implications of information technology and consumer participation in health care patricia flatley...
TRANSCRIPT
![Page 1: Implications of Information Technology and Consumer Participation in Health Care Patricia Flatley Brennan, RN, PhD, FAAN Moehlman Bascom Professor School](https://reader035.vdocuments.net/reader035/viewer/2022070406/56649e045503460f94aef959/html5/thumbnails/1.jpg)
Implications of Information Technology
and Consumer Participation in
Health CarePatricia Flatley Brennan, RN, PhD, FAAN
Moehlman Bascom Professor
School of Nursing and College of Engineering
University of Wisconsin-Madison
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Challenges and Changes
in Health Care Delivery
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Changes in Health CareShifting responsibilities, shifting
costs, shifting valuesShortened Length of StayEmphasis on evidence and
outcomesBroader idea constitutes health
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What is health care & who’s involved?
Patient
Professional
Disease Self Help Self Care Management
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Patients are
Changing, too!at least some of them
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Transitions in our view of patients
From ‘flat and silent’
To Collaborative Problem Solvers
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What makes patients change?
clinical recognition of the importance of patient participation
social valuing of autonomy, self-help and self-determination
withdraw of previously-delivered service changing cost model
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Moving the site of care
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Contemporary Health Care rests on a
successful partnership betweenPatients, Clinicians, and Delivery
Systems
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Consumer Health Informatics: Putting Information Resources in the
hands of Consumers
Accepted and Alternative Health General Health Information Personal Health Data
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Delivering CHIBroadcast and print mediaThe InternetHealth-related WWW sitesSelf help BBS, Listsrvs & e-mail
groupsFreestanding kiosks, CD-ROMs, and
SmartCards
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Evaluating CHI
Perspectives: Credentialling sites or Educating consumers
Involved groupsODPHP Scientific PanelHITI, Inc (Mitretec)AMIA Internet Working Group
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CHI JIT Y2K
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SMART Patients
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SMART Patients Self-assured Motivated Aware Resourceful Talented
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Remember they may also be:
Scared Minors!
Anxious Reluctant Time consuming
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Common behaviors of SMART patients
self triagevalues and preference clarificationparticipativecollaborativeindependently engage in health
promotion
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What they aren’t :complacentquietunchallengingsimilar
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SMART Patients: Who needs ‘em?
we do!Why? partners in careClinicians have too much to do episodic nature of care doesn’t work
any more
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Clinician’s responses to the SMART patient:
engaging tolerant dismissive condescending
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The Challenges for Clinicians
Use technology to help make patients smarttreat them as a resourceChange our practice activities to capitalize
on their talentsReorganize our practice environments
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What are we expecting patients to do?
case managemonitorperform therapeuticsinitiate conversation with us
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Information tools needed:
access to their clinical recordsPersonal Case Management
toolsCHI and assistance with using
it (access, interpretation)
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Clinical Practice IssuesHenderson “...what the patient can
do...”Re-examining every actionTrusting our colleaguesTiming of interventions
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Clinical RolesContent ExpertEnvision a clinical practice that
makes use of the patient as a resource
Re-organize care and care activities to incorporate patients
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Constructing a Health Care Delivery
System responsive to
SMART Patients
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Clincial Systems Issues
Collaborative with other disciplinesreciprocity of change
Practice StandardsOptimized work patternsIncentive Structures
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Information Systems Issues
Patient-centered careLanguage:
Data relevant to all care providersMapping from professional to vernacular
Inter-organizational communicationSecurityCost model
Clinical information systems integration
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InformationTechnology’s Response
Patient- Centered Systems
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Patient-Centered Systems
Clinical Records Network CommunicationConsumer Health
Informatics
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Clinic
Hospital
Physician Office
Pharmacy
FurtiveRecords
Dentist
Patient-Centered Information Systems
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What can you do differently tomorrow?
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There are degrees of SMART!
Not all patients are equally SMART -- nor are they smart in the same way
but we must seek that which is SMART in each patient
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Seen any ‘SMART’ patients lately?
...they’re there,
everywhere!
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