HI 630 - Week 11

What 3 implicit themes emerge in the analysis of various definitions of CHI?

(!) did not exist until computers/internet were available (2) only pull of information by consumer (3) dependent on experts to create and make content available -a- consumers do not seek information for understanding disease or illness -b- solitary and personal activity -c- information that is available in a searchable repository

What 5 things can be attributed to lower literacy skills?

(1) English as a second language (2) years of education completed (3) ethnicity or race (4) physical, mental, and health conditions (5) age over 65

What are 5 examples of trusted sources for online health information?

(1) MedlinePlus Gudie to Healthy Web Surfing (2) Finding Reliable Health Information Online (3) Evaluating Health Information (4) MedlinePlus Quality Guidelines (5) Medical Library Association List of 100 Websites You Can Trust

What are the 4 main topics most frequently accessed by consumers according to PEW's 2012 study?

(1) specific disease or medical problem (55%) (2) medical treatment or procedures (43%) (3) weight control or loss (27%) (4) health insurance (25%)

What have been the results of patients becoming engaged and informed regarding their health? (according to ONC and their promotion of health IT)

- increased emphasis on patient engagement - decreased number of hospital stays - reduced morbidity and mortality rates - increased patient compliance in treatment of chronic diseases - increased quality of life - reduced overall costs - maintaining (sometimes improving) quality of care

When was the initial version of the HON Code of Conduct (HONcode) published? When was it revised?

- initial: 1996 - revised: 1997

Describe the mindmap of CHI

- left side: reflects the process for analyzing the explicit themes (concepts that can be clearly expressed and included identifying major categories to be considered) - right side: reflects the process for analyzing the implicit themes (identifying aspects that are not as readily apparent and may come from brainstorming in addition to the review of definitions)

What are some features of a patient portal?

- record of healthcare visits - discharge summaries - medication - immunizations - allergies - laboratory results - secure e-mail exchange with healthcare providers - prescription refill requests - scheduling of appointments - verification of benefits and coverage - update contact information - make payments - download and complete forms - access education materials

numerical (computational) literacy

- the ability to calculate or reason numerically - example of the need for this can be found in an understanding of body mass index calculations or if drug dosing may call for calculations

literacy

- the ability to read and write - using printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential

visual literacy

- the ability to understand graphs or other visual information - for example, the consumer may need to understand a graph trend line of lab results

In what decade was health literacy introduced as a concept?

1970's

According to a 2015 Pew survey of internet users, what percentage of people had searched online for health information within the past year?

84%

Check Your Understanding 15.1 (T/F) 4. The increased use of smart phones has no effect on the digital divide.

False; Widens the digital divide

Check Your Understanding 15.2 (T/F) 5. Information maintained on smart phone applications has no relationship to the PHR.

False; applications can facilitate the patient maintaining information such as weight, BP, and blood sugar results (can be important to patient's PHI)

Check Your Understanding 15.2 (T/F) 3. Government-sponsored libraries for consumers access to disease information are the only reliable healthcare websites.

False; example of other reliable websites - American Cancer Society and American Heart Association

What is the name of the national government initiative that includes a goal to improve health literacy skills for all citizens?

Healthy People 2020

What Stage of Meaningful Use requires the patient to have electronic access to view online, download, and transmit their health information within specified time frames both for eligible providers and for hospitals?

Stage 2

Check Your Understanding 15.1 (T/F) 3. In the design of an online application, it is important to know if the user is a digital immigrant or digital native.

True

Check Your Understanding 15.1 (T/F) 5. A recall of medication is an example of time-sensitive information that could be found on a consumer health information site.

True

Check Your Understanding 15.2 (T/F) 4. Patient access anytime, anywhere is an advantage of the availability of information found on the Internet.

True

T/F As part of Meaningful Use Stage 2, Advanced Clinical Processes, clinicians are expected to provide patients with secure access to information in their electronic health record (EHR) via a patient portal, as well as exchange secure email with them.

True

T/F The privacy and security of personal identifiable information collected by a website or other technology must be guaranteed to the health information consumer.

True

Blue Button

a big, virtual button on existing patient portals in order to give patients access to their health information

reliability

a measure of consistency of data items based on their reproducibility and an estimation of their error of measurement

digital native

a person who has only known a world of digital toys and tools

consumer

a person who purchases goods and services for personal use

patient portal

a secure method of communicaiton between the healthcare provider and the patient

Chapter 15 Review Exercises 1. Which of the following organizations is focused on increasing consumer involvement in their healthcare? a. Office of the National Coordinator for Health Information Technology (ONC) b. Agency for Healthcare Research and Quality (AHRQ) c. Cenders for Disease Control and Prevention (CDC) d. American National Standards Institute (ANSI)

a. Office of the National Coordinator for Health Information Technology (ONC)

Check Your Understanding 15.2 2. Which of the following results in a reluctance to use social media in healthcare? a. potential for breaches of privacy of PHI b. high-quality of information c. setting qualifications for those who can participate d. information protected from unauthorized users

a. potential for breaches of privacy of PHI

mobile device

items such as tablet computers and smart phones

Of what is the MedlinePlus website a subsidiary?

the US National Library of Medicine (NLM) and the National Institutes of Health (NIH)

e-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

health literacy

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

What are the 11 characteristics of the online health consumer according to the Pew Research Center of adults in the US?

(1) 87% of US adults use internet (2) 72% of internet users have searched online for health information in the past year (3) 50% of US adults have searched for health information for themselves or another individual (4) 77% of those seeking info used a search engine (5) 13% began at a specialized health information site (6) 85% of US adults own a cell phone (7) 58% of US adults own a smart phone (8) 31% of cell phone users and 52% of smart phone owners used their phones to conduct health info searches (9) 19% of smart phone users have a health app downloaded (10) 7/10 US adults have followed a leading health indicator and of those 34% shared their records (11) 3-4% have shared their experience with healthcare professionals/treatments as a posting

The ONC has initiated what 4 projects to study privacy and security issues related to mobile and online health information?

(1) Mobile Devices Roundtable: Safeguarding Health Information (2) mHealth Privacy and Security Consumer Research (3) Survey on Privacy, Security of Medical Records (4) Model Privacy Notice for Consumers for Personal Health Records

What were 3 benefits listed by a study of patients who participated in the pilot of My HealtheVet?

(1) a positive effect on their communication with providers and the health system (2) enhanced knowledge of their health with improved self-care (3) facilitation of increased participation in the quality of their care indicating follow-up on abnormal test results and in decision making on seeking care

On what 8 tenets are the HONcode principles groudned?

(1) authoritative - qualifications of the authors (2) complementary - information should support, not replace, the doctor-patient relationship (3) privacy - respect the privacy and confidentiality of data submitted to the site by the visitor (4) attribution - cite sources of published information, date medical and health pages (5) justifiability - back up claims relating to benefits and performance (6) transparency - accessible presentation, accurate e-mail address (7) advertising policy - clearly distinguish advertising from editorial content

Low health literacy can result in what 7 things?

(1) medication errors (2) low rates of treatment compliance due to poor communication between providers and patients (3) reduced use of preventive services and unnecessary emergency room visits (4) ineffective management of chronic conditions, due to inadequate self-care skills (5) longer hospital stays and increased hospital readmissions (6) poor responsiveness to public health emergencies (7) higher mortality

The current technology-enabled tools making health information available to consumers include what 9 things?

(1) online self-help books for use on e-readers, computers (2) online health articles sties (3) bulletin boards and online discussion groups (4) automated appointment reminders (5) automated systems for learning more about health conditions (6) wearable sensors, such as glucose monitors (7) social media sites such as Facebook and Twitter (8) smart phone apps (9) internet of things

What are the 5 most common barriers to PHR implementation?

(1) risk of security and confidentiality, potential for breaches (2) physicians question the quality, accuracy, and integrity of patient-reported data (3) costs and who would bear the costs (costs to the providers include those for the technology and licensing fees, time for checking records, and increased workload to maintain) (4) health literacy of individuals seeking information and concern for their inability to completely understand the information (5) computer literacy and difficulties for individuals to navigate systems

What 7 explicit themes emerge in the analysis of various definitions of CHI?

(1) types of consumers (2) the term health as opposed to disease or illness (3) tools and applications (4) rationale for CHI (5) nondependency on a healthcare professional for health information (6) information on structures and processes (7) intersection with other disciplines

Check Your Understanding 15.1 (T/F) 6. The digital divide is synonymous with digital immigrant.

(?) False digital immigrant - an individual who lived before the advent of the digital age but has adapted more or less to the digital age digital divide - the gap between those with and those without convenient internet access which results in differences in the amount and types of information that can be accessed by the user

Chapter 15 Review Exercises 6. Social media is enabled by Web 2.0, which refers to a. an electronic data exchange standard b. a consumer healthcare website c. a consumer application that is downloaded d. a platform of connected devices that deliver software

(?) d. a platform of connected devices that deliver software

When and under which POTUS was the Blue Button initiated? When was it formally launched?

- August 2, 2010 initiated - Barack Obama - formally launched October 2010

What is the title of Stage 1 of Meaningful Use?

- Data Capture and Sharing - this data is used by Stage 2

What is the title of Stage 3 of Meaningful Use?

- Improved Outcomes requirements - uses data from Stage

What are common attributes to social media?

- a user account - a profile page - friends, followers, groups - hashtags - news feeds - personalization - notifications - information updating, saving, or posting - like buttons - comment sections - review, ratings, or voting systems

personal health record (PHI)

- an example of consumer informatics - an electronic or paper health record maintained and updated by an individual for him or herself - a tool that individuals can use to collect, track, and share past and current information about their health or the health of someone in their care

CHI applications (as defined by AHRQ)

- any electronic tool, technology, or system that is... (1) primarily designed to interact with health information users or consumers (2) interacts directly with the consumer who provides personal health information to the CHI system and receives personalized health information form the tool application or system (3) one in which the data, information, recommendations, or other benefits provided to the consumer, may be used with a healthcare professional, but is not dependent on a healthcare professional

What are some common examples of social media technologies?

- blogs - microblogs - photo sharing - social bookmarking - forums - video sharing - social gaming - virtual worlds - knowledge and information aggregation - professional networking

What are the legal implications of including PGHD into the EHR?

- defined legal health record - risk of using information - all of the record management and information management considerations

computer literate customer

- having sufficient knowledge and skill to be able to use computers - familiar with the operations of a computer

validity

- the extent to which data correspond to the actual state of affairs or that an instrument measures what it purports to measure - a term referring to a test's ability to accurately and consistently measure what it purports to measure

Web 2.0

- the network as a platform, spanning all connected devices - delivering software as a continually-updated service that gets better the more people use it - consuming and remixing data from multiple sources - providing their own data and services in a form that allows remixing by others

consumer health information (CHI)

- the union of health care content with the speed and ease of technology - as defined by GAO (the US Gov't Accountability Office Accounting and Information Management Division)

informatics

- using technology to acquire, manage, maintain, and use information as a basis for the plethora of decisions that must be made in a cost-effective manner - the study of collecting, organizing, storing, and using electronic information

T/F Disparities in access to health information when it is tied to computer technology is also an issue for the increased use of PHRs and web portals.

True

T/F Each agency administers Blue Button with its own rules.

True

T/F Getting consumers involved in their healthcare and the healthcare of their loved ones is one focus of the ONC.

True

T/F HIPAA mandates that individuals have some voice over their PHI, such as access, amendment, accounting of disclosure, restriction requests, and confidential communication.

True

T/F One object of Meaningful Use Stage 3 is patient electronic access for viewing, downloading, and transmitting their PHI.

True

T/F Online health consumers require internet access.

True

T/F Presently, new challenges for managing privacy and security issues have arisen related to mobile and online health information .

True

T/F Reputable online health information websites should include a hyperlink to a privacy policy statement.

True

T/F Some of the benefits of using electronic PHRs relate to the interoperability of having an electronic PHR tethered to the EMR.

True

digital immigrant

an individual who lived before the advent of the digital age but has adapted more or less to the digital age

Chapter 15 Review Exercises 4. What are skills related to calculating insulin dosages or understanding body mass index values? a. health informatics b. numeric literacy c. visual literacy d. health literacy

b. numeric literacy

Check Your Understanding 15.1 2. What specific actions that exhibit health literacy by a patient can make a difference in the outcomes of care? a. a family member relates symptoms of the patient to the provider b. the patient questions the instructions given by a provider c. the patient chart is used to determine previous procedure done d. a caregiver is provided instructions for administration of medications

b. the patient questions the instructions given by a provider

Chapter 15 Review Exercises 2. Nonadapters who have not looked online for health information within the past year tend to a. be more affluent b. have no differences among age groups c. be of African American and Hispanic descent in low income areas d. have more education

c. be of African American and Hispanic descent in low income areas

Check Your Understanding 15.1 1. What is an important concept of health literacy? a. having an interpreter available b. visual literacy c. knowledge of medical terminology d. having the capacity to understand basic health information

d. having the capacity to understand basic health information

Chapter 15 Review Exercises 3. What term describes the ability of consumers to obtain, process, and understand healthcare information for the purpose of decision making? a. health informatics b. numeric literacy c. visual literacy d. health literacy

d. health literacy

Chapter 15 Review Exercises 5. What types of health information are not available to consumers via a search on the Internet? a. medicine or medical device information b. medical conditions c. lifestyle tips d. past medical history

d. past medical history

Check Your Understanding 15.2 1. Which of the following is not an attribute of social media? a. user account b. hashtags c. groups d. validated information

d. validated information

technologically literate

entails having some basic knowledge about technology, some basic technical capabilities, and the ability to think critically about technological issues and act accordingly

leading health indicator (LHI)

health issues that serve as measures of the nation's health

online diagnosers

individuals who use the internet to determine a diagnosis or identify a medical condition

digital divide

the gap between those with and those without convenient internet access which results in differences in the amount and types of information that can be accessed by the user

health

the state of being free from illness or injury

social media

websites and applications that enable users to create and share content or to participate in social networking