Transcript eHtM_w5
COMM 3302 eHealth & Telemedicine Shawn McCombs UH School of Communication http://soc.class.uh.edu/~smccombs 2006 UH School of Communication - Health Communication Lecture Series - All Rights Reserved Health and Medicine Online: A Diversity of Applications COMM 3302 eHealth & Telemedicine Shawn McCombs UH School of Communication http://soc.class.uh.edu/~smccombs Topics Key Terms Overview Transacting in an Online Doctor’s Office Health Info Online: Learning from Others Computer-Mediated Health Applications Web-Based Health Applications Public Services Online Key Terms •ComputerMediated Communication Systems •Efficacy •Informed Patient •Mutual Aid Groups •World Wide Web •Accommodation •IRC (web app) •ICQ (web app) •Telehealth/Teleme dicine •Database •Static Web Pages •Data-Driven (Dynamic) Web Pages •Authorware (app) •HyperCard (app) •Online Transaction Processing •PDF Major Topics: •ComputerAssisted Communication and Learning •Web-Based Communication and Learning Overview There is enormous potential for online delivery of health-related communication and services: Advice Diagnostics Information/consultation Feedback With Convergence, TV may soon play a larger role in Interactive Health Communication and Services Overview Early Transaction Services based largely on telephone communication systems Convergence and rapid expansion of computing technologies creates possibilities for health consumers Health-based Transactional Services online allow care seekers / givers to engage with medical and health professionals with relative surety While Digital Divide may prevent some Overview, Continued... •Telehealth/Telemedicine: The use of electronic and communication technology to accomplish health care and communication over distance.☤ The Doctor will “Convergence” You Now : Transacting in an online World Online Health Delivery Methods Computer-Mediated Delivery Systems - At A Glance Elements of online Transaction Processing Transactions & Multimedia Online The Internet, WWW, and DATA Transacting Online Two Primary eHealth Delivery Methods: Asynchronous - downloading PDFs - email - Discussion Boards/Blogs/Wikis Asynchronous - Online Transaction Processing - Dynamic, on-the-fly, data-driven web delivery - IM, IRC, ICQ eHealth component based on earlier telephone-based transactional systems • *Significance = methods for eHealth communication online. Transacting Online, Continued... Computer Mediated Communication Systems: - Changing the face of health communication and care... Internet WWW eMail - Online Transaction Processing closely resembles a telephone call in many ways... ...All of which opens up the realm of possibilities w/ eHealth Communication! Transacting Online, Continued... Elements of Online Transaction Processing: 1. Channel - Must have pathway for 2-way communication to exist - * The Internet & WWW make transaction processing look easy 2. Message - Must initiate a request for some kind of communication based on needs 3. Sender / Requester / Client - Must have a purpose or NEED for answers or help 4. Intermediary - Must translate between two components whom otherwise could not communicate 5. Receiver / Server - Must have the answers sender and intermediary seek Transacting Online, Continued... Examples of Online Transaction Processing: 1. Channel INTERNET - Must have pathway for 2-way communication to exist - * The Internet & WWW make transaction processing look easy 2. Message LOOKING FOR HELP WITH ... X - Must initiate a request for some kind of communication based on needs 3. Sender / Requester / Client USER (Browser) - Must have a purpose or NEED for answers or help 4. Intermediary PHP, JAVASCRIPT, ASP (Program) - Must translate between two components whom otherwise could not communicate 5. Receiver / Server SQL, MySQL, ORACLE (database) - Must have the answers sender and intermediary seek Transacting Online, Continued... Transactions & Multimedia Add Multimedia into the mix, and you have a visuallystimulating environment that can aid in the health communication process. Transaction Processing Add Online Transaction Processing as a base, the addition of multimedia and real-time, synchronous communication (video, audio, or just text) can closely simulate the real experience -- at least as close to the real thing as possible Transacting Online, Continued... The Internet, WWW, and Data: Internet holds communication infrastructure potential WWW holds application-rich transaction processing potential Vast Storage Capabilities allow for integration of information already online with virtually unlimited update capacity Medium serves as a tremendous intermediary / facilitator between care givers and care seekers I’m no Copycat: Health Info Online: Learning From Others Online Access - Old School The Web Today Versus Legacy Health Communication Delivery Methods At the Outset... •NHS example is Learning from mistakes to avoid potential pitfalls that accompany any new system: •Key Points •• Two patients died as a result of failures in NHS 24 treatment advice • Sheriff James Tierney critical of senior management in charge of NHS 24 • NHS 24 insist procedures are effective, despite the ruling Read More: http://thescotsman.scotsman.com/index.cfm?id=1058012006 Health Information Online: Learning From Others “Online” access technically not new 1980’s and the Telephone Was very difficult for lay people A bit more sophisticated, catered to medical professionals and providers Linked doctors with healthcare leadership, government services, researchers Health Information Online: Learning From Others, Continued... The Web is where it’s at: But What About Earlier Forms? Other than Internet and WWW, other forms of health communication have shown to be very successful in the past: Written Instructions (from the Doc) Pre-Printed Leaflets Telephone Monitoring, Servicing, Followups (Nursing Staff / Doctors) Computer Mediated Applications (legacy) ...but these are expensive to administer and can promote higher healthcare costs Answer: World Wide Web? Health Information Online: Learning From Others, Continued... Presumption: The act of providing people with health information leads to better health outcomes Smoking, Drinking, Drugs, Alcohol Theory of Excesses, Abstinence, Reality To what degree to social norms and pressures play into these issues? How about demographics? What does this say for health communication in general, let alone online Inside the Box: Computer As-sisted / Mediated Health Applications Computer-Based Health Apps (PreInternet) Interactivity and the User Effectiveness of Computer-Based Health Communication The Need for User-Friendly Apps Computer Mediated Health Applications Computer-Assisted Learning is not new: - Primary means of multimedia-based learning - Before that, were heavily text-based, without the aesthetics we take for granted today Early ICT-based applications ran on standalone machines, or within limited, dedicated intranets - CD ROMs and localized resource sharing - Introduced primitive interactivity to the mix linear, sequential, though relatively effective Computer Mediated Health Applications, Continued... Interactivity revisited What does it mean to be interactive? - Reciprocity Elements of Interactive Computing • 1. User Prompts and Unique Identification • 2. Variable Outcomes Based on User Inputs • 3. Dynamically-Driven Experience - based on Conditions, Loops, Sequentials Computer Mediated Health Applications, Continued... Early Computer Mediated Applications Built on Legacy Technologies: - HyperCard - Authorware - Director - Shockwave - ActiveX • ...And a host of other “programming” apps that used GUI to assemble non-linear, scripted Computer Mediated Health Applications, Continued... Fast Forward 20+ Years: Now the Web is considered as good as - if not better - Offers greater potential with same dynamic, interactive experiences... With one MAJOR advantage: Connectivity and Integration linked with people; linked to resources Dynamically-driven Web experiences allow for individualized feedback ✓ Preferred over isolation of legacy systems ✓ Web introduces M:N versus 1:1 Computer Mediated Health Applications, Continued... Integrated Computer Applications can create an autonomous virtual environment - With multiple Outcomes and Options - Can Provide “Roadmap” to care upon completion of the tutorial/application Usually offers the ability to personalize the experience - Increased likelihood of behavioral and attitudinal changes Interactivity creates “symbolic” connection with user - Participant takes ownership of session and outcomes Computer Mediated Health Applications, Continued... Resource Sharing: Using the Provider’s Time Wisely A visit to an oncologist today can almost certainly involve ICTs for communicating treatment options Saves the provider from repeating the same message over and over Can lose that “human-touch” felling, but ICTs built correctly and help by including “feel good” elements ICTs can help in treatment planning, advice, and option selections Fact-based, User-Friendly Tools a Must! Computer Mediated Health Applications, Continued... ICTs and Children / Adolescents... •...and Visual Learners Video Game theme-based ICTs work better with children, adolescents, and those who are visual learners The Comprehensive Health Enhancement Support System (CHESS) Video Games with health themes encourage family interaction and discussion More likely to be open to discussion with others Internet makes more prolific and accessible Outside the Box: Online (Web-Based) Health Applications The Many Faces of Tele-Health •Online Health Information •Patients Helping Patients (and others) •Connections: Communicating with Health Professionals Internet-Based Health Applications The Internet seen as one giant encyclopedia Because of vast quantities of text resources available Exacerbated by “Google” and “MySpace” and the like... Comes with hazards But there’s a whole lot more to the Internet than Google, AIM, and Hotmail In case you’ve missed the past 10 years... • ...Convergence! Internet-Based Health Applications, Continued... Tele-Health takes many forms and moves through many channels - Web-Based Libraries, IRC/ICQ, Online Communities, etc. - Blogs, Wiki’s, Chat Rooms, Interactive Media, Streamed Media, Podcasts The most significant advances include reaching people in remote locations who otherwise wouldn’t have access • ...Perhaps one of the greatest benefits. Internet-Based Health Applications, Continued... Convergence leads today’s Internet to Tomorrow’s iDTV... Types of Online Applications: - General Health Information - Text / Video Formats; - Health Info in Text / Audio; or, Special Topics Video; - Online Communities - Support Groups - Access to Health Professionals, diagnosis, care • ...Also advanced online resources for healthcare professionals, providers, and researchers Internet-Based Health Applications, Continued... Self-Help Sucks (Let’s try Mutual Aid) - Self-Help conjures up images of isolation Picking a “self-help” book off the shelves - Mutual Aid presents ideas of group dynamics Online Community Building - not an isolationist’s friend - Both offer autonomy and acceptance... Instead of rejection Can eventually lead to F2F or sincere introductions Internet-Based Health Applications, Continued... The Most Popular Health-Related Online Communities related to: - Addictions Chronic disease and pain Terminal illness Socially-challenging ailments Other reasons / benefits for online communities: ✓ Open 24 / 7 ✓ Mobility not an issue ✓ Convenience ✓ Alternative to awkward social intercourse Internet-Based Health Applications, Continued... Knock.. Knock... Who’s There? Not the Doc! - - While good in theory, most providers slow to adopt email and chat as a method of communication Those who do, often do so anonymously, answering asynchronous posts to discussion boards Risky to Patient - Who knows if they’re really a doctor??? But the Evidence is Strong: People Want It - In this fast-paced, connected world, people opt for convenience when possible Most surveyed WANT doctor’s email addy. Okay when used with (and not instead of) visits when necessary... Internet-Based Health Applications, Continued... Not so Fast - Often means additional work for doctor Can lead to need for additional staffing and/or reduction in office hours Add to the mix the “educated patient,” armed with conflicting information “learned” online, and now you’ve got big issues.. opens debate over empowering care seekers versus creating unnecessary extra work for medical staff •...If Patient challenges doc based on inaccurate info found online! Additional Reading, Cites: http://www.who.int/bulletin/pdf/2001/issue9/bu1338.pdf http://www.mlanet.org/press/hotquot1.html http://thescotsman.scotsman.com/index.cfm?id=1058012006 http://www.beyonddiscovery.org/content/view.pdf.asp?a=438 More To Come... COMM 3302 eHealth & Telemedicine Shawn McCombs UH School of Communication http://soc.class.uh.edu/~smccombs 2006 UH School of Communication - Health Communication Lecture Series - All Rights Reserved