Health Literacy and Consumer-Facing Technology Workshop Summary (2015) / Chapter Skim
Currently Skimming:
4 Catalyzing Widespread Informed Engagement
4 Catalyzing Widespread Informed Engagement
Pages 43-62
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 43... ...
An open discussion moderated by Bernard Rosof followed the three presentations. CONSUMER-GENERATED HEALTH INFORMATION: PROVIDER "READINESS," ATTITUDES, AND SKILLS1 Patient-generated health information, explained Patricia Dykes, is health information that is created, recorded, gathered, or inferred by or 1 This section is based on the presentation by Patricia Dykes, senior nurse scientist and program director for research in the Center for Patient Safety Research and Practice and the Center for Nursing Excellence at Brigham and Women's Hospital and assistant professor at Harvard Medical School, and the statements are not endorsed or verified by the IOM.
|
From page 44... ...
Patient-generated data can also provide the care team with access to the patient's problems, concerns, goals, and preferences, which can then improve the care plan concordance between patients and the care team, Dykes explained. Given that research has shown that when providers pay attention to patient-generated information it improves engagement and activation ( ibbard and Lorig, 2012)
|
From page 45... ...
At Brigham and Women's Hospital, for example, physicians and nurses engage care partners who are communicating for patients who are in intensive care and oncology units. Assessment skills are also important when it comes to determining how health literate a particular patient may be, and the outcomes of these on-the-spot assessments should determine the types of tools that the care team uses with a particular patient.
|
From page 46... ...
Its goal is to optimize the overall experience of patients and care partners by facilitating engagement, improving care plan concordance, promoting dignity and respect, and enhancing satisfaction. The first of two important components to the intervention is the Patient SatisfActive Model, a structured team communication model that tries to improve patient experience and satisfaction in real time by giving providers the skills, tools, and workflow to improve communication between clinicians and patients and their family members.
|
From page 47... ...
In conclusion, said Dykes, patient-generated health information can be used to inform care decisions and to promote shared decision making. "It is important that we first recognize the value of patient-reported health information and that we consider what the impact is going to be on workflow and address that as part of the project," she said.
|
From page 48... ...
Forecasts project there will be some 68 million users of wearable electronic fitness monitoring devices worldwide in 2015 (Gartner, 2014) , and that more than 70 million personal health and wellness devices will be sold in the United States alone by 2018, generating more than $8 billion in product sales and service revenues.
|
From page 49... ...
Money is a big one, and potential sources include employers, payers, providers, and accountable care organizations. As an example, Ricciardi described the Welltok Health Platform, an app that employers can offer that gives people incentives such as coupons based on adoption of healthy behaviors.
|
From page 50... ...
Funds for this project are part of a major infrastructure investment by the Agency for Healthcare Research and Quality (AHRQ) through the Health Information Technology for Economic and Clinical Health (HITECH)
|
From page 51... ...
A report from the PricewaterhouseCoopers Health Research Institute stated that 47 percent of consumers agree that mobile devices can be used more effectively to coordinate care, and that 65 percent of consumers with one or more health apps on their mobile devices use them at least once weekly. Half of the consumers surveyed said they would be likely to use consumer devices to perform self-evaluations and 56 percent said they would be comfortable having their health data shared if doing so would improve care coordination (PricewaterhouseCoopers, 2014)
|
From page 52... ...
There is no comprehensive framework for health information privacy and security, Rein said. Although this has been said many times, it bears repeating, she explained.
|
From page 53... ...
Consumer participation in research or voluntarily donating data for research is another health literacy–sensitive area that holds a great deal of promise for generating advances, particularly in light of the release of Apple's research kits. In addition to looking for "terms of use" and privacy statements and determining if their own data are accessible, consumers need to assess the value of participation in a given research project.
|
From page 54... ...
"Again, going out on a limb and being a bit provocative, this may be an opportunity where regulatory and/or policy solutions are needed." DISCUSSION Bernard Rosof started the discussion by asking panelists to comment on the key challenges they see in getting consumers to sustain their use of consumer-facing technology and on getting providers to use the data generated by their patients' use of the technology. Rein said that one general rule regarding consumer sustainability is that the technology needs to be easy to use without changing the consumer's workflow.
|
From page 55... ...
Bringing up the concept of behavioral economics and the way in which incentives were used with meaningful use, Rosof asked if a similar approach was going to be taken to encourage uptake of consumer-facing technology. Ricciardi predicted there will not be a meaningful use program for consumer health information technology.
|
From page 56... ...
"Then there are endless opportunities for far larger sample sizes than we have enjoyed in prior research efforts. Obviously, that means there is another set of methodological and other issues that are going to be triggered." Ricciardi commented that Apple, because of its cache among con sumers, is helping to put health on the map for the average person even though the average Apple user tends to have a higher income because the products are more expensive.
|
From page 57... ...
On one side is an individual's listening and comprehension skills, while on the other side is the health care provider's speaking and explanatory skills. "One cannot measure someone's listening skills without measuring the speaking skills, and one cannot measure literacy skills without understanding the difficulty and complexity of the various texts," she explained.
|
From page 58... ...
" Earnestine Willis, the Kellner Professor in Pediatrics and director of the Center for the Advancement of Underserved Children and of Health Equity and Urban Clinical Care Partnerships at the Medical College of
|
From page 59... ...
"In this project, we are trying not just to enroll the patient, but also to ask the patient who else can work with you to make sure that when you are not feeling well that we can still further your care plan and make sure that your goals are achieved," explained Dykes. She added that this is an attitude shift that she hopes is being communicated to the community, that Brigham and Women's Hospital is taking the time to not only engage the patient, but to make sure that others in the community are working with patients when they go home to further their care plan.
|
From page 60... ...
In a PCORI-funded project aimed at preventing falls, Dykes and her colleagues are running a clinical trial at 10 sites across the United States that involves a health information technology intervention. Nurses serve as fall care managers and make sure that patients receive and understand their assessments and tailored plans.
|
From page 61... ...
"If we could just get out the word that HIPAA at a minimum guarantees you the right to get your own health information and that you can then share it with anyone you want," said Ricciardi. "I think if that understanding were more prevalent, HIPAA need not be such a barrier to the flow of information." Rein noted that there is little reason for any institution not to share information with another HIPAA-covered entity, but that is not how the HIPAA regulations are interpreted.
|
From page 62... ...
Ricciardi, while acknowledging that she is not a FERPA expert, said she believes FERPA has right-of-access provisions similar to those in HIPAA -- that people have a right to their data. "Maybe, just like with Blue Button and health information in general, the individual is part of the solution here," said Ricciardi.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.