ITCH 2009 Plenary
Sunday, February 22, 2009
Don Juzwishin CHE PhD
   1987: TODAY’S CHALLENGES -
    TOMORROW’S SOLUTIONS
   1990: IMPROVING COMMUNITY HEALTH
    THROUGH APPLIED TECHNOLOG...
REVOLUTIONIZING HEALTH
 CARE with INFORMATICS:
   FROM RESEARCH to
       PRACTICE
   to offer or accept a challenge; "threw down
    the gauntlet"; "took up the gauntlet"
   form of punishment in which ...
REVOLUTIONIZING
 HEALTH CARE with
  INFORMATICS:
FROM RESEARCH to
    PRACTICE
Health 2.0, Medicine 2.0
 and Web 2.0: Enabling
technologies for practice,
   policy and systems
   Power and will of the people
     Web 2.0
   Power and will of autonomous health care
    providers and researchers ...
   Health informatics is a necessary condition
    for the revolution but it is not sufficient – it
    needs a cultural ...
Data source: 2005 Canadian Internet Use Survey.
Figure source: Statistics Canada, 2008, "Getting a second opinion: Health ...
Data source: 2005 Canadian Internet Use Survey.
Figure source: Statistics Canada, 2008, "Getting a second opinion: Health ...
   While most (94%) think it’s important to have
    access to one’s own medical history, only six
    in ten (60%) say i...
   (93%) Canadians believe that medical errors
    can be prevented by improving collaboration
    between medical profes...
   A similar proportion (87%) is of the opinion that
    electronic health records help medical
    professionals make be...
   Similarly, most (89%) say they want to play a
    more active role in the health care decisions
    made for them and ...
 Three rules of open spaces that have
 emerged on the Internet
  ▪ (1) no body owns it,
  ▪ (2) everybody uses it and
  ▪...
Informed
                                 Improved
    Public                                                   Improved
 ...
Web 2.0, Health 2.0 and
 Medicine 2.0 offer the
platform for the cultural
revolution to take place
   Changing trend of the World Wide Web and
    web design
     Enhance creativity
     Communications
     Secure inf...
   "Health 2.0 is participatory healthcare
    characterized by the ability to rapidly share,
    classify and summarize ...
   “Medicine 2.0 applications, services and tools are
    Web-based services for health care consumers,
    caregivers, p...
   Hughes et al. argue there are four major tensions
    represented in the literature on Health/Medicine
    2.0:
     ...
   It is now humanly impossible for health care
    professionals to single handedly accumulate
    and possess the knowl...
   It is unpardonable to ignore or not undertake
    a policy action that will benefit the health of
    the population o...
   “Some problems are so complex that you
    have to be highly intelligent and well
    informed just to be undecided ab...
   Synergy between health care reform and
    Web 2.0
     Synergism – the cooperative action of discrete
     agencies ...
   Provide 24/7 access to high quality evidence on the
    effectiveness of health care interventions
   Provide the opp...
 Provide 24/7 access to high quality evidence on
  effectiveness of health care interventions
 Provide immediate news of...
   A storehouse of linked data
   Provide a bridge to anonymous data and
    information on the citizen, customer, patie...
   Make explicit accountability relationships,
    roles and responsibilities
   Provide transparency on the monitoring ...
• Potential to improve and inform citizen knowledge
  and understanding
• Provide opportunity to shift the ownership of th...
   Migrate the personal health record to
    citizens, consumers, patients
   Provide 24/7 and universal access to high
...
   Leadership
   Courage - sacrifices
   Vision
   Commitment
   Hard work
   Effective bridges between research, pr...
   The reasonable man adapts himself to the
    world; the unreasonable one persists in trying
    to adapt the world to ...
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University of Victoria ITCH 2009 Feb 22 Plenary Address

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Health 2.0, Medicine 2.0 and Web 2.0: Enabling technologies for practice, policy and systems

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University of Victoria ITCH 2009 Feb 22 Plenary Address

  1. 1. ITCH 2009 Plenary Sunday, February 22, 2009 Don Juzwishin CHE PhD
  2. 2.  1987: TODAY’S CHALLENGES - TOMORROW’S SOLUTIONS  1990: IMPROVING COMMUNITY HEALTH THROUGH APPLIED TECHNOLOGY  1994: CHANGING OPPORTUNITIES  1996: APPROPRIATE SYSTEMS / APPROPRIATE DECISIONS  1998: NEW PARTNERSHIPS: BETTER CARE  2000: FROM POTENTIAL TO PRACTICE  2007 - TODAY’S INFORMATION FOR TOMORROW’S IMPROVEMENTS
  3. 3. REVOLUTIONIZING HEALTH CARE with INFORMATICS: FROM RESEARCH to PRACTICE
  4. 4.  to offer or accept a challenge; "threw down the gauntlet"; "took up the gauntlet"  form of punishment in which a person is forced to run between two lines of men facing each other and armed with clubs or whips to beat the victim
  5. 5. REVOLUTIONIZING HEALTH CARE with INFORMATICS: FROM RESEARCH to PRACTICE
  6. 6. Health 2.0, Medicine 2.0 and Web 2.0: Enabling technologies for practice, policy and systems
  7. 7.  Power and will of the people  Web 2.0  Power and will of autonomous health care providers and researchers committed to collaborate and advance best practice and continuous quality improvement  Medicine 2.0  Power and will of the state to achieve a high performing health care system and improvements in the health and quality of life of its citizens  Health 2.0
  8. 8.  Health informatics is a necessary condition for the revolution but it is not sufficient – it needs a cultural revolution to take place as well  The fundamental tenant of this address is that improvements to the health care system must come from reforms to its structures and processes not by imposing e-health on an archaic artifact
  9. 9. Data source: 2005 Canadian Internet Use Survey. Figure source: Statistics Canada, 2008, "Getting a second opinion: Health information and the Internet", Health Reports, Vol. 19 No. 1, catalogue number 82-003-XWE.
  10. 10. Data source: 2005 Canadian Internet Use Survey. Figure source: Statistics Canada, 2008, "Getting a second opinion: Health information and the Internet", Health Reports, Vol. 19 No. 1, catalogue number 82-003-XWE.
  11. 11.  While most (94%) think it’s important to have access to one’s own medical history, only six in ten (60%) say its ‘easy’ to access them  a majority (55%) of Canadians indicate their medical history is tracked on paper, not electronically (30%)  Simpson, 2008, Ipsos survey
  12. 12.  (93%) Canadians believe that medical errors can be prevented by improving collaboration between medical professionals using technology, and that efficiencies could be created through the additional exchange of information amongst care gives and medical professionals (91%).  Simpson, 2008, Ipsos Survey
  13. 13.  A similar proportion (87%) is of the opinion that electronic health records help medical professionals make better decisions when address health issues of patients.  Nine in ten (91%) believe that the information they get from their medical professionals allows them to take an active role in managing their own health and the health of the family members.  Simpson, 2008, Ipsos Survey
  14. 14.  Similarly, most (89%) say they want to play a more active role in the health care decisions made for them and their family  Simpson, 2008, Ipsos Survey
  15. 15.  Three rules of open spaces that have emerged on the Internet ▪ (1) no body owns it, ▪ (2) everybody uses it and ▪ (3) anyone can improve it.  They characterize the Internet with (1) openness, (2) peering, (3) sharing, and (4) acting globally ▪ Tapscott and Williams
  16. 16. Informed Improved Public Improved Web 2.0 Knowledge Reforms Outcomes Providers Health 2.0 Practices Population Policy Makers health Personal Health Medicine 2.0 Decision Makers Policy Decisions
  17. 17. Web 2.0, Health 2.0 and Medicine 2.0 offer the platform for the cultural revolution to take place
  18. 18.  Changing trend of the World Wide Web and web design  Enhance creativity  Communications  Secure information sharing  Collaboration  Functionality  Social networking, video sharing, wikis, blogs, folksonomies
  19. 19.  "Health 2.0 is participatory healthcare characterized by the ability to rapidly share, classify and summarize individual health information with the goals of improving health care systems, experiences and outcomes via integration of patients and stakeholders.“  Ian Furst  http://waittimes.blogspot.com/
  20. 20.  “Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.” ▪ Eysenbach G Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness J Med Internet Res 2008;10(3):e22 <URL: http://www.jmir.org/2008/3/e22/>
  21. 21.  Hughes et al. argue there are four major tensions represented in the literature on Health/Medicine 2.0:  lack of clear definitions;  issues around the loss of control over information traditionally the purview of health care providers;  safety and the dangers of inaccurate information; and  issues of ownership and privacy  Hughes B, Joshi I, Wareham J Health 2.0 and Medicine 2.0: Tensions and Controversies in the Field J Med Internet Res 2008;10(3):e23 <URL: http://www.jmir.org/2008/3/e23/>
  22. 22.  It is now humanly impossible for health care professionals to single handedly accumulate and possess the knowledge to deliver the health care with the safety and quality made possible by current scientific knowledge
  23. 23.  It is unpardonable to ignore or not undertake a policy action that will benefit the health of the population or improve its quality of life.  It is unpardonable to not undertake the improvement of the functioning of the health care system in respect to its effectiveness and efficiency
  24. 24.  “Some problems are so complex that you have to be highly intelligent and well informed just to be undecided about them.”  Laurence J. Peter
  25. 25.  Synergy between health care reform and Web 2.0  Synergism – the cooperative action of discrete agencies such that the total effect is greater than the sum of the effects taken independently
  26. 26.  Provide 24/7 access to high quality evidence on the effectiveness of health care interventions  Provide the opportunity for social networking, support groups, sharing of experiences  24/7 monitoring of health status parameters – smart house  Instantaneous feedback on medication effects  Encourage health literacy being a priority in education  The citizen, consumer, patient own their personal health record  Reduce adverse events  Access to remote locations  Support of chronic disease management and health promotion
  27. 27.  Provide 24/7 access to high quality evidence on effectiveness of health care interventions  Provide immediate news of breakthrough findings or cautions  Identify and share international best practices  Provide opportunity for immediate and trended outcomes associated with interventions  Offer opportunities for collaboration and partnership  Provide decision support tools  New forms of education and continuing education
  28. 28.  A storehouse of linked data  Provide a bridge to anonymous data and information on the citizen, customer, patient community  Facilitate clinical and field trials matching client criteria and research design requirements  Bring them into the collaboratory  Need to make explicit peer review processes
  29. 29.  Make explicit accountability relationships, roles and responsibilities  Provide transparency on the monitoring and performance of the health care system  Provide access to linked data bases  Drive and link health policy informatics from the sub cellular to the individual and population health levels
  30. 30. • Potential to improve and inform citizen knowledge and understanding • Provide opportunity to shift the ownership of the personal health record to the citizen • Provide instantaneous access to the highest quality evidence of clinical and cost effectiveness of health care interventions to citizens, providers and policy makers • Provide the state with knowledge and insights of what policy actions have what results
  31. 31.  Migrate the personal health record to citizens, consumers, patients  Provide 24/7 and universal access to high quality evidence on the effectiveness of health care interventions to citizens, providers and policy makers  Encourage apomediation  Require transparent declaration of private versus public interests in technologies
  32. 32.  Leadership  Courage - sacrifices  Vision  Commitment  Hard work  Effective bridges between research, practice & policy
  33. 33.  The reasonable man adapts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man.  George Bernard Shaw (1856 - 1950), Man and Superman (1903) "Maxims for Revolutionists"

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