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Uk connected health 1 25 2017

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Invited presentation to the University of Kentucky's Markey Cancer Center. I used the opportunity to update cancer prevention and control specialists on implications of the President's Cancer Panel report on Connected Health.

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Uk connected health 1 25 2017

  1. 1. Bradford W. Hesse, PhD Chief, Health Communication and Informatics Research Branch Improving Cancer-Related Outcomes with Connected Health Implications from the 2016 President's Cancer Panel Report
  2. 2. Jessie Gruman, Pres. CFAH In Memoriam December 7, 1953 - July 14, 2014
  3. 3. “The millions of dollars of biomedical research … aimed at a disease that was costing 10’s of thousands of dollars to treat and it ultimately relied on the actions of a skinny, weak, scared 20-year old to have its impact.” Jessie Gruman
  4. 4. “Those of us with multiple chronic conditions may consult many physicians in the course of a year. Last year, I saw 11. Not one of my doctors has ever communicated directly with another… I am the sole arbiter of who gets what information in what format and when.” Jessie Gruman
  5. 5. No Ma&er Where: The Movie Dr. Kevin B. Johnson Filmmaker
  6. 6. Disconnections in Cancer Care
  7. 7. *Source: Jemal,A., Siegel, R., Xu, J., & Ward, E. Cancer statistics, 2010. CA Cancer J Clin, 60(5), 277-300. John Seffrin, CEO American Cancer Society “We know what kinds of things need to be done to increase the number of people who survive from 350 per day to1,000.” Lives saved (annually): 1975 to 2005
  8. 8. The Epidemic of Communication Errors Blocking Optimal Outcomes ❑ Total number of preventable medical errors from all sources exceeds 17 million each year ❑ Joint Commission’s Sentinel Database reports 70% of all reported events had communication as root cause http://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2014.pdf
  9. 9. Source: Zapka JG, Puleo E,Taplin SH, Goins KV,Yood MU, Mouchawar J, et al. Processes of care in cervical and breast cancer screening and follow-up--the importance of communication. Prev Med. 2004;39:81–90. [PubMed] Communication Breakdowns in Care
  10. 10. Reforging the Links: Assessment Alex Krist Virginia Commonwealth Grant # CA168795
  11. 11. Michael Fiore, U Wisconsin CA197573 Reforging the Links: Prevention
  12. 12. “Within 90 days of identifying a care gap … 6X pap screens completed, … 6X mammograms completed, … 10 X CRC screening completed” -Testimony to President’s Cancer Panel, 2014 Nirav Shah VP & COO, Kaiser So Cal Dashboards Focused Comms EHR Tracking Reforging the Links: Screening
  13. 13. RobinVanderpool DrPH, CHES University of Kentucky Reforging the Links: Adaptation
  14. 14. Reforging the Links: Dx & Treatment Transforming the Patient Encounter: Source Kaiser Internal Data • Synchronous & Asynchronous Comms • Point of Need Care • Connected Support
  15. 15. Reforging the Links: Survivorship Survivorship Care Planning, Tracking, & Vigilance “Long Data” over Life Span Ellen Beckjord, UPMC Ben Shneiderman, UMD
  16. 16. Reforging the Links: Advanced Cancer Lori DuBenske, U Wis. Channels of Communication David Gustafson, U Wis. “High Touch” for patients, families supported through High Tech”
  17. 17. Rise of the “Connected Patient”
  18. 18. “Almost half of the Internet users in 1997 reported looking for health information” -- Rice & Katz Source: Rice RE, Katz JE. The Internet and health communication : experiences and expectations. Thousand Oaks, Calif.: Sage Publications; 2001.
  19. 19. Search Term % Using Term Depression 19% Allergies/sinus 16% Cancer 15% Bipolar disorder 14% Arthritis/rheumatism 10% High blood pressure 10% Migraine 9% Anxiety disorder 9% Heart disease Sleep disorders 8% 8% Terms Searched Source: Rice RE, Katz JE. The Internet and health communication : experiences and expectations. Thousand Oaks, Calif.: Sage Publications; 2001.
  20. 20. Search Term % Using Term Depression 19% Allergies/sinus 16% Cancer 15% Bipolar disorder 14% Arthritis/rheumatism 10% High blood pressure 10% Migraine 9% Anxiety disorder 9% Heart disease Sleep disorders 8% 8% Terms Searched Source: Rice RE, Katz JE. The Internet and health communication : experiences and expectations. Thousand Oaks, Calif.: Sage Publications; 2001.
  21. 21. An Extraordinary Opportunity
  22. 22. Health InformaSon NaSonal Trends Survey (HINTS) hints.cancer.gov Funded 2001
  23. 23. Where would you prefer to go for cancer informaSon? Source: Hesse BW, Nelson DE, Kreps GL, et al.Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information NationalTrends Survey.Arch Intern Med. Dec 12-26 2005;165(22):2618-2624.
  24. 24. Where did you go for cancer informaSon? Source: Hesse BW, Nelson DE, Kreps GL, et al.Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information NationalTrends Survey.Arch Intern Med. Dec 12-26 2005;165(22):2618-2624.
  25. 25. See: Rutten LF, Moser RP, Beckjord EB, Hesse, BW, Croyle RT. Cancer Communication: Health Information National Trends Survey. Washington DC: National Cancer Institute. 2007. *51.6% looked for self *45.7% looked for others 2003* Lila Rutten Mayo Clinic Rick Moser NCI Ellen Beckjord U of Pittsburgh Med Diffusion of online health informaSon seeking
  26. 26. See: Rutten LF, Moser RP, Beckjord EB, Hesse, BW, Croyle RT. Cancer Communication: Health Information National Trends Survey. Washington DC: National Cancer Institute. 2007. *51.6% looked for self *45.7% looked for others 2003* 2005* *58.4% looked for self *59.4% looked for others Lila Rutten Mayo Clinic Rick Moser NCI Ellen Beckjord U of Pittsburgh Med Diffusion of online health informaSon seeking
  27. 27. Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. HINTS Trends: New England Journal 2010
  28. 28. Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. HINTS Trends: New England Journal 2010
  29. 29. Source: Hesse BW, Moser RP, Rutten LJ. Surveys of physicians and electronic health information. N Engl J Med. Mar 4 2010;362(9):859-860. HINTS Trends: New England Journal 2010
  30. 30. HINTS Selected to Track HP 2020 Goals: Health IT
  31. 31. Tracking & AdjusSng HP 2020 Goals: Access to the Internet Source: Hesse BW, Gaysynsky A, Vieux S, et al. Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to Monitor Progress on Health Communication Objectives. Journal of Health Communication. 2014;19(ISS12).
  32. 32. Tracking & AdjusSng HP 2020 Goals: InteracSng with Health Systems Source: Hesse BW, Greenberg AJ, Rutten LJ. The Role of Internet Resources in Clinical Oncology: Promises and Challenges. Nature Reviews; Clinical Oncology (in press).
  33. 33. Tracking & AdjusSng HP 2020 Goals: Broadband & Mobile Source: Hesse BW, Greenberg AJ, Rutten LJ. The Role of Internet Resources in Clinical Oncology: Promises and Challenges. Nature Reviews; Clinical Oncology (in press).
  34. 34. Mobile ApplicaSons Extend Care to “Point of Need” NIH Funding Opportunities: • NOT-OD-13-041: National Science Foundation - National Institutes of Health NSF-NIH Interagency Initiative: Smart and Connected Health • PAR-16-292: Mobile Health: Technology and Outcomes in Low and Middle Income Countries (R21)
  35. 35. Journal of NaSonal Cancer InsStute: Special Issue on Changing Comms Landscape NIH Funding Opportunities: • Innovative Approaches to Studying Cancer Communication in the New Media Environment » PAR-16-249 (R01) » PAR-16-248 (R21)
  36. 36. Consumer Engagement: Internet of Things (IOT) at Local Home Depot
  37. 37. The IOT RevoluSon Applied to Health: PaSent Engagement & Telemedicine
  38. 38. Behavioral Support from IOT Technologies: e.g., Adherence June 2015, Office Behavioral and Social Science Research NIH-OD
  39. 39. “When I wrote ‘The World is Flat’ … Facebook didn’t exist; Twitter was a sound; the cloud was in the sky; 4G was a parking place; LinkedIn was a prison; applications are what you sent to college; and Skype, for most people, was a typo.” - Thomas Friedman, “Thank You for Being Late” (2016) A “Superconvergence” of Mobile, IOT, Cloud, and Data Flows
  40. 40. The President’s Cancer Panel
  41. 41. President’s Cancer Panel Barbara K. Rimer, DrPH Univ. of North Carolina at Chapel Hill Hill Harper, JD Cancer Survivor, Actor, and Best-Selling Author Owen N. Witte, MD University of California Los Angeles
  42. 42. Connected Health Source: https://prescancerpanel.cancer.gov/
  43. 43. Connected Health
  44. 44. Enable Interoperability Action Item 1.1: Interoperable health IT system. Action Item 1.2: Technical standards for cancer. Action Item 1.3: Standard, open API platforms. Source: Office of the National Coordinator for Health Information Technology (2015). Connecting Health and Care for the Nation: A 10- year Vision to Achieve an Interoperable Health IT Infrastructure. Washington, DC, Department of Health and Human Services,: 13.
  45. 45. Action Item 1.1: Interoperable health IT system. Action Item 1.2: Technical standards for cancer. Action Item 1.3: Standard, open API platforms. Shore up Standards
  46. 46. Action Item 1.1: Interoperable health IT system. Action Item 1.2: Technical standards for cancer. Action Item 1.3: Standard, open API platforms. Application Programing Interfaces (API)
  47. 47. Action Item 1.1: Interoperable health IT system. Action Item 1.2: Technical standards for cancer. Action Item 1.3: Standard, open API platforms. Application Programing Interfaces (API)
  48. 48. Quantified Self Patient Engagement Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials.
  49. 49. Medication Management Patient Engagement Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials.
  50. 50. Patient Portals Patient Engagement Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials.
  51. 51. The Smart Home Patient Engagement Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials.
  52. 52. Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials. Patients as QC Support
  53. 53. Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials. Patients as QC Support
  54. 54. Action Item 2.1: Develop tools for patient engagement. Action Item 2.2: Patients should flag errors in record. Action Item 2.3: Better tools for Clinical Trials. Source: Source: https://www.cancer.gov/syndication/api Tools for Clinical Trials
  55. 55. Support Clinical Workforce Action Item 3.1: Support for high quality care. Action Item 3.2: Employ human centered design. Action Item 3.3: Interfaces for oncology workforce.
  56. 56. Action Item 3.1: Support for high quality care. Action Item 3.2: Employ human centered design. Action Item 3.3: Interfaces for oncology workforce. Human-Centered Design
  57. 57. Action Item 3.1: Support for high quality care. Action Item 3.2: Employ human centered design. Action Item 3.3: Interfaces for oncology workforce. Human-Centered Design Interdisciplinary Research • Human Computer Interaction • Organizational Systems • Communication • Design • Cognitive Psychology
  58. 58. Action Item 3.1: Support for high quality care. Action Item 3.2: Employ human centered design. Action Item 3.3: Interfaces for oncology needs. Support Needs in Oncology Paul Jacobsen, AD
  59. 59. Action Item 3.1: Support for high quality care. Action Item 3.2: Employ human centered design. Action Item 3.3: Interfaces for oncology needs. Support Needs in Oncology November 2016 Veronica Chollette Sallie Weaver Supports for Team Based Care
  60. 60. Public Access Action Item 4.1: Bolster public access. Action Item 4.2: Ensure provider access. “Connect2HealthFCC is exploring the intersection of broadband, advanced technology and health and further charting the broadband future of health care – serving as an umbrella for all FCC health-oriented activities to help enable a healthier America.”
  61. 61. Provider Access Action Item 4.1: Bolster public access. Action Item 4.2: Ensure provider access. Rural Health Pilot Program
  62. 62. Learning Oncology System Action Item 5.1: Learning Oncology Care Systems. Action Item 5.2: Enhance surveillance. Action Item 5.3: Data integration.
  63. 63. Enhance Surveillance Action Item 5.1: Learning Oncology Care Systems. Action Item 5.2: Enhance surveillance. Action Item 5.3: Data integration. Patient Generated Health Data: SEER Rapid Response Special Study
  64. 64. Data Integration Action Item 5.1: Learning Oncology Care Systems. Action Item 5.2: Enhance surveillance. Action Item 5.3: Data integration. 15 Cancer Centers Funded: National Meetings Open to All
  65. 65. High Priority Research
  66. 66. Thank You! On behalf of those who will benefit, www.cancer.gov

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