Day 3 :
- Track 9: Patient Engagement Strategies and Experiences
Track 12: Interactions with Health Information Technologies
Chair
Gunnar O Klein
Örebro University School of Business, Sweden
Co-Chair
Placide Poba-Nzaou
University of Quebec in Montreal, Canada
Session Introduction
C Peter Waegemann
Waegemann Associates
USA
Title: mHealth is enabling ecare
Time : 10:00-10:25
Biography:
C Peter Waegemann was CEO of Medical Records Institute for over 25 years. He was also Executive Director of Center for Cell-Phone Applications in HealthCare (C-PAHC) and President of mHealth Initiative. Since the 1980s, he has been a visionary and promoter of electronic medical record systems (EMRs). He is internationally known as one of the top experts in healthcare informatics, has published both in the US and in Germany, and is a sought-after speaker on EHRs, eHealth, and mHealth. He has special expertise in electronic patient record systems, standards, networking, telemedicine, and the creation of the national information infrastructure. Waegemann has testified to US Congressional committees. In 2007, he was cited as one of 20 outstanding people who make healthcare better (HealthLeaders). He is the Author of hundreds of publications, including Editor of 18 proceedings books; 100+ published articles and the Past Editor-in-Chief, "Health IT Advisory Report”.
Abstract:
mHealth differs from telemedicine in that it is multi-lateral. In contrast, telemedicine depicts bilateral communication between two partners, in many cases between two providers. The definition of mHealth should not stop at the use of mobile devices, such as smart phones, tablets, watches, or glasses. mHealth has seven distinct elements: (1) Internet resources for patients, (2) Internet access for physicians and other professionals, (3) new devices and their apps representing new tools, (4) new communication patterns and systems, (5) new research, financial, and administrative solutions, (6) enabling data collection in homes and in other places through sensing, tracking, and other therapeutic methods, (7) enabling documentation systems at the point of care and/or away from the office. eCare involves both information-driven care processes and artificial intelligence (AI) in the diagnostic and care process. mHealth enables medical Big Data as well as the Internet of medical Things. mHealth enables the use of non-medical data such as environmental, behavioral, or nutrition-related information to provide further insights into a patient’s health in order to achieve Care, which involves personal care, communication-based care, and AI-based decision making. The implementation of mHealth varies in different regions. The status of implemented features of the Digital Society, as well as legal and professional issues, determines a country’s readiness to take advantage of the benefits mHealth provides.
Ingrid Hegger
National Institute for Public Health and the Environment (RIVM)
Netherlands
Title: Empowerment of patients in online discussions about medicine use
Time : 10:25-10:50
Biography:
I Hegger completed her PharmD at Utrecht University of Utrecht and is a Senior Researcher at the National Institute for Public Health and the Environment, The Netherlands. She is an expert on the regulation of medicinal products, with special interest in biologicals. Currently, her focus is on “close-to-policy” projects in the field of medical products, pharmaceutical care and health policy. She is project leader of project ‘e-Medication’ on the influence of internet on medicines use and involved in projects on the EU regulatory system for medicinal products and clinical trials. Furthermore, she is working on her PhD in a strategic research project on the utilization of knowledge within public health policy and healthcare supervision.
Abstract:
Patient empowerment is crucial in the successful self-management of people with chronic diseases. We investigated whether discussions about medicine use taking place on online message boards contribute to patient empowerment.From seven Dutch message boards, we analyzed posts related to the conditions ADHD, ALS and diabetes by a deductive thematic analysis method and coded the posts for empowerment processes and the quality of the information exchanged. Patient empowerment processes were identified in posts related to all three disorders. There is some variation in the frequency of these processes, but they show a similar order in the results: Patients used the online message boards to exchange information, share personal experiences and for empathy or support. The type of information shared in these processes could contribute to the patient’s self-efficacy when it comes to medicine use. The exchanged information was either correct or largely harmless. We also observed a tendency whereby participants correct previously posted incorrect information, and refer people to a healthcare professional following a request for medical advice, e.g. concerning the choice of medication or dosage. Our findings show that patient empowerment processes occur in posts related to all three disorders and that the type of information shared can contribute to the patient’s self-efficacy when it comes to medicine use. The tendency to refer people to a healthcare professional shows that patients still reserve an important role for healthcare professionals in the care process, despite the development towards more self-management.
Gunnar O Klein
Örebro University School of Business
Sweden
Title: Smart Glasses – a New Mobile Tool for Health Care and Education
Time : 11:10-11:35
Biography:
Gunnar O Klein has spent 40 years on IT for health and medical research. He was for many years working for Karolinska Institutet, the medical University of Stockholm, Sweden both as a cancer researcher and for the development of health informatics research and education. He is now Professor of eHealth at the Centre for Empirical Research on Information Systems at the Örebro University School of Business. He has made many contributions to the development of security techniques for health and semantic interoperability. He was leading European Standardization of Health Informatics in CEN/TC 251 1997-2006 and was a co-founder of the global standardization in ISO/TC 215. He is now involved in research on patient empowerment in interaction with healthcare using apps and other techniques and new innovative functions for managing elderly patients with multimorbidity. He is a member of the regional eHealth steering group and one day a week he works as a primary care physician.
Abstract:
Smart Glasses, defined as a computerized communicator with a transparent screen and a video camera, wearable as a pair of glasses have started to be tested for a variety of health related applications. Smart glasses is an intersting new technology which already has a number of tested applications in medicine which are reviewed in this presentation. It is important that continued testing is carried out in a variety of clinical settings. The applications in medical education are perhaps the most promising, where this tool allows both the supervision of a medical student and reversely to give virtual the presence to students in demanding clinical situations where experienced clinicans are recording the interaction with the patient while performing.
Placide Poba-Nzaou
University of Quebec in Montreal
Canada
Title: Patterns of clinical information systems sophistication: An empirical taxonomy of European hospitals
Time : 11:35-12:00
Biography:
Placide Poba-Nzaou is an Assistant Professor of Information Systems and Human Resource. His research interests include the adoption and implementation of IT in organizations, the impact of IT in healthcare organizations and open source software. The results of his research has been published in internationals refereed journals such as Journal of Information Technology, Information & Management, Information Systems Frontiers, Information, Systems Management, International Journal of Operations & Production Management, International Journal of Health Informatics; as well as international conferences such as HICSS, AMCIS, ECIS. He has an extensive experience as a consultant in the fields of IT and Organizational Development.
Abstract:
Several empirical evidences revealed that a growing number of healthcare organizations are adopting Clinical Information Systems (CIS) to improve their performance. But the outcomes associated with the use of CIS depend, among other things, on the level of their sophistication. Drawing on data from 1000 European hospitals, we conducted an exploratory study to empirically derived patterns of CIS sophistication, combining hierarchical and non-hierarchical cluster analysis algorithms. Our study reveals four different clusters or patterns. We also investigate the extent to which contextual factors such as hospital size influence the level of CIS sophistication.
Josep Picas
European Association of Healthcare IT Managers
Spain
Title: IT and reengineering processes in Primary Care. We should do it better
Time : 12:00-12:25
Biography:
Dr. Josep M. Picas. M.D., at the University of Barcelona. Diploma at the ESADE Business School of Barcelona. He is the President of the European Association of Healthcare IT Managers. He began his career in 1974 as a Medical Doctor, he was appointed deputy Director of the Hospital de l’Esperança, in Barcelona, in 1979-84. Medical Director of Municipal Institute of Health Care Services from 1985 to 2004 (Public HMO in Barcelona). He has been Director of the Primary Care of Barcelona City, from 2004 to 2007. CIO at the Hospital del Mar in Barcelona in 2008 and CIO at the Hospital de St. Pau in Barcelona, Spain from 2009 to 2012. Now he is beginning a new project with 2 University Hospitals of Barcelona, pharmaceutical industries and technological companies applying ICT and PBM to healthcare processes under the model of shared savings He has worked actively on the development of disease management programs, computerised information health systems. He participates on Boards and Steering Committees at local and international level. He has belonged to the Board of the International Disease Management Alliance, New Jersey (US) and the Medical Records Institute, Boston (US)
Abstract:
Healthcare is now in an interesting crossroad, the socio demographic evolution, the economic sustainability and the most active role of the patients, makes a big pressure on the healthcare workforce and of course on the managers of these servicesIs generally well accepted that it is needed a dramatic change on the services in the way they are provided, at this level, the use of information technologies at the primary care levels is clear that are having an increasing role, but this solutions, alone, do not obtain the expected results The main reason of failing, as it is known in other sectors, is the lack of process reengineering when we introduce IT solutions With this approach, this presentation will explain the experience with 4 primary care centers (Medical Home - team model) in Barcelona (145 physicians, nurses and support professionals attending 95.000 people).The work done with the clinicians has had three basic points: 1. - Processes (lean healthcare), 2. - Innovation (advanced practice with nurses) and 3. - Clinical leadership Next steps will be open to discussion in future strategies on linking processes with hospitals, social services…, and applying knowledge from concepts as population health management and global health
Sandra Milena Agudelo-Londono
Pontificia Universidad Javeriana
Colombia
Title: Why Diagnosis related groups are not welcome in Colombia?
Time : 12:25-12:50
Biography:
Sandra Agudelo is a Health information system Manager and has a Master in Epidemiology from Universidad de Antioquia in Colombia. She is proffesor of Health information systems and Managerial Epidemiology in Pontificia Universidad Javeriana, Bogotá. She has published several papers in reputed journals and has been serving as member of the editorial board of Gerencia y Políticas de Salud Journal in her country.
Abstract:
Diagnosis Related Groups (DRGs) are a electronic patient classification system that allows hospital homogenize the product to compare the performance of specialists care, reduce the variability of medical practice, improve clinical management and make transparent the payment system. DRGs are used in many countries and would be useful for the Colombian Health system. However, attempts to introduce DRGs in Colombia were unsuccessful. Only eight of fifty high complexity hospitals have DRGs, which makes it an innovation. The existing literature is abundant in the use of DRGs, but is scarce on the reasons for accepting or rejecting DRGs in hospitals. The aim of our study was to explore the determinants for non-implementation of DRGs in hospitals in Colombia. We use a qualitative case study approach to analyze the perceptions of the directors of six hospitals with and without DRGs in Bogota. The theory of diffusion of innovation was the theoretical basis of the interview applied. It was found that the directors had similar perceptions of the determinants. Although DRGs are perceived as positive, obstacles to implement it were found in two levels: organizational (threats to physician autonomy, culture of non conflict, poor diagnostic coding and emphasis on processes rather than results) and institutional (imperfect health market, negotiation between insurers and providers based on procedures not on diagnoses and finally lack of public policies pro DRGs). It was concluded that unless there is a public policy that leverages the issue, the possibility of DRGs in Colombia is not in the near future. Los Grupos Relacionados de Diagnóstico (GRD) son un sistema de clasificación de pacientes que permite homogeneizar el producto hospitalario para comparar el desempeño de los especialistas, reducir la variabilidad de la práctica médica, mejorar la gestión clínica y hacer transparente el sistema de pagos. Los GRD se utilizan en muchos países y serían útiles para el Sistema General de Seguridad Social en Salud de Colombia. Sin embargo, los intentos de introducir GRD en Colombia fueron infructuosos. Solo ocho de cincuenta hospitales de alta complejidad tienen GRD, que los convierte una innovación para el país. La teoría de difusión de innovación sugiere que la adopción de una innovación depende de sus atributos: ventaja, compatibilidad, complejidad, capacidad de prueba y observabilidad. La literatura existente, abundante en cuanto al uso de los GRD, es escasa sobre los motivos para aceptar o rechazar GRD en hospitales. El objetivo de nuestro estudio fue explorar los determinantes para la no implementación de los GRD en hospitales en Colombia. Enfoque cualitativo de estudio de casos, para analizar las percepciones de los directores de seis hospitales con y sin GRD en Bogotá. La teoría de difusión de la innovación fue el fundamento teórico de la entrevista aplicada. Se encontró que los directores tuvieron percepciones similares frente a los determinantes. Aunque los GRD se percibieron como positivos, se encontraron obstáculos para implementarlos a nivel organizacional (amenaza a la autonomía del médico, cultura del no conflicto, mala codificación diagnóstica y énfasis en procesos en vez de resultados) e institucional (competencia imperfecta en salud, negociación entre aseguradoras y proveedores basada en procedimientos no en diagnósticos y finalmente, falta de políticas públicas pro GRD). Estos hallazgos son únicos en su tipo en el mundo, debido a la particularidad del sistema de salud colombiano. Se concluyó que a no ser que haya una política pública que apalanque el tema, la posibilidad de GRD en Colombia no se ve en el futuro cercano.