weaving your way through the medical information web a survivors aaa roadmap to the medical web...
TRANSCRIPT
Weaving Your Way Through the
Medical Information WebA Survivors AAA Roadmap
to the Medical Web
Dennis Mungall , Pharm.D.Director,Virtual Education, NTPDAssociate Professor , Pharmacy PracticeOhio State University/ College of Pharmacyhttp://[email protected]
http://www.coagexpert.net/octobertalk2/frame.html
http://www.coagexpert.net/octobertalk/octoberimpatica.html
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Introduction
•Overview•Content•Communication•Patient Management•Commerce•Education on the Web
The Web is the Fastest Growing Medium...Ever
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Content Areas
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Characteristics
Medical Record Self-Care Mgmnt. References Physician Order
Entry Telemedicine Patient
Information and Education
Telecommunication
Monitoring News and Issues Telephony Case Management Database Decision
Support CME Practice Mgmnt. Scheduling
Categories of Technology Emphasis for Caregivers
Content on the Web
Where to Find Information
General Content Resources
Drug Information Resources
Pediatric Information Sites
• http://www.npan.org/• National Pediatric AIDS Network• http://kidshealth.org/• Kids Health site for consumers• http://www.aap.org/bpi/ID.html• Children’s infectious disease site
Disease and Drug Information : MD
Consult
MD Consult: Clinical Information For Physicians
Drug And Disease Sites
Welcome To MerckMedicus
Drug Information Site
Drug Information Resources: A Guide for Pharmacists
Micromedex
PHARMACY 693: NTPD Cafe - WebCT 3.8.4
Disease Specific Databases
Welcome to Medscape
Disease Databases
Diseases Database Ver 1.55 ; Medical lists and links Diseases Database
http://www.guideline.gov
National Guideline Clearinghouse
Free Medical Books and Journals
http://www.amedeo.com/FreeBooks4Doctors - Free Medical Books online
The Free Medical Journals Site
Evaluating the Literature
Appraisal Tools
eBMJ -- How to read a paper
Communication
Wired and Wireless Web
What is Mobile E-HealthCare?
“The use of mobile handheld devices to communicate, interact, and transact via always
on, high-speed connection to the Internet to manage and evaluate patient care.”
Mobile Medical Applications: The Missing Link
Paper Full EMRMobile Applications
Clinical Automation Tools which are delivered via Handheld (and potentially wireless) devices.
The Wireless Market Will Be Huge
Mobile and Internet Subscribers
By 2003 – More that 500 Million Data Enabled Mobile Phones
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MobileInternet
Mobility - The only thing growing faster than the
Internet
"We believe that the mobile phone will become the e-commerce platform of the future." Goldman Sachs, November 1999
• The ‘net’ is the virtual information megastore
• People expect instant access to information
• Much of our work and personal lives are spent on the move
• People want to be connected at anytime & from anywhere
• Worldwide adoption of wireless - portable devices is steadily increasing
Wireless Market Drivers
Future ServicesFuture Services
Be close to your customer Be close to your customer Personal ProductivityPersonal Productivity
Mobile Field ServiceMobile Field Service
• Portfolio/Account Information• Indication of Interest• Research & Alerts• Quotes• Trading/Allocation & Confirm• Analyst Reports
• E-Mail• Instant Messaging• Chat• Personal Trading• Mobile Banking• Ticketing/Entertainment• Mobile Shopping• Betting/Gambling• Games
• Alerts & Notification• Remote Monitoring• Remote Diagnostics• Telemedicine• Telemetry• Service Reporting
• Video Conferencing• Virtual Collaboration• Audio on Demand• Video on Demand
Mobile Opportunities
Wireless Technology Overview
Wireless Technology Overview
• Networks• 1G…2G…2.5G...3G
• Emerging Technologies & Standards• WAP• Bluetooth
• Devices• Smart Phones• Two Way Pagers• PDAs / Hand Held Computers• Laptop Computers
WAP: Wireless Application Protocol
• What’s so good about it• Network independent• If you have a WAP browser, you can get WAP
content…..usually• Worldwide support for WAP
A communication protocol between a mobile terminal and an IT system (Internet, Intranet, corporate IT network) providing mobile access to services and content.
Bluetooth: The Basics
• A key enabler for the mobile handset• Uses a 9x9mm microchip, requires little power or space• Enables numerous devices to communicate wirelessly• Supported by 1,500+ companies (e.g. IBM, Intel,
Motorola) who are Bluetooth Special Interest Group (SIG) members
• Intended for transmitting small amounts of data over short distances • Broadcasts in a 10 meter radius & at just 720kbps• Designed to work in a noisy radio environment• Optimized for improved security and decreased
interference
www.bluetooth.com
Wireless Glossary
http://www.tatrc.org/website_wme/documents/WMEglossary1.htm
Wireless Devices
How Can these be used in healthcare?
Comparisons
• Phone
• Pager
• PDA
• Laptop w/modem
• Mobility, Good Penetration
• Most Mobile Large Penetration, 2-Way capabilities
• Mobility, Market Potential, Better Functionality
• Large Work area, Most functionality, Market Penetration
• Small work area, Difficult input, limited uses
• Smallest work area, Difficult input, limited uses
• Small work area, Difficult input, limited functionality
• Size and Weight = least mobile
DEVICE STRENGTHS WEAKNESSES
Wireless Healthcare
• Out-patient Care Centers, Home Healthcare, Off-site Medical Facilities• Decentralization of services driven by managed care• Wireless is a remote lifeline keeping hospital nurses, home healthcare nurses, EMS
technicians and doctors in touch
• Access anytime / anywhere to:• Medical history, patient records• Medical assistance• Patient care plans• Test / lab results
• Visiting nurses• Burdened by paperwork on patients• Need to reach doctors
• Doctors• Need to be reached by
hospital and patients• Transmit prescriptions• Remote monitoring of
vitals
• EMS• Receive real time medical
support at scene of accident
Mobile E-HealthcareHow it can revolutionize the Patient Experience
• Email with healthcare provider• Online Medical Record: Personalized and Mobile
• Instant Online scheduling• Wellness Management and Disease Management• Routine and Emergency availability of data• Ordering of prescriptions and other treatments, patient
can check formulary at POC if doctor does not.• Administrative workflow: Billing, Referrals...
• Analysis of Cost-Quality Issues• I can pay more for a once-a-day antibiotic, but is it worth it to
me?• Should I get a PSA test, based on my personal risk-benefit
analysis
Mobile E-Healthcare How it can revolutionize the Physician Experience
• Mobile Email with patients and other providers• Administrative Workflow Support
• schedule, to do list, billing, referrals...
• Clinical Workflow Support• History and Physical documentation• Electronic Prescriptions and other Orders• Timely access to patient data
• Support of “Information Overload”• Instant access to Medline, PDR, other texts…• Instant access to interactive tools (e.g. risk-benefit
calculators)• Instant access to high value local information
• Regional Flu statistics, Antibiotic resistance data
Mobile E-HealthcareE-Prescriptions: A Killer App?
• Criteria to succeed with Physicians• Fast: sub-second speeds• Easy: Intuitive and Mobile• Flexible• Reliable• Integrated: PMS, Lab• Knowledgeable: Formularies, DURs• Cheap (OK- Free)
Internet Communication in the “Palm “ of your hand
Netmeeting
Windows NetMeeting Download
Conclusion
• Wireless Technology is paving the way for the next stage of the Internet revolution - and
Healthcare needs to be ready.• Smart Organizations will not simply use the
wireless Internet, they’ll help create it.
• The wireless Internet is not simply a trend, it very well may be the foundation for E-Business and E-Healthcare in the near future.
Digital Patient Care Tools
Hardware/Software
Sony Vaio
Sony VAIO® - Notebooks
Comparison of Palm Products
http://www.tatrc.org/website_wme/documents/PDAspreadsheet.htm
Tablet PCs
http://www.tatrc.org/website_wme/documents/Tablets.htm
Internet Palm Resources
Prior Health Sciences Library - Personal Digital Assistant (PDAs) Resources
Palm Based Medical Software
http://www.tatrc.org/website_wme/documents/SoftwareApps.htm
Palm Accessories
http://www.tatrc.org/website_wme/documents/PDAaccessories.htm
Mobile Health Data
Mobile Health Data | The Hand-held Health Care Authority
Mobile Healthcare Alliance
Mobile Healthcare Alliance (MOHCA)
Hand Held Trade Offs
Use of Mobile Devices in Healthcare
Warfarin Palm Study
palmemulatorpptaudio
Health Education Web Sites
Evaluation
Evaluating Health Sites
Evaluating Health Care Sites
Evaluating Asthma Web Sites
An Evaluation of the Quality and Contents of Asthma Education on the World Wide Web
Donita R. Croft MD, MS 1
Michael W. Peterson MD, FCCP 1
1 Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA.
Asthma Web Site Evaluation
Study objectives: To measure the accessibility and quality of currently available asthma education World Wide Web sites using the following criteria: accessibility by readability, language, and download time; information quality based on inclusion of core educational concepts and compliance with Health On the Net (HON) principls; and utilization of innovative technology.
Design:Objective evaluation of 145 Web sites.
Content Evaluation
General Principles
General Principles
General Principles
General Principles
Results
Measurements and results: Four search engines or directories (Yahoo, HON, Alta Vista, and Healthfinder) were searched for “asthma, patient information.”A maximum of 50 Web sites from each search engine or directory was evaluated. Only 90 of the 145 Web sites actually contained asthma educational material. The mean (± SD) time necessary to open each Web site on a 28.800-bits-per-second modem was 33.6 ( ± 36.6) s.
The mean number of graphics on the Web sites was 24.6 ( ± 30.2) files per page. The educational material required a mean reading level beyond the 10th grade. Only nine Web sites contained multilingual asthma education material. The mean number of HON principles with which the Web sites conformed was 6.3 ( ± 1.0) of 8 principles; 14 Web sites conformed to all the HON criteria. The average Web site contained 4.9 (± 2.5) of 8 core asthma educational concepts, and only 20 Web sites contained all 8 educational concepts. Very few Web sites utilized innovative educational technology.
Conclusions
While patient asthma education Web sites are common, asthma educational material contains many accessibility barriers, is highly variable in quality and content, and takes little innovative use of technology. Patient educational material currently available on the World Wide Web fails to meet the information needs of patients.
Breast Cancer Project
Beth Alison Novak, M.S.Master’s ProjectPeter Kwok Chan, AdviserDr. Elizabeth SandersDr. Dennis Mungall
Breast Cancer Project
Breast Cancer Project
Breast Cancer Project
Breast Cancer Project
Patient Education Web Sites
Examples
Home Infusion Web Site: Sue Mashni, R.Ph.
Home Infusion Therapy
Mulitple Information Sites for Consumers
Consumer Health Resources
Healthology
Healthology : Health Topics
LillyDiabetes.com
Lily Diabetes Site
LifeScan Diabetes Care -- Diabetes Essentials
Lifescan Diabetes
Mayo Clinic
MayoClinic.com - Medical and health information for a healthier life from Mayo Clinic
PersonalMD.com-YourLifeline Online
PersonalMD
Patient Management Via the Web
http://www.coagexpert.net/clinic
Virtual Anticoagulation Clinic
Health Hero
Welcome to Health Hero Network
Health Buddy
Health Buddy
Health Buddy
Health Buddy
http://www.informedix.com/overview.htm
MediMonitor
Library
Telemedical
Point of Care Coagulation Monitors
http://www.coaguchek.com, http://www.devicelink.com/mddi/archive/00/04/009.htmlhttp://www.pointofcare.net, http://www.itcmed.com,http://www.hemosense.com/
Timex - BodyLink
Timex Bodylink
Timex Ironman
Telemedicine
Commerce
Using the Web for HealthCare Business
What to Do with a Web Page
• Market (Virtual Welcome Wagon)• Inform (Hours, Staff, Services, Location)• Sell (HBA, OTC, DME, Comp. and Alt.
Medicines, Services, Specials/Promotions)• Communicate (Refills, POE, DSM, Feedback,
IVR, Chats, Ordering)• Educate with Health Content and Links
Why should I put my practice on the Internet?
You can put information on your site for prospective patients
Patients can access your Internet site 24 hours a day, 7 days a week
You can provide information on your Internet site for your existing patients
If you prefer, you can answer questions from patients through E-mail
There are no incremental costs, such as postage or printing
You can include maps on your sites that help patients find you
You can post newsletters on your site, thus saving money.
My Web-site, what do I need?
You need three things:• 1. A Domain-Name• 2. Web-Space (Hosting Service) • 3. A Program, which can save your
documents in HTML.
Example : WWW.Bigstep.Com
www.clinpharmacologist.bigstep.com
Registering your web address
Professional Education on the Web
Objectives
• Review Education on the Web• Demonstrate Web Based Education• Discuss possible outcomes of a Web
Based Program
Consistency
• Design a common interface for all courses
• Use common , identifiable elements for video , audio , and text feedback
Developing the Feeling of “Being on Campus”
• How do you replace the classroom?• Does the internet reduce the student to
student interaction• Email, Bulletin boards, Virtual Class
rooms• Identify faculty and students with their
personal web pages that can include audio, video, text information
Faculty Training
• Faculty need to become proficient in creating web based presentations
• Learn how to use communications technologies to communicate with students: email, chat room, live video on the web to communicate
• Have a clear understanding of the advantages of online learning e.g. increase communication , highly visual medium, speed of learning fit to the student, time of learning set by the student
• Clear understanding of disadvantages: slow online access, maintaining student motivation, not the same as a real classroom
Student Training
• Online training, CD ROM, on campus training session
• Each student needs basic computer skills• When course implements new technology,
training of students and faculty critical
Academic Concerns of WWW
• Loss of personal, face to face interaction• Cheating• Student tracking issues• Possibility of a decrease in professional
respect for online graduates
Potential Academic Benefits
• Opens up the ability to implement CQI to the educational process
• Opportunity to perform educational research to evaluate impact of the educational process
• Allows implementation and assessment of newly developed , online clinical tools for patient care
• Much finer control of the students progress via instantaneous , online assessment and feedback
Potential Financial Benefits
• Use the medium to innovate in clinical practice
• Develop and test teaching, patient management tools that have general value
• Develop online teaching that serves the Professional program and can be modified for continuing education on-line
General Capabilities of a WWW Educational System
• Outcome Assessment• Student Tracking• Lecture Notes/Slides/Audio/Video• Assignments• Course evaluation
Academic Issues
• Allow a number of development tools that reflect differences in courses and teaching styles
• Intellectual Property issues
