it & communication
symptoms and treatments. The Pew Internet Foundation’s 2008 study on ‘The Engaged ePatient Population’ found that 80% of American’s internet users looked online for health information, whilst 75% reported that their last health search affected a decision about how to treat an illness or condition. So people are seeking information and acting on it. This raises important questions about the need to grade the quality of healthcare information available on the web in order to prevent avoidable harm.
‘passive/guided by clinical and care needs’ – This quadrant is about monitoring and alerting services, where the user is
taking advantage of services which may be provided by social care organisations, clinics or 3rd parties. It includes cases such as social alarms and alerts and remote patient monitoring. The aim of these services is to promote the possibility of independent living for the vulnerable, and improving continuity of care for those with long-term and largely self-managed conditions, such as diabetes, congestive heart failure, COPD and dementia, to name a few. The services may involve sensors and panic buttons installed in the individual’s home, easy-to-use connected medical devices such as scales, blood pressure cuffs and glucometers, and an interface that captures patient’s self-reported data, such as mood, sleep patterns, degree of pain and medication side effects. This is a fruitful area for research and investment and could provide important early warnings of deterioration or falls, avoiding the need for emergency hospital admissions. Pandemic surveillance services also fit within this quadrant, with the possibility of combining information from social media and online news sources with text analytics to pick up early warnings about the outbreaks and spread of infectious disease.
‘collaborative/self directed’ – this is the world for connecting or relating to other people with similar problems or situations using social media, and is sometimes referred to as Health 2.0. It can include ‘peer to peer’ healthcare services, such as those provided by sites such as PatientsLikeMe, or blogs like ePatients, where people with a health issue or a recent diagnosis can go online to find, connect and share information with others. These sites rely on user-generated content and it is interesting to see how willing people are when faced with an incurable condition or unexpected diagnosis, to share their most personal health stories and daily measurements with strangers, in order to provide and seek help. Indeed, PatientsLikeMe is now considered by some to be one of the best sources of information on the realities of living with conditions like multiple sclerosis and motor neurone disease. Another type of site is the ‘patient reported experience’ or PREM, where individuals submit their praises, complaints or opinions about their experience of care, with good examples being HealthGrades (USA) and IWantGreatCare (UK). The feedback provided on these sites could be used by providers to better understand and improve care processes.
‘collaborative/guided by clinical and care needs’ – This final quadrant is centred on deciding and managing and should be considered a key area to explore in the co-creation of health. In this domain, doctors and carers can use online services to collaborate with patients, avoiding unnecessary face-to-face appointments and can improve continuity of care. The tools used to provide these
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