Common-Sense Epidemiology in the Age of Electronic Patient Records (EPR)

Encouraging patients to play a more active role in their health care is crucial for healthcare planning and for the design of services. This chapter shifts the scholarly focus from practitioners' decision making to that of laypersons' trying to make sense of the lab results available on their EPRs. The authors developed a methodology to capture the relationship between information formats (graph, numeric, or verbal), laypersons' assessment of the conditions' gravity, and their preferred course of action. Focusing on the effect of “not knowing” on laypersons' preferred courses of action, our findings show that formats that left respondents less able to understand the results—namely, the numeric and verbal formats—produced a lower sense of urgency, and correspondingly, less inclination to actively seek professional help. The chapter takes a step toward deriving practical recommendations as to how personal clinical information should be communicated, to improve laypersons' interpretation of the information's significance.

Using Technology to Empower People With Multiple Sclerosis (MS) to Make Shared Decisions About Managing Their Own Healthcare

In 2014, the UK National Health Service (NHS) ‘Five Year Forward View' plan set out key objectives to reform the NHS, which included empowering the population as a whole (particularly those with long-term health conditions) to take more responsibility for managing their own healthcare and introducing initiatives to use technology to improve services and reduce costs. The “Long Term Plan” explains how the 2014 initiatives will be further developed. This chapter presents a review of literature on digital health information and information usability. It presents the key findings from a mixed methods study that explored how people with MS (PwMS) access and use health digital information when trying to manage their MS. While the study found that there is much good quality digital health information available for PwMS, and that this facilitates shared decisions, some necessary information is still missing. The chapter concludes with recommendations for digital health information providers.

Patient-Centered Empowerment Through Evidence-Based Engagement in Sensitive Clinical Settings

Patient-centered empowerment is enhanced through evidence-based engagement in stressful medical situations. The current study provided expert-vetted educational materials in dynamic text and video formats using the 5S approach. The materials are relevant, reliable, and readable for patients with abnormal Pap test results. Findings indicated patients that understood the information better were more engaged. Engagement was measured using a coding system that kept track of explicitly shared information, requested recommendations, and tacit knowledge during patient-physician interaction. Other outcomes were that dynamic text had a greater impact on engagement in both initial and follow-up meetings. Important findings included that those who found the dynamic text relevant had their social well-being, self-esteem, optimism, and acceptance improved in initial meetings. Those who found the dynamic text reliable were more confident in the relationship with their physician in follow-up meetings and felt their social well-being was improved in both initial and follow-up meetings.

Use of Predictive and Simulation Models to Develop Strategies for Better Access Specialists Care

No-shows are patients who miss scheduled Specialist Outpatient Clinic (SOC) appointments. No-shows can impact patients' access to care and appointment lead time. This chapter describes a data-driven strategy of improving access to specialist care through first developing a stratified predictive scoring model to identify patients at risk of no-shows; second, studying the impact of a dynamic overbooking strategy that incorporates the use of the no-show prediction model using discrete event simulation (DES) on lead time. Seventeen variables related to new SOC appointments for subsidized patients in 2016 were analyzed. Multiple logistic regression (MLR) found eight variables independently associated with no-shows with area under receiver operation curve (AUC) 70%. The model was tested and validated. DES model simulated the appointment overbooking strategy as applied to the top highest volume specialties and concluded that lead time of Specialty 1 and 2 can be shortened by 27.5 days (49% improvement) and 21.3 (33%) respectively.

The Promise of Gamification in Addressing Health Challenges of the Modern World

This chapter explores gamification and its potential to address leading health and healthcare issues, to promote healthy behaviors and empower patients to take charge of their own health. It discusses some of the key advantages of gamification over past iterations of technology-based behavioral health interventions, including personal informatics and serious games. The advantages discussed in this chapter include: 1) a greater emphasis on the promotion of intrinsic motivation through quality, intentional game design; 2) broader accessibility to patients through mobile technology and advancing sensor systems; and 3) broader applicability to tackle a variety of health challenges. This chapter is useful for those hoping to gain a deeper understanding of the promise that drives the excitement in gamification as a method for addressing the health challenges of the modern world, as well as the work that is still required to fulfill that promise.

Big Data

In the last three decades, big data has been applied to diverse fields, such as the government, international development, and education. It is only now that the US healthcare system has begun to explore its under-utilized data. Big data is not only referencing the quantity, but also the complexity, diversity, and relativity of the information. This information may be analyzed to reveal patterns, trends, and associations that may be applicable to the healthcare field. This information can be gathered through sources, such as EHRs, IRIS registry, and MIPS. Recognizing patterns would aid in predicting preventative measures for an increased holistic and personalized patient care. Although big data proves to have endless beneficial applications, it can bring into question the ownership of this information. Additionally, big data poses a risk for security breaches, and thus, precautionary measures will also be discussed. Ultimately, the emergence of big data creates an exhilarating frontier for healthcare with its unlimited possibilities.

Web-Based Information for Patients and Providers

The exponential development of Information Technologies revolutionized healthcare. A significant aspect of this revolution is the access to health information in the Internet. The Internet World Stats estimates that 56.8% of the world population used the Internet in March 2019, an increase of 1,066% from 2000. According to The Pew Research Center survey of 2012 81% of Americans used the internet and 72% of them searched for health information. Even though there is a lack in more recent data on the percentage of online health information seekers, it is clear that this trend is on the rise. This chapter focuses on the characteristics of the search for online health information by patients and providers, investigates features related to the quality of health web sites, and discusses the impact of these searches on healthcare.

mHealth Collaboration for Social Good

The World Health Organization lauds mobile health (mHealth) technology as a means of creating stronger healthcare systems and improving health-related outcomes. This chapter reports on an action research study examining the development of a mHealth technology hypertension app to help people living in India's urban slums and rural villages take better care of their health. The collaboration involved a multidisciplinary team of U.S.-based academic researchers, and India-based healthcare and technology professionals. This study suggests that traditional Western-based project management approaches alone are insufficient when developing technology for social good. Specifically, the study finds that team, process, and technology adaptability are key to successfully developing healthcare technology to serve at-risk populations in resource-constrained areas. Implications of these findings to systems development research are discussed.

Use of a Mobile App by Older People in an Integrated Care Setting

The current study analyzes the information collected and the lessons learned during the first six months of the CONNECARE project in Israel, in order to assess the use of the mobile technology by patients, their motivations and obstacles; as well as their satisfaction. As of the middle of February 2019, 59 patients were recruited and 18 discharged from the project and completed the feedback questionnaires. Based on preliminary data presented in this chapter, as measured against the McGaughey et al. Research Framework, it can be concluded that the usage of the CONNECARE mobile platform can be rated as moderate. The analysis together with insights from the literature, suggest that usage of the CONNECARE app could be improved by introducing additional features that would increase patients' motivation to use the system as well as its full integration into usual healthcare processes.

The Design and Evaluation of an Intelligent Pain Management System (IPMS) in Cancer Patient Care

This case study reviews the design and development of a mobile-based intelligent pain management system (IPMS) app in cancer patient care and pain management in a rural hospital in China. Healthcare professionals were involved throughout the design to the evaluation stages. The IPMS facilitated real-time pain recording and timely intervention among cancer patients with pain. To evaluate the effectiveness of the IPMS, a clinical trial was administrated under the supervision of healthcare professionals. The result confirmed that the IPMS was a feasible, effective, and low-cost pain management tool for cancer patients and healthcare professionals. This case provides preliminary data to support the potentials of using IPMS in cancer pain management and emphasized that the involvement of healthcare professional throughout the system development lifecycle is crucial to the successful implementation of the IPMS.