Source-accreditation rather than content-confirmation • No new content, but bundling and transparency • Commerce and unknown sources excluded
  • 11. • “RELIABLE SOURCE.nl” • Goals: – To gather and bundle reliable patient information on the internet • Provide reliabel relevant information to patiënts • Safe referral harbor voor doctors and health professionals • Cross-sector and independent presentation – Assumptions: • Each Reliable Source is right (from their specific viewpoint) • Every patient is unique (in disease and need for information)
  • 12. What is a BetrouwbareBron (Reliablesource)? • Nationwide • Dutch language • Non-commercial • On diseases, symptoms, health care, education and prevention • Information aimed at patients / consumers • Approved by or part of accrediting health organization
  • 13. Accreditation organizations • Professional associations: KNMG (doctors, AMA), KNMP (pharmacists), NMT (dentists) • Governmental and government-linked: RIVM (CDC) • Patient organizations: member NPCF of CG-raad patiënt association • Non-profit organizations – Comprehensive criteria such as objectives, association, funding, partners
  • 14. BetrouwbareBron (Reliablesource) websites • Collection of content striaght to the relevant subject page • Different sources with the same subject are bundled • Bundles manually selected by medical volunteers • Example (click to view)
  • 15. Betrouwbare Bron Base (database) • Largest dutch database of non-profit public health information • Since 2008 • 258 BetrouwbareBron organizations • > 8000 relevant links • Continuous medical maintenance – > 30 medical volunteers – BetrouwbareBron organizations (NPCF, ENT-surgeons, Child and hospital foundation)
  • 16. Betrouwbare Bron Base • Available for patients – Published on the internet www.BetrouwbareBron.nl • Available for health professionals and institutions – Integration in websites, portals • Available for e-health applications – For example “Inforium”
  • 17. Start a movement (click to view)
  • 18. How do we beat Dr. Google?
  • 19. Why do people go to Dr. Google? • Information in the doctors consult is: – Too much – Too fast – Too difficult (words and content) – Too little knowledge – Too emotional • Told only once!  Make information repeatable!
  • 20.
  • 21. Doctor-patiënt communication • 60 % of the information is forgotten instantly • Of the remaining 40%, – half the information is remembered incorrectly Kessels, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE Volume 96 May 2003
  • 22. But we have a website...
  • 23. PATIENTS DO NOT VISIT YOUR WEBSITE • Most people use Google or Yahoo for health information • To publish information on your website is not enough • Portals are too user unfriendly (for doctors and patients) • The solution has to be easier than Dr. Google
  • 24. KISS (Keep It Simple, Stupid) US Navy 1960 • The KISS principle states that most systems work best if they are kept simple rather than made complex; therefore simplicity should be a key goal in design and unnecessary complexity should be avoided.
  • 25. User friendly • Easier for doctors – Doctors/departments can manage the information themselves – Doctors can choose Inforiums tailored to the patient • Easier for managing information – Easier content creation – Responsibility to the proper persons • Communication department in charge of readability, look and feel • Doctor responsible for medical content • Easier for patients!
  • 26. What does Inforium® do? • Collects, makes and delivers tailored content – Local flyers and information – Databases (eg BetrouwbareBron) – Multimedia (video) – Hyperlinks, questionnaires • Straight to patiënt mailbox – Privacy compliant (anonymous) – No mail addresses stored
  • 27. • Easier for patients than Google ! –Tailored information in their own mailbox –Multisource, multimedia information –Privacy respected and environment friendly –Information can be shared easily –Better information for shared decision making
  • 28. What did you say? • Video (click to view)
  • 29. How we do it at the Flevo hospital! • Shared Decision Making in the ENT department with Inforium • In the doctor’s office (click to view) • At the reception desk (click to view) • Example doctor screen (click to view)
  • 30. Patient experiences • Subjective: enthusiasm • Questionnaires: – Do you like Inforium in mail? Yes – Do you like the content? Yes – Easy to use? Yes – Would you like to receive Inforiums more often? YES, please
  • 31. Results 100%:Yes What kind of information do you appreciate the most? Do you understand the information? Nomination client award 2012
  • 32. Make our own Planetree presentation Inforium
  • 33. www.inforium.info Use this code: ENG-montreal ( Dutch live Inforium: www.inforium.nl Code: FZA-SDMMOD )
  • 34. Conclusions en future developments • In Shared decision making, is reliable information a key element • Make it easy for the patiënt and yourself • Getting information to the patient is crucial, not making it. • Websites get beat by Dr. Google, Inforium® beats Dr. Google
  • 35. Future developments • Share our knowledge and resources ! – Patient organizations – Professional associations – Health institutions – Health websites • Connect our knowledge – PHR Personal health records – EHR Electronic health records – Health portals