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01-05-2023
Catherine Chronaki, Rita Mendes, Anne Moen
In search of a
Digital Health CompassPatient Empowerment
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Agenda - tweet #digitalhealthcompass
• Empower people - digital health compass– Digital Health Literacy to make confident decisions– Health Data Standards to use own data– Emerging solutions and policy directions
• Q&A – interaction with you all
Tell me and I forget, Show me and I may remember, Involve me and I’ll understand
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Objectives
• How can eHealth investments pay-off? – ePower: Citizens – patients, caregivers and providers
come together with standards, industry and researchers to co-create a digital health compass
• Call for joint actions by citizens, health care, informatics, policy, standards, and industry – Digital Health Literacy in the service for health for ALL
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Digital health: Gutenberg moment for healthcare
Undiagnosed disease network Patient Centered Outcomes Research Institute (PCORI)
non-profit, non-government organization
Patient powered research networks
Patients share, load to apps, donate their genomic data
• .
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The terrain is shifting• Sick care to Health• Provider focus to patient focus• Proprietary to shared• Competition to collaborative• Licensed to free• Site specific to mobile• National to global
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Examples of storing and organizing health information artifacts and spaces
Moen A, Brennan PF. Health@Home: the work of Health Information Management in the Household (HIMH) - implications for Consumer Health Informatics (CHI) innovations. Journal of the American Medical Informatics Association, 2005;12:648-56.
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Digital
literacy, eSkills
Co-creation tomorrow’s care
Health & Digital Health
Literacy
Personal characteristics
health & wellness
Health care experiences &expectations
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Digital Health Literacy
• Capacity to identify and appraise health information from multiple sources
• Make it into trusted, actionable knowledge • Relevant for me over time – my life trajectory
Achievements travels at the speed of trust
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- Use myData for knowledge and give me tools to participate in digital transforming society
- Patient & families, health professionals and health informatics join forces with research and policy to advance digital health literacy
- Health Data standards and API as catalysts
Vision – a digital health compass
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ExpertEmpower
Equity Evaluate
EvolveEducate
Engage
Enable
Searching for my digital health compass
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Digital Health: One size does not fit all !
Beyond socio-demographic aspects that challenge adoption of digital health technology, there is also behavior and segmentation• Self Achievers• Priority Jugglers• Direction Takers• Balance Seekers• Willful Endures
Learn from marketing
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Ref: Benson T, Bowman C, Potts HWW. Health Confidence Score (HCS): development and validation of a short generic questionnaire for person centred care. Submitted for publication 2015
Health Confidence The Health Confidence Score (HCS) is a short generic measure of person’s confidence to engage fully in their health and care.• Knowledge• Self-management• Access to information • Engage in decision-making
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• Knowledge and expertise to us as citizens – Resources that make sense – the relevant data – Engage – convenient – balance – targets
• Balance what really matters – Human relationships – empathy – the people – Complex knowledge based collaboration – Self care, choices and life trajectory
Moving forward
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My Data – My Decision – Our ePower
Foster patient engagement, myHealthData, tailored, adaptive and actionable health experience for individuals, families and communities.
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My Data …
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Know the effects of medication you take or not...
ePatients• Empowered• Educated • Engaged• Enabled
• information integration can help patients and care givers to improve treatment effectiveness, quality of life
• Integration with scales, glucose meters, blood pressure... All in one patient’s 360 view.
• Standards like HL7 FHIR can be the catalyst in this live integration enabling participatory medicine.
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My Decision ..
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Enhanced tailored medication information for you!Imagine yourself in a pharmacy for over the counter medicine:Walk down the corridorYour medication app suggestions are based on your health and wellness data scanning the box.Response to questions:
– is it the right medication?– Characteristics are highlighted
for the patient (e.g. Considering allergies, preconditions, etc).
– Comparison among medication poducts
ID........................
Prescribing
App
Patient App
European Medicines Database
Treatmentdata
Productdata
PersonalProduct
data
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Our ePower…
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Health eHeart Alliance• Patient-Powered Research
Network for preventing and managing cardiovascular disease
• patient-led Steering Committee – patient engagement in the design,
conduct and oversight of results dissemination for cardiovascular-focused research.
• Supported by – Health eHeart Study, platform for
data collection, study management – coalition of heart-related advocacy
groups including the American Heart Association, Mended Hearts, StopAfib.org, and Sudden Arrhythmia Death Syndromes Foundation.
Source: http://health-eheartalliance.org/
“Pioneer new ways to empower patients in improving research, care and quality of life for heart patients.”
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Maybe we should just
… Liberate the data
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eHealth Standard APIs support Just-in-time interoperability!
• Complex simple• Costly free• Specialized generic• Comprehensive simple and tools-driven
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HL7 Fast Healthcare Interoperability Resources (FHIR)
• Fast Healthcare Interoperability Resources (FHIR, pronounced "Fire") defines a set of "Resources" that represent granular clinical concepts.
• The resources can be managed in isolation, or aggregated into complex documents. Where possible, open internet standards are used for data representation.
• FHIR resources are based on simple XML or JSON structures, with an http-based RESTful protocol where each resource has predictable URL.
http://wiki.hl7.org/index.php?title=FHIRwww.fhir.orghttp://www.fhir.org simplifier
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What is FHIR? • Based on a set of modular components - “Resources”
– Resources refer to each other using URLs– Small discrete units of exchange with defined behaviour and meaning– Have known identity and behaviour– Extensions permit adding data not part of core
• Resources are combined into “Profiles” to solve clinical and administrative problems in a practical way.
– Parties exchanging data define the specific way they want to use resources and their relations using Profiles.
– Profiles are the framework for defining services.
• Exchange resources between systems– Using a RESTful API (e.g. web approach)– As a Bundle of resources (messages, documents)
• Positives– Service driven– Modify components with changing need– Portability of components by moving program code with the data
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HL7 standardization projects in mobile Health
• mFHAST– Mobile Framework for Healthcare Adoption of Short-Message Technologies – transport, structure and content
• FHIRframe– Fast Healthcare Interoperability Resources for mobile devices open API
standard• Meds-on-FHIR:
– Patient Medication Administration IG using FHIR profile• MH2F
– Mobile Health Functional Framework Standard • Consumer Mobile Health Application Functional Framework
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www.estandards-project.eu
Shaping a new standards culture for large scale eHealth deployment
• Think of a global eHealth ecosystem where:– people (digital natives and immigrants)
enjoy timely safe and informed health, anywhere around the globe
– interoperability assets fuel creativity, entrepreneurship, and innovation
• where eStandards:– nurture large-scale eHealth deployments to
strengthen Europe’s voice and impact locallyon its citizens and globally on the world
– enable co-creation in interoperability where trusted dialogs on health, costs, and plans meet great expectations.
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New competences
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Search for a digital health compass
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1. From Health Literacy to eHealth Literacy: the main determinants
2. Health mobile solutions: one way to achieve all in their pockets
3. The importance of consumers profile in eHealth Literacy and mHealth strategies
01-05-2023 45
Emerging solutions and policy actions:
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01-05-2023 47
Health Literacythe degree to which individuals have the
capacity to obtain, process, and understand basic health information and
services needed to make appropriate health decisions.
Institute of Medicine. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies
Press; 2004
Health literacy concerns the capacities of people to meet the complex demands
of health in modern society. (Sorensen et al, 2015)
Age
Social Class
Educational background
Main determinants variables that influence health literacy levels
….
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Digital Health Literacy
The ability to seek, find, understand, and appraise health
information from electronic sources and apply the knowledge gained to addressing or solving a
health problem. Eng TR. The e-Health Landscape: A Terrain Map of
Emerging Information and Communication Technologies in Health and Health Care. Princeton, NJ: The Robert Wood
Johnson Foundation; 2001.
Age
Social Class
Educational background
Main determinants variables that influence e- health literacy levels
eskills
motivation for seeking information using technologies
Health issues/diseases
engagement with electronic health resources
….
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1. From Health Literacy to eHealth Literacy: the main determinants
2. Health mobile solutions: one way to achieve all in their pockets
3. The importance of consumers profile in eHealth Literacy and mHealth strategies: an
opportunity to improve
01-05-2023 49
Agenda:
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The right Information (quality, trustable)
At the right time(allow to act when is needed to)
To the right people(regarding needs and skills to
understand)
With access anywhere
We have to promote:
Doctors AND PATIENTS knowledge based
PREVENTIVE MODEL
In a user friendly way
E/mhealth strategies
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e/mHealth strategy to tear down barriers to provide better online access to digital goods and health services.Create an environment where digital networks and services take full advantage of digitalisation, improve healthcare for the benefit of patients, give patients more control of their care, ensure sustainable health systems and unlock innovation in health markets
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Why is important to consider eHealth Literacy
and mHealth consumers profile?
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1. From Health Literacy to eHealth Literacy: the main determinants
2. Health mobile solutions: one way to achieve all in their pockets
3. The importance of consumers profile in eHealth Literacy and mHealth strategies: an
opportunity to improve
01-05-2023 54
Agenda:
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eHealth literacymHealth initiatives that help citizens make informed choices
eHealth literacy and hyper-personalization for eHealth consumers
seeking care, preserving their dignity and independence
eHealth literacy determinants
mHealth specific initiatives that help citizens to access and ahieve the right information at the right time
Hyper-personalization concept… efforts that uses personal data to point out information and knowledge, services and/or tool at the right time (Kvedar, 2015)
Privacy, Physical (IoT), Predictive, Proactive
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In the IoT era we see a plethora of tools, gadgets, and apps that promise to improve life, health, and independence. However, eHealth consumers frequently find it hard to oriented themselves in the unfolding digital reality dominated by fragmented information, data, and knowledge they don’t control. With hyper-personalization, careful selection and use of data provides for more personalized and targeted products, services, and content. For this workshop we are specifically focusing on challenges and opportunities of such hyper-personalization in view of varying eHealth literacy, lifestyle and health goals.
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Mary Ann
John
Rachels parents
Pregant
23 y
man
66 y
diabetes
caregivers
5 y
vaccination
smoker
woman
Mary Ann’s Profile apps and respective moocs to learn how
to use themHigh-degree
Examplenot exhaustive
Cancer in family
John’s profile apps and respective moocs to learn how
to use them
Children Development
Asthma
Rachel’s profile apps and
respective moocs to allow their
parents to treat her
My Health data
register
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eHealth literacy and mhealth solutions:
a Privacy, Physical (IoT), Predictive, Proactive path to improve health
Is that possible?
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