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Inforium®
opens the internet for
shared decision making
2013 Planetree Annual Congress,
Montreal Octobre 7
Dr. M.L.Y.M. Oei, Dr. M. Vleming
MD, PhD, ENT-surgeons
Flevoziekenhuis, Almere, The Netherlands
Introduction
Contents
• Introduction
• Shared decision making: How can we help to choose?
• Reliable medical information: BetrouwbareBron.nl
(Reliabesource.nl)
• How do we beat Dr. Google?
• How we do it in the Flevo Hospital
• Conclusions and future developments
Shared decision making
• An approach where clinicians and patients share the best available
evidence when faced with the task of making decisions,
• and where patients are supported to consider options, to achieve
informed preferences
• Elwyn et al. 2012
How do we make choices?
• Determine your goal.
• Determine its value.
• Arrange and examine the options available to reach it.
• Determine the likelihood of each option meeting your goal.
• Choose the option with the highest likelihood of meeting it.
• Use the outcome of this experience to adjust your future goals and the
way in which you make future decisions.
Shared decision making process
choice talk option talk decision talk
D
E
C
I
S
I
O
N
“RELIABLE SOURCE. NL”
Traditional internet method
-Patient searching through engine
(usually Google)
-Get a selection based on popularity
instead of not reliability
-Not patiënt specific
-Sources not transparent
- often commercial
- often advertorials
-"Reliable Sources" not recognizable
-Small "Reliable Sources" difficult to
find because of small target audience
D
r
.
G
O
O
G
L
E
Inforium opens  the internet for shared decision making  planetree congress montreal flevoziekenhuis slideshare
BetrouwbareBron Method
• The Patient is the core for information search
• Source-accreditation rather than content-confirmation
• No new content, but bundling and transparency
• Commerce and unknown sources excluded
Doctors
governmentpatiënts
non-profit
Patiënt
• “RELIABLE SOURCE.nl”
• Goals:
– To gather and bundle reliable patient information on the
internet
• Provide reliabel relevant information to patiënts
• Safe referral harbor voor doctors and health professionals
• Cross-sector and independent presentation
– Assumptions:
• Each Reliable Source is right (from their specific viewpoint)
• Every patient is unique (in disease and need for information)
What is a BetrouwbareBron (Reliablesource)?
• Nationwide
• Dutch language
• Non-commercial
• On diseases, symptoms, health care, education and prevention
• Information aimed at patients / consumers
• Approved by or part of accrediting health organization
Accreditation
• Professional associations: KNMG (doctors, AMA), KNMP
(pharmacists), NMT (dentists)
• Governmental and government-linked: RIVM(CDC), KiesBeter.nl
Patient organizations: member NPCF of CG-raad patiënt
association
• Non-profit organizations
– Comprehensive criteria such as objectives, association, funding,
partners
BetrouwbareBron (Reliablesource) websites
• Collection of content striaght to the relevant subject page
• Different sources with the same subject are bundled
• Bundles manually selected by medical volunteers
• Example
Betrouwbare Bron Base (database)
• Largest dutch database of non-profit public health information
• Since 2008
• 258 BetrouwbareBron organizations
• > 8000 relevant links
• Continuous medical maintenance
– > 30 medical volunteers
– BetrouwbareBron organizations (NPCF, ENT-surgeons, Child
and hospital foundation)
Betrouwbare Bron Base
• Available for patients
– Published on the internet www.BetrouwbareBron.nl
• Available for health professionals and institutions
– Integration in websites, portals
• Available for e-health applications
– “White-label”
How do we beat Dr. Google?
Why do people go to Dr. Google?
• Information in the doctors consult is:
– Too much
– Too fast
– Too difficult (words and content)
– Too little knowledge
– Too emotional
• Told only once!  Make information repeatable!
Inforium opens  the internet for shared decision making  planetree congress montreal flevoziekenhuis slideshare
Doctor-patiënt communication
• 60 % of the information is forgotten instantly
• Of the remaining 40%,
– half the information is remembered incorrectly
But we have a website...
PATIENTS DO NOT VISIT YOUR WEBSITE
• Most people use Google or Yahoo for health information
• To publish information on your website is not enough
• Portals are too user unfriendly (for doctors and patients)
• The solution has to be easier than Dr. Google
KISS (Keep It Simple, Stupid) US Navy 1960
• The KISS principle states that most systems work best if they are
kept simple rather than made complex; therefore simplicity should
be a key goal in design and unnecessary complexity should be
avoided.
User friendly
• Easier for doctors
– Doctors/departments can manage the information themselves
– Doctors can choose Inforiums tailored to the patient
• Easier for managing information
– Easier content creation
– Responsibility to the proper persons
• Communication department in charge of readability, look and feel
• Doctor responsible for medical content
• Easier for patients!
What does Inforium®
do?
• Collects, makes and delivers tailored
content
– Local flyers and information
– Databases (eg BetrouwbareBron)
– Multimedia (video)
– Hyperlinks, questionnaires
• Straight to patiënt mailbox
– Privacy compliant (anonymous)
– No mail/IP addresses stored
– Secure site
• Easier for patients than Google !
–Tailored information in their own mailbox
–Multisource, multimedia information
–Privacy respected
–Environment friendly (no more prints)
–Always available
–Better information for shared decision making
How we do it at the Flevo hospital!
• Shared Decision Making in the ENT department with Inforium
• http://youtu.be/NPPptPFHEfM
• http://youtu.be/fxjswG6WFi0
• Examples:
– Shared decision making Grommets
– BPPV
Patient experiences
• Subjective: enthusiasm
• Questionnaires:
– Do you like Inforium in mail? Yes
– Do you like the content? Yes
– Easy to use? Yes
– Would you like to receive Inforiums
more often?
YES, please
Results
100%: Yes
What kind of information do you appreciate the most?
Do you understand the information?
Nomination
client award
2012
Make our own Inforium
• Keywords from the audience
• Slideshare
• Infogram
• Video
• Article
• Reliable source link
www.inforium.info
Code: ENG-montreal
Conclusions en future developments
• Shared decision making: Reliable information is a key element
• Bundling and sharing medical information
• Getting information to the patient is crucial, not making it.
• Tell the patiënts what to do!
• Websites get beat by Dr. Google, Inforium®
beats Dr. Google
Future developments
• Share our knowledge and resources !
– Patient organizations
– Professional associations
– Health institutions
– Health websites
• Connect our knowledge
– PHR Personal health records
– EHR Electronic health records
– Health portals
“How to start a movement”
• Lesson 1: Easy to follow
• Lesson 2: First follower is crucial
• Lesson 3: Followers are made public
• Lesson 4: Followers have to hurry to be part of the in-crowd
• Lesson 5: Late comers are ridiculed
• www.Flevoziekenhuis.nl
• www.Inforium.nl or www.Inforium.info
More info?

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Inforium opens the internet for shared decision making planetree congress montreal flevoziekenhuis slideshare

  • 1. Inforium® opens the internet for shared decision making 2013 Planetree Annual Congress, Montreal Octobre 7 Dr. M.L.Y.M. Oei, Dr. M. Vleming MD, PhD, ENT-surgeons Flevoziekenhuis, Almere, The Netherlands
  • 3. Contents • Introduction • Shared decision making: How can we help to choose? • Reliable medical information: BetrouwbareBron.nl (Reliabesource.nl) • How do we beat Dr. Google? • How we do it in the Flevo Hospital • Conclusions and future developments
  • 4. Shared decision making • An approach where clinicians and patients share the best available evidence when faced with the task of making decisions, • and where patients are supported to consider options, to achieve informed preferences • Elwyn et al. 2012
  • 5. How do we make choices? • Determine your goal. • Determine its value. • Arrange and examine the options available to reach it. • Determine the likelihood of each option meeting your goal. • Choose the option with the highest likelihood of meeting it. • Use the outcome of this experience to adjust your future goals and the way in which you make future decisions.
  • 6. Shared decision making process choice talk option talk decision talk D E C I S I O N
  • 8. Traditional internet method -Patient searching through engine (usually Google) -Get a selection based on popularity instead of not reliability -Not patiënt specific -Sources not transparent - often commercial - often advertorials -"Reliable Sources" not recognizable -Small "Reliable Sources" difficult to find because of small target audience D r . G O O G L E
  • 10. BetrouwbareBron Method • The Patient is the core for information search • Source-accreditation rather than content-confirmation • No new content, but bundling and transparency • Commerce and unknown sources excluded Doctors governmentpatiënts non-profit Patiënt
  • 11. • “RELIABLE SOURCE.nl” • Goals: – To gather and bundle reliable patient information on the internet • Provide reliabel relevant information to patiënts • Safe referral harbor voor doctors and health professionals • Cross-sector and independent presentation – Assumptions: • Each Reliable Source is right (from their specific viewpoint) • Every patient is unique (in disease and need for information)
  • 12. What is a BetrouwbareBron (Reliablesource)? • Nationwide • Dutch language • Non-commercial • On diseases, symptoms, health care, education and prevention • Information aimed at patients / consumers • Approved by or part of accrediting health organization
  • 13. Accreditation • Professional associations: KNMG (doctors, AMA), KNMP (pharmacists), NMT (dentists) • Governmental and government-linked: RIVM(CDC), KiesBeter.nl Patient organizations: member NPCF of CG-raad patiënt association • Non-profit organizations – Comprehensive criteria such as objectives, association, funding, partners
  • 14. BetrouwbareBron (Reliablesource) websites • Collection of content striaght to the relevant subject page • Different sources with the same subject are bundled • Bundles manually selected by medical volunteers • Example
  • 15. Betrouwbare Bron Base (database) • Largest dutch database of non-profit public health information • Since 2008 • 258 BetrouwbareBron organizations • > 8000 relevant links • Continuous medical maintenance – > 30 medical volunteers – BetrouwbareBron organizations (NPCF, ENT-surgeons, Child and hospital foundation)
  • 16. Betrouwbare Bron Base • Available for patients – Published on the internet www.BetrouwbareBron.nl • Available for health professionals and institutions – Integration in websites, portals • Available for e-health applications – “White-label”
  • 17. How do we beat Dr. Google?
  • 18. Why do people go to Dr. Google? • Information in the doctors consult is: – Too much – Too fast – Too difficult (words and content) – Too little knowledge – Too emotional • Told only once!  Make information repeatable!
  • 20. Doctor-patiënt communication • 60 % of the information is forgotten instantly • Of the remaining 40%, – half the information is remembered incorrectly
  • 21. But we have a website...
  • 22. PATIENTS DO NOT VISIT YOUR WEBSITE • Most people use Google or Yahoo for health information • To publish information on your website is not enough • Portals are too user unfriendly (for doctors and patients) • The solution has to be easier than Dr. Google
  • 23. KISS (Keep It Simple, Stupid) US Navy 1960 • The KISS principle states that most systems work best if they are kept simple rather than made complex; therefore simplicity should be a key goal in design and unnecessary complexity should be avoided.
  • 24. User friendly • Easier for doctors – Doctors/departments can manage the information themselves – Doctors can choose Inforiums tailored to the patient • Easier for managing information – Easier content creation – Responsibility to the proper persons • Communication department in charge of readability, look and feel • Doctor responsible for medical content • Easier for patients!
  • 25. What does Inforium® do? • Collects, makes and delivers tailored content – Local flyers and information – Databases (eg BetrouwbareBron) – Multimedia (video) – Hyperlinks, questionnaires • Straight to patiënt mailbox – Privacy compliant (anonymous) – No mail/IP addresses stored – Secure site
  • 26. • Easier for patients than Google ! –Tailored information in their own mailbox –Multisource, multimedia information –Privacy respected –Environment friendly (no more prints) –Always available –Better information for shared decision making
  • 27. How we do it at the Flevo hospital! • Shared Decision Making in the ENT department with Inforium • http://youtu.be/NPPptPFHEfM • http://youtu.be/fxjswG6WFi0 • Examples: – Shared decision making Grommets – BPPV
  • 28. Patient experiences • Subjective: enthusiasm • Questionnaires: – Do you like Inforium in mail? Yes – Do you like the content? Yes – Easy to use? Yes – Would you like to receive Inforiums more often? YES, please
  • 29. Results 100%: Yes What kind of information do you appreciate the most? Do you understand the information? Nomination client award 2012
  • 30. Make our own Inforium • Keywords from the audience • Slideshare • Infogram • Video • Article • Reliable source link
  • 32. Conclusions en future developments • Shared decision making: Reliable information is a key element • Bundling and sharing medical information • Getting information to the patient is crucial, not making it. • Tell the patiënts what to do! • Websites get beat by Dr. Google, Inforium® beats Dr. Google
  • 33. Future developments • Share our knowledge and resources ! – Patient organizations – Professional associations – Health institutions – Health websites • Connect our knowledge – PHR Personal health records – EHR Electronic health records – Health portals
  • 34. “How to start a movement” • Lesson 1: Easy to follow • Lesson 2: First follower is crucial • Lesson 3: Followers are made public • Lesson 4: Followers have to hurry to be part of the in-crowd • Lesson 5: Late comers are ridiculed
  • 35. • www.Flevoziekenhuis.nl • www.Inforium.nl or www.Inforium.info More info?

Editor's Notes

  1. - bewustmaking rol van patiënt in besluitvorming - bewustmaking geen objectief proces: informatie, kennis, gevoelens, wensen, beslissing - zin van samenwerking in betrouwbabare informatie - bewustmaking van verbeteringsmogelijkheden informatieoverdracht "- bewustmaken van beperkingen/ mogelijkheden internet - praktijkvoorbeeld Flevoziekenhuis KNO NB: andere doelen Promotie Flevoziekenhuis, BetrouwbareBron en Inforium   Inforium Opens The WWW For Shared Decision-Making In this session the E.N.T. doctors present the Inforium project. They will share with you how they manage to help patients to be better informed before, during and after their visit to the doctor by sending an email with specific links and videos. Beside hospital information the main source is the Dutch foundation ‘ Reliable source ’ (Stichting Betrouwbarebron). It   has its own website where doctors with a variety of specializations give reliable information on diseases, treatments and health. The website has written, produced and directed by medical doctors, and supported by the Dutch patient organizations and insurance companies.   - Better informed patients - Shared decision making - Compliance improvement - More effective doctor ’ s visit - More time for personal contact between patient and doctor Presenter:   Markus Oei MD, PhD and Marleen Vleming MD, PhD of Flevoziekenhuis          Room: 520 A&D
  2. Planetree en ons ziekenhuis: eerste ziekenhuis in Europa. Wij blij Eerste ziekenhuis online afspraken in 2004 bla bla Markus voorbeeld shared decision making HAN - dia Galaxy note 2 met reviews test en specificaties - dia bruiloft: keuze partner
  3. - Introductie (Markus) 5 - Shared decision making: Hoe maak je keuzes? (Marleen) 5 - Betrouwbare informatie: Betrouwbare Bron (Markus) 5 - Informatie overdracht problemen en oplossing met BetrouwbareBron, Inforium (Markus) 10 - Flevoziekenhuis praktijk (Marleen) 10 - Conclusies en toekomst: samenwerking organisaties, integratie persoonlijk gezondheidsdossier (Samen) 10
  4. PLAATJE MARLEEN toevoegen
  5. Voorbeeld van buisjes, Value is ook emotionele waarde. Aan de hand van buisjes voorbeeld.
  6. Uitleg en vertellen hoe later we uitweiden over kennis
  7. Start is reliable informatieon Begon in 2008 Patient in de spreekkamer
  8. AKTIE ??????
  9. Bestaande dia’s vertalen Hoe versla ik Dr. Google 50% van de patiënten gaat verward bij dokter weg 40% van gesproken tekst wordt onthouden (waarvan de helft fout)
  10. Combineren met vorige
  11. Combineren met vorige
  12. Eventueel in tweeën delen
  13. 2x praatje: 1 inforium in de spreekkamer en 1x aan de balie Inrtoductie: waarvoor gebruiken we het? Welke info zit erin Voorbeelden: BPPD (benigne paroxysmale positie duizeligheid); stemfilmpje? snurken Wie stopt de info erin Wie geeft de info aan de patiënt (filmpje arts spreekkamer) Foto afsprakenblad, filmpje balie
  14. AKTIE MARKUS