HI 460 Final exam

Social desirability

A tendency to give socially approved answers to questions about oneself.

Observer induced expectations

Such effects can be initiated or increased through the unconscious transfer of expectations from the experimenter to the client

Health assessments based on family health history

By providing personal facts about their own and familial diseases (family trees), clients can receive a fair and well-organized account of their individual risks. However, the accuracy of data that clients provide can sometimes be questionable concerning identification of diagnoses and familial relations

Factors that let one service outperform the other by 4x in participation in colorectal cancer screening

INFORMATION (medical + how to master barriers in the process) PERSEVERANCE(depending on 1st response follow-up calls/mailings) CONVENIENCE(return mail processing of test kit rather than in person) LOGISTICS(+test suggestions for follow-up)

Cost effectiveness

Ideally, the pre-assigned primary outcome of a cost-effectiveness RCT is cost per achieved benefit

The impact of family support on patient adherence

Involving family and peers in the care of a chronically ill person can be beneficial when appropriately integrated into the flow of information and action of the Consumer HealthInformatics service but can create new risks if left to chance

HI interventions success factors

They do not interrupt or put more of a burden on users The meet a need that the user already knows they have instead of one they are not aware of Do not overwhelm the user

negative impact of family support

Trying to replicate a successful service where severely overweight clients are supported through real family living together with the client through randomly assigned SMS buddies, fails for many: Rather than exercising, the clients text.

How to protect health-related data and services

Use encryption! You can usually rely on mathematics, more than on software security and access control mechanisms A two-factor authentication mechanism and a suitable encryption protocol should be used

Drivers of human behavior that can complicate the data collected in randomized controlled trials

Volunteers differ from non-volunteers Hawthorne effect Subject expectancy Observer induced expectations Social desirability Discrepancies between measured and self-reported behavior Decreasing visits to a web site that does not change for a year

EHR

a health care provider's secure electronic record of patient information

Functional monitoring

activity level, motion, gait, meal intake, etc/ activities of daily living

PHR

an electronic application that allows a patient or patient proxy to maintain and manage his or her health information in a private, secure, and confidential manner. This record is owned by the patient and can contain information that is not included in a medical record

Safety monitoring

detect hazards, turn on lights

Security monitoring and assistance

detect human threats such as intruders

Physiological monitoring

detection of biological activity like blood pressure, temperature, respirations

Cognitive and sensory assistance

medication reminders, lost key locators, etc

Volunteers differ from non-volunteers

observed effects may not transfer

Social interaction monitoring and assistance

phone calls, visitors, and participation in activities

Subject expectancy

subject responds to treatment/condition based on their expectations

The impact that HI services that solicit mail in specimens for gene, gene expression or other medical tests scans have

tend to encourage over-utilization even on marginal findings

Sources and types of sensitive consumer HI data

All electronic health records (EHR), e.g. diagnoses, care, medication, medical history, laboratory test results, medical images, conditions etc Personal health records (PHR) including information and observations with health content written by the patient All professional communication of a physician in any network Connection data of Consumer HI services or of communications between patients and physicians Search queries about medical conditions, diagnoses, medication, procedures etc

Hawthorne effect

Announcing an experiments creates expectations that change behaviors even if no experiment takes place

The impact of monitoring technology

Are we creating "societies of high-tech hermits? Does monitoring technology make us less vigilant? Will monitoring exacerbate the condition(e.g., schizophrenia)? Privacy concerns?

positive impact of family support

Involving family in an IVR support of patients of chronic diseases many of whom are illiterate improves clinical outcomes

Barriers to patient portal use

Registration and authentication can cause a great deal of trouble for patients. Computer problems Lack of motivation Lack of information

Noninferiority Trials

Show that a new treatment is unlikely to be less effective than current accepted treatment