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.

1. Consumer Health
Informatics
& Pharmacy
Kevin A. Clauson, PharmD

2. Note
The following slide deck is from
the introductory lecture of
Consumer Health Informatics
and Web 2.0 in Healthcare
(NSU College of Pharmacy)

3. Objectives
Explore assumptions about
pharmacy and roles in consumer
health informatics (CHI)
Define terminology and concepts
used in CHI

4. Objectives
Explain the philosophical shift in
healthcare with the participatory
medicine model
Review the evolution of:
Web 1.0 -> Web 2.0 -> Web 3.0

5. What will the
future of
pharmacy look
like?

6. Is the
profession’s
future limited
to this?

7. Or will it feature more of this…

8. …and maybe look more like this?

9. http://vimeo.com/14032810

11. Contact lenses that change
color with variations in glucose
and can dispense medications
Advanced Functional Materials 2008;18(13):1912-21.

12. Assumptions about Pharmacy
Ass u me

13. Question:
What
percentage of
pharmacists
work in
community
settings?
(e.g., CVS, Duane
Reade, Walgreens)

14. 65%*
Answer:
*of the 269,900 pharmacists in the US
Source: Bureau of Labor Statistics, Occupational Employment Statistics (29-1051), May 2010.

15. 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 – 2.07
Source: Bureau of Labor Statistics, Occupational Employment Statistics (29-1051), May 2010

16. Q: How many pharmacists in the US
have a Doctor of Pharmacy (Pharm.D.)?

17. 2009 National Pharmacist Workforce Study
A: Only about 1 in 4
(proportion increased from 13.9% in 2000 to 21.9% in 2009)

18. Terminology

19. Informatics
“’Use of computers to manage
data and information’ and
represents the nexus of people,
information, and technology”
Building Core Competencies in Pharmacy Informatics, 2010.
Am J Pharm Educ 2011;75(5):93.

20. 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.

21. 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.

22. 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 individualized
assistance, to help the patient better manage
their health or health care.”
AHRQ Publication No. 09(10)-E019, October 2009

23. AMIA CHI WG Definition
“…the field devoted to informatics
from multiple consumer or patient
views. These include patient-focused
informatics, health literacy and
consumer education.”
www.amia.org

24. Consumer Health Informatics
Field that studies and incorporates
patient preferences, behaviors,
tools, and technologies in order to
help inform their decision making
and manage their health
Adapted from www.amia.org

25. Assumptions about Patients
Ass u me

26. What if I told you there was a technology to
allow drugs to be inhaled instead of injected?

27. Pfizer dumps
Exubera bong
“Is that Exubera in your pocket, or are
you just happy to see me?”
- Amy Tenderich
Diabetes Mine
Nature Biotechnology 2007;25(12):1331-2.

28. Why did this #FAIL
cost Pfizer
$3 BILLION?

29. A paternalistic approach to healthcare*
*Ok, so some other factors may have contributed as well…

30. “The obedience of a
patient to the prescriptions
of his physician should be
prompt and implicit.
He should never permit his
own crude opinions as to
their fitness to influence his
attention…”
- Original AMA Code of Medical Ethics
J Participat Med 2011;3:e27.

31. Q: How do we dodge this
type of outcome in the future?

32. A: Engage with empowered
patients who want to be
partners in their healthcare

33. Participatory
Medicine
www.participatorymedicine.org

34. “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 the
National Institutes of
Health (2002-2008)

35. 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

36. eHealth Literacy Scale
(eHEALS)
Literacy
Health Literacy
eHealth Literacy
J Med Internet Res 2006;8(4):e27.

37. eHealth
Literacy Lily
Model
J Med Internet Res 2006;8(2):e9.

38. 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

39. A: When it prevents you from communicating
your 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

40. Q: Are people
ready to be
ePatients?
J Med Internet Res 2011;13(2):e35.

41. A: It depends.
Identification/
quantification
Factors
Access
Literacy
Personal
responsibility
J Med Internet Res 2011;13(2):e35.

42. Q: What type of patient Is this?

43. A: Watch the video.
http://youtu.be/21TL94NEzvg

44. Online Health
Information
Seeking
Behaviors

45. US population with Internet access
Legend
No Internet access 74% with
Internet
Has Internet access
access
Source: Pew Internet & American Life Project. The Social Life of Health Information, 2009.

46. Q: What % of online adults search the
Internet for health information?

48. 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 Tx
Source: Pew Internet & American Life Project. Fall Tracking Survey, 2008.

49. 66% looked online
for info on a
specific disease or
medical problem
Source: Pew Internet & American Life Project.
The Social Life of Health Information, 2009.

50. Treatment #1 Treatment #3
Source: Pew Internet & American Life Project, 2009.
Q. What % of patients report that what they
find online affects their treatment decisions?

51. Treatment #1 Treatment #3
Source: Pew Internet & American Life Project, 2009.
60% of e-patients said health information found
online affected their treatment decisions

52. What will the
future of online
health
information
seeking look
like?

53. It is a fertile area for research

54. Internet users who
do not look online
Social media activity ePatients for health info
(%) (%)
Consult Wikipedia 53 17
Use social networking 39 17
site (e.g., Facebook)
Read someone’s blog 37 10
Create/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.

55. Mobile is going to be the real
GAMECHANGER

56. Web 2.0/
Social Media

57. How does Web 2.0 fit in?

58. Evolution of the Web
Web 1.0 (one-way Web)
 Static, pull
Web 2.0* (two-way Web)
 Dynamic, push
 Collaborative, participatory
Web 3.0/3D/Semantic Web (TBD)
*Web 2.0 is often used interchangeably with "social media"

59. Q: Is Social Media a Fad?
http://www.youtube.com/watch?v=nPYrbSUqr2k

60. A: Watch the video and decide.
http://www.youtube.com/watch?v=nPYrbSUqr2k

62. One Final Query
How did
purposefully
limiting access to
this creation cost
millions of lives?
SuperFreakonomics: Global Cooling, Patriotic Prostitutes, and
Why Suicide Bombers Should Buy Life Insurance, 2009.

63. 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

64. 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/

65. 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

66. 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

67. WebCT
Discussion Board
Email
Other contacts
Direct email
Office telephone
Meeting via Skype
NSU office meeting

68. Required Readings for Lecture
1. 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.