Sunday, August 30, 2009

Uses of 2nd Life in Dr-Patient Relationships

Use of Second Life (SL) for Doctor - Patient Relationships
In an article “A Survey of Health Sites in SL”, several Second Life uses related to Healthcare are discussed – Education and Awareness, Support, Training, Marketing and Promotion of health services and Research.
There are 34 places or activities in SL for dissemination of health information which include links to web sites, video, slides, search information and interactive experiences such as games and classrooms.
I can see that Second Life is especially useful for psychiatric patients. The demonstration on YouTube regarding virtual hallucinations was very interesting, if a bit disturbing. It expressed to me what it must sound like, and somewhat it feels like to have both auditory and visual hallucinations while walking through a benign environment. It was surreal to hear a voice expressing how worthless the patient is, and that they should kill themselves.
I can see that Second Life will be very useful in Patient-Provider relationships for expressing subjective symptoms such as hallucinations, but I can also see that it will be very useful for patient education. Interactive, graphical and audio presentations can be provided to those with limited reading skills.
The Healthinfo Island location was very interesting – I could spend days there looking at the information in the Consumer Health Library. What a fun way to get information!
I can also see that this would be a good way for me to check in to the Dr’s office for some specific follow-up to see how I was doing on particular learning objectives if I had a self care regimen to follow, or to meet up with other patients for support.
It may be too, that how a person creates their avatar may have some meaningful information for the physician, again, back to the psychological aspects – about body image, and why a person chose a particular avatar. (That is if the person understood how to create one – it isn’t that easy to edit once you’ve selected one). That is too, if the Dr knows who the avatar represents – anonymity is also an advantage in the virtual world.
Anonymity is especially helpful for the patient when asking questions initially about personal health information that might be difficult to talk about in person such as HIV, or perhaps a substance abuse problem.
One downside that I can see is that the patient must have access to a computer with the capabilities to download and run the Second Life software (or similar software), and the patient, or someone must help him/her be able to get it loaded and running. Or, the patient must have access to a computer that can run the software, with enough security (if it is a shared computer) to keep the patient’s login and other information secure.
As time goes on, more and more people will have that computer access, and computers and broadband access will enable use of applications such as Second Life to become more useful to more people.
Do you think that people will use Second Life for Health Care information, or to visit their physician? What are the barriers to use that you can see?

Sunday, August 9, 2009

Hello and Welcome

Hello all,

This is my first Blog, and my first public post for an important topic - that is Health Care Informatics (HI), but mostly about the people aspect that HI must address.

My goal is simple - I want to start discussions about how we can get people, both health care professionals and the lay public, including patients to feel more comfortable and confident with using computer technology in managing personal health, the health care of patients and of our population.

First of all, I'm going to borrow a definition of Health Care Informatics (or Biomedical/Health Informatics) from Dr Don Detmer, MD 2004 President and CEO of AMIA (American Medical Informatics Association)
An integrative scientific field that draws upon the information sciences and related technology to enhance the knowledge base of the health sciences to improve health care, biomedical and clinical research, education, management and policy.

Health Care Informatics as noted above is about how technology will be able to help us to improve health care - however, I would like to invite conversation about your experience as to the 'people' issues; both potential and actual barriers that we have faced in HIT/HIS (Healthcare Information Systems) implementations and the future implementations. Hopefully these implementations will lead this country (and the world) to the widespread adoption of Electronic Health Records (EHRs), and also Personal Health Records (PHRs).

In my experience I have seen problems with adoption within the healthcare community as Nurses and Doctors struggle to move away from their paper record to an electronic world. It is not just a technology phobia - as that is melting away as we all become more familiar with computers, the Internet, etc, but more fundamentally; I see a lack of understanding regarding what an EHR actually is (in part, it brings real time access to infomration) and how to make the real time access a reality. This is but one fundamental misunderstanding that I have seen affecting successful implementation of an EHRs.

For example, some clinicians who are using HIT currently continue to believe that by writing progress notes or charting data on to a paper document and scanning in to the record (sometimes at the end of the day) are activities that produce an EHR. While this may be technically true, if we don't have real time entry of discrete data, or scanning at the point of care (not ideal as it is not discrete or trendable for example), we can't come close to reaching the goals we all seek for EHRs. If our goals are to enable research, interoperability and decision support - we must all understand what it takes.

When users are frustrated with a system that doesn't provide what they're looking for when they need it - yet they don't use the technology in front of them to it's capability for discrete entry for example (it does take a little longer to input the data into a form) it's no wonder we don't have the adoption we're looking for. They're not seeing the value.
  • How can we educate our fellow healthcare providers to better understand the underlying principles so that they use the systems we implement to their potential? (and gain compliance to effective use of systems and processes)
  • Can we expect HIT to reach a point where Voice to Text, or OCR can help clinicians quickly enter standardized data that is of use to research, quality management, trending and eventually best practice?
  • What are your thoughts and experiences on this topic

I hope this is an interesting topic - I see it as a fundamental hurdle to be overcome for the adoption of EHRs and PHRs to succeed.

Thanks for listening!

Marie