The patient Empowered – With power comes responsibility

Olivier LAURENT - CEO at Coligane group

With power comes responsibility

Healthcare is now being seen in a totally different perspective. Patients are not afraid to visit a physician or undergo a surgery as in the previous decades. With the use of online health tools, the patients are able to have a clearer awareness about the benefits and drawbacks of the treatments that they will be undergoing. With knowledge comes confidence and power and with power comes responsibilities. The virtual world created by the Health 2.0 has several advantages and limitations. Proper utilization of these facilities is required to ensure the best outcomes. ^{1, 2}

Patients who have access to internet should ensure that the information they are obtaining is from an authentic source. They should respect the doctor’s role in the diagnosis and treatment decisions and should discuss rather than direct the doctor towards a particular treatment or diagnosis. The patients should also ensure that they do not pass biased reports about treatment procedures, doctors or health institutions. Patients with chronic disorders must always encourage the newly diagnosed patients to meet appropriate healthcare providers for a thorough evaluation. The information accessed through the internet should not be blindly passed on as authentic information. With the newly vested powers, patients, especially those who use the Health 2.0 applications more widely, should ensure that the overall healthcare status improves and more number of people are able to avail the best possible healthcare facilities all over the world.

References

1. Fieschi M. Information technology is changing the way society sees health care delivery. Int J Med Inform. 2002 Nov 20; 66(1-3):85-93.
2. Penson RT, Benson RC, Parles K, Chabner BA, Lynch TJ Jr. Virtual connections: Internet health care. Oncologist. 2002; 7(6):555-68.

The Patient Empowered – Patient as a partner

Olivier LAURENT - CEO at Coligane group

Patient as a partner

In the initial periods where medical knowledge was limited only to the healthcare professionals there was a gap between the patient and the healthcare provider wherein healthcare provider was at a much higher level than the patient. The advents in the science of communication technologies have been able to bridge the gap between the patient and the healthcare providers.
The patients are now being looked at as partners who provide valuable feedback for the betterment of healthcare facilities rather than just being the receivers. The reports about the popularity of the treatment protocol, its adverse effects and its benefits are now being used to facilitate improvement in the field of healthcare. The feedbacks about hospitals, doctors and other health related activities has helped hospitals and research agencies to design drugs and treatment protocols accordingly.1, 2
Several studies have revealed that empowering patients to act as co-producers in managing a condition or disorder can improve the outcome of the disorder.3 Training of hospital staff to improve communication with patients are now being practiced in several healthcare establishments. Considering patients as partners has enabled the doctors and other healthcare providers achieve a better outcome from the treatments being administered.

References

1. Haidet P, Kroll TL, Sharf BF. The complexity of patient participation: lessons learned from patients’ illness narratives. Patient Educ Couns. 2006 Sep; 62(3):323-9. Epub 2006 Aug 2.
2. Bogart LM, Uyeda K. Community-based participatory research: partnering with communities for effective and sustainable behavioral health interventions. Health Psychol. 2009 Jul; 28(4):391-3.
3. Trummer UF, Mueller UO, Nowak P, Stidl T, Pelikan JM. Does physician-patient communication that aims at empowering patients improve clinical outcome? A case study. Patient Educ Couns. 2006 May; 61(2):299-306. Epub 2005 Jun 20.

The Patient Empowered – Information retrieval and social networking

Olivier LAURENT - CEO at Coligane group

Information retrieval and social networking

The internet is now being used by many individuals for retrieving health information. It has enabled patients with internet access to learn more about their condition by logging on to a wide range of health websites. Most of the hospitals, healthcare institutions and the governments have their own web pages where in information about various disorders are updated on a regular basis. Information is also available in the form of audio/video clippings that explain the health procedures. This helps in increasing the confidence about various procedures as knowing about the procedure tends to reduce the anxiety associated with it.
Several applications such as facebook, eblogger, LinkedIn etc have enabled patients to form a network of individuals with similar disorders or health concerns. The patients are now able to freely discuss most of the subjects that were considered a taboo. Social networking has enabled patients to connect with likeminded individuals and share information about their health and illness. Patients with chronic conditions are now acting as light bearers for the path towards better health. Such patients tend to make the maximum possible utilization of the Health 2.0 applications. Interactive forums are often created by such individuals to encourage discussions about a particular disorder or health in general. The patients can now weigh their options and discuss their concerns with ease.1, 2

References

1. http://www.heartland.org/publications/health%20care/article/24681/Health_20_Empowers_Patients_Challenges_Status_Quo.html
2. Anderson AS, Klemm P. The Internet: friend or foe when providing patient education? Clin J Oncol Nurs. 2008 Feb; 12(1):55-63.

The Patient Empowered – Wider options for patients

Olivier LAURENT - CEO at Coligane group

Wider options for patients

The patients in this modern world of improved methods of communications have opened up a wide range of options in the field of healthcare. Options include knowing more about the disease status, discussing about the outcomes of treatment with others who have undergone similar procedures, choosing the treatment option that he feels best, selecting the healthcare provider of his choice for the treatment, report any discrepancies in the treatment or any adverse event noted to the concerned authorities, the list goes on. While this has increased the knowledge of the patients in terms of disease and treatment, it has also eased the doctor’s role in explaining about these aspects. The patient is now able to be well informed before undergoing a treatment and make a choice in an easier and confident way.^{1, 2}

References

1. Schwitzer G. A review of features in Internet consumer health decision-support tools. J Med Internet Res. 2002 Apr-Nov; 4(2):E11.
2. Meijer WJ, Ragetlie PL. Empowering the patient with ICT-tools: the unfulfilled promise. Stud Health Technol Inform. 2007; 127:199-218.

The Patient Empowered – Overview

Olivier LAURENT - CEO at Coligane group

Overview

A few decades ago, an individual who was sick could not do much more than speak to his friends over the phone or meet them personally and physically visit a doctor to find out what’s wrong with him. Today, not only can he make his own provisional diagnosis but he also can obtain a doctor’s consultation at the click of a button in the comforts of his home. That’s what technologies such as health 2.0 have done to the today’s patient. It has enabled the patient to obtain a wide variety of services on the health front. It has made the patient powerful; powerful enough to choose the treatment and also choose the healthcare provider. The empowerment of the patients has bridged the long existing gap between the patients and the healthcare providers. The patients are now able to interact with their physicians in a better manner than before. The empowerment of the patients has made doctors and other healthcare providers to be more considerate and responsible while making the diagnosis or planning the treatment strategy. At the same time patients must use this power entrusted in them in a responsible way to improve the health status all over the world.

Patient Adherence and Retention Programs – Health 2.0 and adherence

Olivier LAURENT - CEO Coligane group

Health 2.0 and adherence

The improvements in the field of information technology has brought with a number of benefits. One of the aspects is improved communication. People are now able to communicate with each other more frequently and are able to exchange a variety of information. The ability to contribute to the websites and raise queries regarding various aspects has helped the healthcare field a lot. The introduction of concept of Health 2.0 has revolutionized the healthcare field. The developments in this field have helped patients to adhere to the advised treatments.

Role of patient communities

The core feature of Health 2.0 is the ability of the patients to form online social networks and seek and share health information. There are several websites that provide information about various aspects of disorders such as the causes, diagnosis, treatment options, and complications. Such information helps the patients to understand the disease process and comply with the treatment. Online patient communities have become common joints to discuss about the treatments and the benefits of treatments. Individuals are now able to discuss more freely about the disorders and clear their doubts about various aspects of the treatment from other individuals who themselves are taking similar medications. There are several communities that specifically discuss in detail about one particular disorder such as diabetes, heart disorders, etc. Such communities induce a positive look towards the outcome of treatments and encourage patients to continue with the treatment protocols.¹

Better interaction, better adherence

As stated earlier more than half of the patients forget the instructions about their prescriptions. With the introduction of concepts such as Health 2.0 patients can now consult with their physicians online and obtain additional information about their treatment and also plan future appointments. Repeated instructions about the prescription drugs help the patients to remember the dosages and frequency of their medications. Patients can also set reminders on their personal computers or interactive mobiles to remind them about the medication.

It is also possible for doctors to monitor the progress of their patients online with several tools available. One such study which studied web based diabetes management reported that there was a significant improvement in the blood glucose levels in patients who followed this program. Further, the study also reported that such online programs saved time and cost of treatment.²

Interactive methods

There are several methods through with Health 2.0 is improving patient adherence and retention programs. One of the commonest is the use of online monitoring systems such as internet-based glucose monitoring system (IBGMS) wherein the patients enter their blood sugar values at the comfort of their home and avail automatic responses regarding the improvements or contact a healthcare provider based on the values obtained.³

Several hospitals have made the information chart available online so that the patients can download them, fill it up at home and bring it along while coming for consultation. This saves the time spent in the consultation area. Patients are also able to book an appointment online which is of great use in patients who need repeated visits.

OLDES (older people’s e-services at home) is software that targets elderly population who are not able to visit their physicians on a regular basis for consultation purposes. The users of this program can enter values about their blood sugar levels, blood pressure measurements and food intake and obtain an instant review of their condition. It was noted to be quite effective wherein the patients adhered to the treatment procedures.⁴

There are several other similar applications that are being introduced in the recent decade. With more and more people becoming internet savvy, the amount of internet use is on the rise. This has eased the provision of healthcare and improved patient adherence and retention programs.

Concerns with Health 2.0

While the number of users who are going online is on the rise, a substantial number of people still do not have access to a computer or internet. This has limited the popularity of applications such as Health 2.0. Further constraints are noted relating to the age of the individuals, lack of computer knowledge, illiteracy and negligence towards newer technologies. These are some of the factors that restrict the use of Health 2.0 to improve patient adherence.

Nevertheless, Health 2.0 has been proven to be an effective tool in improving the patient adherence and retention programs in this fast paced world that is going on to the next level of communication. A number of other interactive programs are being developed that would take the healthcare to higher levels which would not only reduce the cost of healthcare but also reduce the number of deaths related non-adherence or other causes.

References

1. Bleicher P. Health 2.0: Do It Yourself Doctoring. [updated: Oct 2008; accessed: Nov 2009]. Available at: http://appliedclinicaltrialsonline.findpharma.com/appliedclinicaltrials/Technology+Viewpoint/Health-20-Do-It-Yourself-Doctoring/ArticleStandard/Article/detail/556205?contextCategoryId=554
2. Azar M, Gabbay R. Web-based management of diabetes through glucose uploads: has the time come for telemedicine? Diabetes Res Clin Pract. 2009 Jan;83(1):9-17. Epub 2008 Dec 3.
3. Cho JH, Lee HC, Lim DJ, Kwon HS, Yoon KH. Mobile communication using a mobile phone with a glucometer for glucose control in Type 2 patients with diabetes: as effective as an Internet-based glucose monitoring system. J Telemed Telecare. 2009;15(2):77-82.
4. Novak D, Stepankova O, Mraz M, Haluzik M, Bussoli M, Uller M, Maly K, Novakova L, Novak P. OLDES: new solution for long-term diabetes compensation management. Conf Proc IEEE Eng Med Biol Soc. 2008; 2008:4346-9.

Patient Adherence and Retention Programs – Overview and factors affecting adherence

Olivier LAURENT - CEO Coligane group

Overview

Several factors decide the success of the treatment for any disorder. One of the major factors is the patient compliance and adherence to treatment. While the healthcare providers can ensure adherence to treatment when the patient is admitted to a hospital, they cannot control the behavior of the patient at home. A patient needs to be committed enough to follow the instructions about medications to be consumed and other related factors advised to ensure faster healing. Studies have reported that every year about 125,000 individuals with heart disorders die due to non-adherence to treatment. Another study reports that about 29% of the European patients do not consume the medications or follow the treatment instructions prescribed to them.^{1, 2} The popularity of Health 2.0 applications has been noted to gradually improve the adherence to treatments and retain patients in different treatment programs.

Factors affecting adherence

It has been reported that only 50% of the patients who leave a physician’s office with a prescription take the advised medication. There are several factors that are associated with non-adherence to treatment. In more than 70% of the cases, the non-adherence is intentional. This is commonly due to the belief that the medication would not relieve the condition. Patients suffering from long term disorders are the ones who commonly fail to take medicines on a regular basis. Other factors reported include: lack of motivation, fear of side effects, denial that the disorder can cause serious effects, forgetfulness, financial restrictions, not understanding the instructions, and reduction in symptoms.¹

References

1. Merck Manual. Adherence to a Drug Regimen. [updated: Nov 2005; accessed: Nov 2009]. Available at: http://www.merck.com/mmpe/sec20/ch302/ch302b.html#CHDDCJID
2. Hawthorne AB, Rubin G, Ghosh S. Review Article: Medication Non-Adherence in Ulcerative Colitis — Strategies to Improve Adherence With Mesalazine and Other Maintenance Therapies . Alimentary Pharmacology & Therapeutics. 2008;27(12):1157-1166.

Health 2.0 – Status and trends – Future trends and concerns

Olivier LAURENT - CEO Coligane group

The rapid increase in the popularity of health 2.0 has attracted a number of players into the virtual world. Patients, health care providers (from all fields), medical institutions (including hospitals and other healthcare facilities), pharmaceutical industries, government organizations and non-government organizations are all using the web portal to improve the healthcare industry and provide better healthcare to the consumers. The health 2.0 is all set to become a powerful tool for both the consumers and the providers.

The concerns about the authenticity of the data and the role of bias in promoting healthcare products can affect the further growth of health 2.0. Other matters of concern include the privacy of the patient data, excessive promotion of certain drugs, interference with provision of treatment (patients may enter into debate with the choice of treatment) and certain other medico legal concerns.

Health 2.0 should be used to improve the quality of healthcare and bring about awareness about various diseases that can be effectively treated or prevented. It is a very powerful tool that will empower both the patients and the healthcare providers and needs to be used with caution.

Health 2.0 – Status and trends – Impact on healthcare

Olivier LAURENT - CEO Coligane group

The introduction of the user-generated healthcare (or the health 2.0) has empowered the patients to a great extent. The users have changed from consumers of information that was available in the internet to generators of information.¹ This is especially true in case of individuals who have been suffering from chronic disorders. Patients are also able to access their health records in the form of electronic health records (EHR) which enable them to visit a doctor of their choice without having to wait for the healthcare providers to transfer the information.

The trend has been noted to move from advised care to self care with the ability of the patients to maintain personal health care records that contain self documented and self obtained information or observations. This has helped the patients to form their own diagnosis and treatment options and become active participants in the process of disease identification and management.^{1, 2}

An interesting finding was noted in a study conducted in England wherein the physicians and nurses reported that many patients brought health information obtained over the internet for their consultations. This practice was noted to lengthen the consultation time. Although many of the nurses believed that bringing such information helped the consultation process they also considered that such information was off-putting in many instances. ³ This trend is expected to grow as the awareness about ICT expands further.

References

1. Randeree E. Exploring technology impacts of Healthcare 2.0 initiatives. Telemed J E Health. 2009 Apr; 15(3):255-60.
2. Marsh AJ, Biniaris CG, Karanasiou IS, Carroll D. Social prospecting. Stud Health Technol Inform. 2008; 137:321-7.
3. Dilliway G, Maudsley G. Patients bringing information to primary care consultations: a cross-sectional (questionnaire) study of doctors’ and nurses’ views of its impact. J Eval Clin Pract. 2008 Aug; 14(4):545-7.

Health 2.0 – Status and trends – Frequent users

Olivier LAURENT - CEO Coligane group

Studies have evaluated the frequent users of web based information for obtaining information. It was observed that majority of the patients or their care-givers accessed information through the internet access available at home or work. Individuals who were well educated and young were the most common users of internet based applications.² Middle aged individuals were more commonly involved in answering the queries on health. Healthcare websites offering information about the treatment, especially those related to tumors and elective surgeries were most commonly visited.^{1, 2}

References

1. Trotter MI, Morgan DW. Patients’ use of the Internet for health related matters: a study of Internet usage in 2000 and 2006. Health Informatics J. 2008 Sep; 14(3):175-81.
2. Välimäki M, Nenonen H, Koivunen M, Suhonen R. Patients’ perceptions of Internet usage and their opportunity to obtain health information. Med Inform Internet Med. 2007 Dec; 32(4):305-14.