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Public health and digital health hesse 6.6.2018

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Invited Keynote to the "Digital Health Promotion Executive Leadership Summit" held at George Washington University on June 5-6, 2018.

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Public health and digital health hesse 6.6.2018

  1. 1. Public Health & Digital Health: The Road to Discovery Bradford W. Hesse Chief, Health Communication & Informatics Research
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  4. 4. 4 What is the road ahead for public health in the digital age? (with apologies to Bill Gates)
  5. 5. 5 Public Health
  6. 6. 6 Source: Colgrove, J. K., Markowitz, G. E., & Rosner, D. (2008). The contested boundaries of American public health. New Brunswick, N.J.: Rutgers University Press. The first half of the 20th Century belonged to public health, with dramatic improvements in sanitation, infection control, infant mortality, and life span.
  7. 7. 7 The second half of the 20th Century belonged to biomedicine, with the emergence of “wonder drugs,” advances in biomedical knowledge, and technology. Penicillin Artificial Heart Source: Colgrove, J. K., Markowitz, G. E., & Rosner, D. (2008). The contested boundaries of American public health. New Brunswick, N.J.: Rutgers University Press.
  8. 8. 8 Challenges Confronting the 21st Century • Global rise in chronic disease • Aging populations world-wide • Rising number of co-morbid conditions • Increasing medical costs for patients with complex conditions • Decreasing supply of trained health professionals to accommodate projected rise in medical demand See: Hesse, B. W. (2009). Rebuilding the levees in public health [review of The Contested Boundaries of American Public Health]. PsycCRITIQUES, 54(2), No Pagination Specified.
  9. 9. 9 Public Health Biomedicine Health Promotion Neither Public Health Practice nor Biomedical Practice alone will be sufficient. Boundaries must converge. See: Hesse, B. W. (2009). Rebuilding the levees in public health [review of The Contested Boundaries of American Public Health]. PsycCRITIQUES, 54(2), No Pagination Specified.
  10. 10. 10 NIH Director Testimony to Congress: March 9, 2005 Elias Zerhouni, NIH Director 2002-2008 Medicine and Public Health must go beyond their industrial, mass communication roots.
  11. 11. 11 The Last Mile Problem
  12. 12. 12 The Digital World
  13. 13. “Augmenting Human Capacity” – December 9, 1968 13
  14. 14. Connecting Data & People: ARPAnet 1970’s to 1980’s 14
  15. 15. 15 Power to the people: Computing goes personal. Jobs and Wozniak Pioneer Personal Computing
  16. 16. Congress opens up its investments in TCP-IP (Internet Protocol) to schools, the public, and commercial interests Senator (later VP) Al Gore Representative Newt Gingrich 16
  17. 17. Psychological research provides insight into sociotechnical influences on behavior See also: Hesse, B. W., Sproull, L., Kiesler, S. B., & Walsh, J. P. (1993). Returns to science: computer networks in oceanography. Commun. ACM, 36(8), 90-101. 17 • Increase in candor as social cues become less salient • Increases in disinhibited speech (flaming) • One to many query capabilities: “Does anyone know?” • Increased capacity for parallel processing -- crowdsourcing • Benefits to temporally or geospatially displaced individuals
  18. 18. 18 The Interface Wars: Cognitive principles and human factors approaches improve intuitiveness & marketability. See: Hesse, B. W., & Shneiderman, B. (2007). eHealth research from the user's perspective. Am J Prev Med, 32(5 Suppl), S97-103.
  19. 19. 19 Public Health Surveillance on Communication Environment
  20. 20. National Goals: Healthy People 2010 & 2020 20
  21. 21. The Rise of Mobile to Access Health Information 21
  22. 22. 22 Trust vs. Use of Information Sources / Channels Source: Hesse, B. W., Moser, R. P., & Rutten, L. J. (2010). Surveys of physicians and electronic health information. N Engl J Med, 362(9), 859-860.
  23. 23. 23 Trends for Interacting with Healthcare System Online Source: Hesse, B. W., Greenberg, A. J., & Rutten, L. J. F. (2016). The role of Internet resources in clinical oncology: promises and challenges. Nat Rev Clin Oncol. doi:10.1038/nrclinonc.2016.78
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  25. 25. 25 We’ve reached a “supernova” of change fueled by: • Smartphone technology • Internet of things, ubiquitous computing • Parallel processing • Cloud computing • Cognitive technologies • Expansive social media platforms
  26. 26. 26 Public Health in the Digital World: The Road to Discovery
  27. 27. 27 National Committee on Vital & Health Statistics: Creating a National Health Information Infrastructure Published in 2001
  28. 28. 28 See: Hesse, B. W., Hansen, D., Finholt, T., Munson, S., Kellogg, W., & Thomas, J. C. (2010). Social Participation in Health 2.0. IEEE Computer, 43(11), 45-52.
  29. 29. 29 Prelude to Healthcare Reform Meaningful Use Safety, Quality Improvement Privacy, Security Patient Engagement Continuity of Care Population Health Management HITECH Act of 2009: Meaningful Use for Health IT
  30. 30. 30 21st Century Cures Act: Connecting Systems for Accelerated Impact • Trusted Exchange Network • API without Special Effort
  31. 31. 31 Creating an Ecosystem for Advancing Public Health through Connected Data Flows Source: Mandl, K. D., & Kohane, I. S. (2016). Time for a Patient-Driven Health Information Economy? N Engl J Med, 374(3), 205-208.
  32. 32. 32Courtesy: Wendy Nilsen, National Science Foundation Smart and Connected Health Funding Initiative
  33. 33. L.A.U.N.C.H. Linking and Amplifying User-Centered Networks through Connected Health FundingFocus on symptom management: Patrick et al achieved 50% reduction in preventable hospitalizations with this approach
  34. 34. 34 What if?
  35. 35. 35 We could link our public health data systems to improve our support for population health management. Source: NCI and Department of Energy Collaboration to Improve Cancer Surveillance.
  36. 36. 36 We could create a life-sensitive support system to optimize health across the life span?
  37. 37. 37 We could solve the last mile problem by connecting all of our communities through telehealth and digital therapies?
  38. 38. 38 We could apply industry-level engagement techniques to help individuals and communities improve their health.
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