This a very interesting post about some facts of the drivers of changing healthcare. The impact of information and communication is measurable. However the measurements are often related to coarse grained concepts like healthcare costs. Information in the role of a therapeutical intervention or in the role of a framework for a changing society needs other measures. Value oriented measurements are not available short term. The development of apropriate methods to measure outcome in a long termin is just not availabale. However it it seems intuitive to see the relationship between the documented difficulty of understanding health related information and the difficulty to follow medical advice. We tend to build causal relationships between documented facts.This may not be the best option. But there is a lot more research needed to identify relationships between the facts that may support a positive influence on health literacy and outcome. Enjoy the graphics.
Given vulnerable low-income homebound older adults’ substantial health and mental needs, examining their ability to search for high-quality health information/resources and make informed decisions about applying the information to improve their quality of life may be particularly useful.
Internet access and education must become a first order resource for healthcare and should be paid by health insurance plans and considered by welfare organizations. Just like any other measures that improves outcomes.
Patients with full EHR seem to be encouraged to particpate more in healthcare delivery. The EHR access triggers some behaviour to improve health literacy and active participation to cope with and handle zhe information contained in EHR. This is all in line with the concepts of the Patients Centered Process which i will document in a follow-up post
Especially this is important:
Concern about workload is likely more complex. Patients’ accounts suggest that sharing all records reduce workload in some areas, for example, fewer visits or decreasing requests for copies of records. At the same time, participants’ experiences also challenge traditional roles for patients and physicians.
This references a change in culture and is related to the effort done in healthcare delivery. Patients claim a different role in an active position.
especially i would subscribe
EHRs and other forms of health information technology hold the promise of enabling users to provide more effective, more efficient, more coordinated, and safer care
My concern however is another. Since Healthcare in general runs a bit behind in providing adecuate information systems for the people involved in healtcare processes compared to other sectors, healthcare information models have a tendency to be kind of sticky. The EHR model is a bit old fashioned IMHO. A paper record is a perfect representation of the information model within the limits of paper technology. Diggin into the digital domain an EHR may be no more the perfect representation of digitally processed information. I am refering to the fact that RECORDS somehow relates to a data-centric models. No matter the complexity of the concrte EHR implementation. The notion is still a record.
A better approach would be a process oriented or even better Petient Centered model. Modeling healthcare from a patient centered perspective hepls to break down complexity. An EHR that approaches medicine in general could easily be outperformed by small application models that specifically solve small problems and give specific answes or support specific processes.
Another advantage of the application model is to measure application performance and to model application delivery chains
it starts by benchmarking its application performance. This means clearly defining what is, and what is not, acceptable application speed, based on the needs of its users.
- support processes and people instead of data
- modeling communication and relationships with information technology takes healthcare delivery beyond the restrictions of ancient delivery models
- the Patient Centered approach reduces complexity of healthcare with improved performance of healthcare processes
- the App model further reduces complexity and give a possibility to model healthcare chains
“We define the patient experience as the sum of all interactions, shaped by an organization’s culture that influence patient perceptions across the continuum of care.”
But why so distant? The patients perception may tell him: ‘I am fine’ but next day he’ dead. I think we must be more specific to address the patient experience within Patient Centeredness.
These are some points:
- is an inherent part of the patients health
- is a primary focus of healthcare because a good experience is an important contribution to a patients well being
- has to be treated as a primary goal in the healthcare process
These points express patients rights and safety in healthcare. The contribution of technology as Patient Centered IT must comply with the intention of the Patient Experience definition whatever it is. Patient Centeredness expresses the aim of an healthcare architecture with the patients as drivers. Patient Experience should is the fuel needed for driving
Creating appropriate products for low-resource settings requires not only a rethinking of what is considered a health technology, but also cross-disciplinary innovation and in-depth understanding of the particular needs of each country. Location-specific needs assessment will help ensure that more appropriate devices reach people in need and will support parallel efforts to deploy novel devices, processes, or information technologies to cost-effectively reduce disease incidence. It will also help to prevent the adoption of ineffective or inappropriately costly technologies that could divert resources from other critical health care areas.
Exactly. Despite all good that is delivered by device centered health technology it is a big source of unequality because it means expensive development. Lot of money for some improvement that impresses on a tiny scale but fails in a global context. Considering information and the access to it as a health technology that scales up globally is the first step in rethinking health technolgy and its impact to societies. The power of information is that it is flexible. Access is not cheap however, but it inherently contains the notion of distribution. Cost effective health technology needs careful asessment in different contexts (see also: http://patient-centered-it.com/2010/04/10/the-economic-value-of-patient-centered-it/).
At the same time i subscribe to the idea of reverse innovation which is capable to tell the first world what is really a necessary health technology. Again information technology is able to provide the infrastructure to enable this process …
Communication for patients is an essential and non-disputable act in healthcare delivery. I totally subscribe to this statement:
There is no industry where communication is not an essential component to keep things running smoothly and efficiently. In healthcare, however, communication can save lives and that is beyond essential
It is absolutely necessary to improve communication skills of providers and patients in order to save lives. This is not a new claim and has always been an issue. The newer development with enhanced possibilities of information system together with the need for Patient Centered Applications just put an additional focus on this.