Consumer Health Informatics & Pharmacy

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This is the slide deck from the first lecture of the Consumer Health Informatics and Web 2.0 in Healthcare course at Nova Southeastern University. The course is taught by CCHIR faculty and guest lecturers. This deck is from the pharmacy version of the course.

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Consumer Health Informatics & Pharmacy

  1. 1. Consumer Health Informatics & Pharmacy Kevin A. Clauson, PharmD
  2. 2. NoteThe following slide deck is from the introductory lecture of Consumer Health Informatics and Web 2.0 in Healthcare (NSU College of Pharmacy)
  3. 3. ObjectivesExplore assumptions aboutpharmacy and roles in consumerhealth informatics (CHI)Define terminology and conceptsused in CHI
  4. 4. ObjectivesExplain the philosophical shift inhealthcare with the participatorymedicine modelReview the evolution of:Web 1.0 -> Web 2.0 -> Web 3.0
  5. 5. What will the future ofpharmacy look like?
  6. 6. Is the profession’sfuture limited to this?
  7. 7. Or will it feature more of this…
  8. 8. …and maybe look more like this?
  9. 9. http://vimeo.com/14032810
  10. 10. Contact lenses that changecolor with variations in glucoseand can dispense medications Advanced Functional Materials 2008;18(13):1912-21.
  11. 11. Assumptions about Pharmacy Ass u me
  12. 12. Question:Whatpercentage ofpharmacistswork incommunitysettings?(e.g., CVS, DuaneReade, Walgreens)
  13. 13. 65%* Answer:*of the 269,900 pharmacists in the US Source: Bureau of Labor Statistics, Occupational Employment Statistics (29-1051), May 2010.
  14. 14. Location quotient of pharmacists by area Location quotient 0.40 – 0.76 0.77 – 0.89 0.90 – 1.00 1.01 – 1.10 1.11 – 1.28 1.29 – 2.07Source: Bureau of Labor Statistics, Occupational Employment Statistics (29-1051), May 2010
  15. 15. Q: How many pharmacists in the UShave a Doctor of Pharmacy (Pharm.D.)?
  16. 16. 2009 National Pharmacist Workforce Study A: Only about 1 in 4(proportion increased from 13.9% in 2000 to 21.9% in 2009)
  17. 17. Terminology
  18. 18. Informatics “’Use of computers to manage data and information’ andrepresents the nexus of people, information, and technology” Building Core Competencies in Pharmacy Informatics, 2010. Am J Pharm Educ 2011;75(5):93.
  19. 19. Pharmacy Informatics“Use and integration of data,information, knowledge, and technology involved with medication use processes to improve outcomes” Am J Health-Syst Pharm. 2007;64(2):200-203. Am J Pharm Educ. 2008;72(4):89.
  20. 20. Consumer Health Informatics (Eysenbach Definition) “analyses consumers needs for information; studies and implements methods of making information accessible to consumers; and models and integrates consumers preferences into medical information systems” BMJ 2000; 320(7251):1713-6.
  21. 21. CHI Definition “any electronic tool, technology, or electronic application that is designed to interact directly with consumers, with or without the presence of a health care professional that provides or uses individualized (personal) information and provides the consumer with individualizedassistance, to help the patient better manage their health or health care.” AHRQ Publication No. 09(10)-E019, October 2009
  22. 22. AMIA CHI WG Definition “…the field devoted to informatics from multiple consumer or patientviews. These include patient-focused informatics, health literacy and consumer education.” www.amia.org
  23. 23. Consumer Health InformaticsField that studies and incorporates patient preferences, behaviors,tools, and technologies in order tohelp inform their decision making and manage their health Adapted from www.amia.org
  24. 24. Assumptions about Patients Ass u me
  25. 25. What if I told you there was a technology toallow drugs to be inhaled instead of injected?
  26. 26. Pfizer dumps Exubera bong“Is that Exubera in your pocket, or areyou just happy to see me?” - Amy Tenderich Diabetes Mine Nature Biotechnology 2007;25(12):1331-2.
  27. 27. Why did this #FAIL cost Pfizer $3 BILLION?
  28. 28. A paternalistic approach to healthcare**Ok, so some other factors may have contributed as well…
  29. 29. “The obedience of apatient to the prescriptionsof his physician should beprompt and implicit.He should never permit hisown crude opinions as totheir fitness to influence hisattention…” - Original AMA Code of Medical Ethics J Participat Med 2011;3:e27.
  30. 30. Q: How do we dodge thistype of outcome in the future?
  31. 31. A: Engage with empowered patients who want to bepartners in their healthcare
  32. 32. Participatory Medicine www.participatorymedicine.org
  33. 33. “As opposed to the doctor-centric, curative model of the past, the future is going to be patient-centric and proactive.”Elias A. Zerhouni, M.D.Former Director of theNational Institutes ofHealth (2002-2008)
  34. 34. Patient ePatientPassive role Active (engaged) roleInformation is given to They seek out them information (Internet)Top down delivery of Partner in their healthcare healthcarePaternalistic medicine Participatory medicine
  35. 35. eHealth Literacy Scale (eHEALS) Literacy Health Literacy eHealth Literacy J Med Internet Res 2006;8(4):e27.
  36. 36. eHealthLiteracy Lily ModelJ Med Internet Res 2006;8(2):e9.
  37. 37. Q: When is speaking like a professor bad? http://www.colbertnation.com/the-colbert-report-videos/312658/june-17-2010/obama-s-simplified-bp-oil-spill-speech
  38. 38. A: When it prevents you from communicatingyour message effectively to your target audience http://www.colbertnation.com/the-colbert-report-videos/312658/june-17-2010/obama-s-simplified-bp-oil-spill-speech
  39. 39. Q: Are people ready to be ePatients? J Med Internet Res 2011;13(2):e35.
  40. 40. A: It depends. Identification/ quantification Factors Access Literacy Personal responsibility J Med Internet Res 2011;13(2):e35.
  41. 41. Q: What type of patient Is this?
  42. 42. A: Watch the video. http://youtu.be/21TL94NEzvg
  43. 43. Online Health Information Seeking Behaviors
  44. 44. US population with Internet access Legend No Internet access 74% with Internet Has Internet access accessSource: Pew Internet & American Life Project. The Social Life of Health Information, 2009.
  45. 45. Q: What % of online adults search the Internet for health information?
  46. 46. Internet users (%) who searched online for specific health information by type 45 45 40 34 35 35 28 30 25 18 20 2002 20 2008 15 10 5 0 Info about RX or Info about CAM Info about OTC meds experimental TxSource: Pew Internet & American Life Project. Fall Tracking Survey, 2008.
  47. 47. 66% looked online for info on a specific disease or medical problemSource: Pew Internet & American Life Project.The Social Life of Health Information, 2009.
  48. 48. Treatment #1 Treatment #3 Source: Pew Internet & American Life Project, 2009. Q. What % of patients report that what theyfind online affects their treatment decisions?
  49. 49. Treatment #1 Treatment #3 Source: Pew Internet & American Life Project, 2009.60% of e-patients said health information found online affected their treatment decisions
  50. 50. What will thefuture of online health information seeking look like?
  51. 51. It is a fertile area for research
  52. 52. Internet users who do not look onlineSocial media activity ePatients for health info (%) (%) Consult Wikipedia 53 17Use social networking 39 17 site (e.g., Facebook) Read someone’s blog 37 10Create/write own blog 13 4 Use Twitter or other 12 4 update service Source: Pew Internet & American Life Project. The Social Life of Health Information, 2009.
  53. 53. Mobile is going to be the real GAMECHANGER
  54. 54. Web 2.0/Social Media
  55. 55. How does Web 2.0 fit in?
  56. 56. Evolution of the WebWeb 1.0 (one-way Web)  Static, pullWeb 2.0* (two-way Web)  Dynamic, push  Collaborative, participatoryWeb 3.0/3D/Semantic Web (TBD) *Web 2.0 is often used interchangeably with "social media"
  57. 57. Q: Is Social Media a Fad? http://www.youtube.com/watch?v=nPYrbSUqr2k
  58. 58. A: Watch the video and decide. http://www.youtube.com/watch?v=nPYrbSUqr2k
  59. 59. One Final Query How did purposefullylimiting access tothis creation costmillions of lives? SuperFreakonomics: Global Cooling, Patriotic Prostitutes, and Why Suicide Bombers Should Buy Life Insurance, 2009.
  60. 60. Summary Points Pharmacy needs to evolve with patient- driven changes altering healthcare delivery Part of our challenge with CHI is to facilitate interested consumers who want to be ePatients Online health information seeking motivations and behaviors need to be fully characterized to develop best interventions
  61. 61. Images• http://vimeo.com/14032810• http://vimeo.com/14032810• http://www.patientslikeme.com/patients/view/96860?patient_page=12• http://www.bls.gov/oes/current/oes291051.htm• http://www.adcouncil.org/files/ahrqhhsbrand_full.jpg• http://www.amia.org/programs/working-groups/programs/consumer-health-informatics• http://www.nature.com/nbt/journal/v25/n12/images/nbt1207-1331-I1.jpg• http://www.goremasternews.com/wp-content/uploads/2010/04/Leonard-Nimoy-as-Spock.jpg• http://3.bp.blogspot.com/__KTfFRApx8I/TUwkLe5ULzI/AAAAAAAAADI/LXpTiOKOFFY/s1600/soccer+ball+t o+the+face.jpg• http://survivethejourney.blogspot.com/
  62. 62. Images• http://www.ua.edu/features/findyourpassion/diabetes.html• http://epatientdave.com/about-dave/• http://bushofdoctors.blogspot.com/• http://www.phlaunt.com/diabetes/bio.php• http://www.sixuntilme.com/about/ http://askmanny.com/wordpress/wp-content/uploads/2010/02/Manny_Mucubaji.jpg• http://rawarrior.com/about/• http://www.alliancehealthnetworks.com/company/management-team• http://en.wikipedia.org/wiki/File:Elias_Zerhouni_close-up_official_photo.jpg
  63. 63. Images• http://www.colbertnation.com/the-colbert-report-videos/312658/june-17-2010/obama-s-simplified-bp-oil-spill- speech• http://www.colbertnation.com/the-colbert-report-videos/312658/june-17-2010/obama-s-simplified-bp-oil-spill- speech• http://youtu.be/21TL94NEzvg• http://images5.cpcache.com/product_zoom/387303425v0_480x480_Front_Color-Black_padToSquare-true.jpg• http://leomessiofficial.com/wp-content/uploads/2011/04/leo_messi_wallpaper4.jpg• http://www.jopm.org/opinion/letters/2011/08/08/one-step-forward-two-steps-back-why-can%e2%80%99t-we- protect-doctors-who-put-patients-first/• http://www1.sciencemuseum.org.uk/hommedia.ashx?id=8903&size=Small Unreferenced photographs are licensed images
  64. 64. WebCTDiscussion BoardEmailOther contactsDirect emailOffice telephoneMeeting via SkypeNSU office meeting
  65. 65. Required Readings for Lecture1. Eysenbach G. Consumer health informatics. BMJ. 2000;320(7251):1713-6.2. Van De Belt TH, Engelen LJ, Berben SA, Schoonhoven L. Definition of Health 2.0 and Medicine 2.0: a systematic review. J Med Internet Res. 2010;12(2):e18.3. Ferguson T and e-Patient Scholars Working Group. Chapter 1. Hunters and gatherers of medical information. e-Patients: how they can help us heal healthcare 2007:1-20. Available at: http://e-patients.net/e-Patients_White_Paper.pdf.

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