An Empirical Validation of the Patient-centered e-Health Framework in Patient-focused Websites

Although the Internet is in its second decade of wide-spread adoption, many patient-centered health websites are still in a phase of early adoption, scrambling to define and defend market segments in a shifting healthcare information landscape. Consequently, healthcare and health information providers are jockeying for position in a dynamic industry trying to serve different patients’ needs. To understand the situation, this article takes the approach of Patient-centered e-Health (PCEH) and makes three contributions. One, we empirically test the PCEH framework on patient-focused websites. Two, given the PCEH framework, we identify five categories of websites that serve different segments of the patient-centered health information market. Three, we analyze the five categories in terms of different features and derive a classification model. This article helps us better understand PCEH websites and guide the future development of online healthcare and health information services

Editors’ Introduction to the Special Section on Patient-centered e-Health: Research Opportunities and Challenges

We initiated the CAIS Special Section on Patient-Centered e-Health (PCEH) to provide support for the PCEH discipline, which has recently emerged to meet the practical need of supporting patients in managing their health. Because there are significant challenges in designing, developing, and using PCEH applications, there are many opportunities for IS researchers to study familiar topics, but in the very different healthcare delivery context. As an emerging discipline, PCEH is struggling with reconciling ambiguous definitions across studies, defining the discipline boundaries (how they overlap and are distinct from related research areas), and developing the exemplary research studies that can guide future research. Thus, the goal of this Special Section, as far as possible, is to gather a set of research articles that will move the PCEH discipline forward by providing resources and examples to support future PCEH research that is theory-based, is focused, and can build a cumulative literature and research tradition. In this Introduction to the CAIS Special Section, we argue that IS researchers are especially well-equipped to undertake PCEH research and thereby overcome the many challenges unique to PCEH study. We discuss the challenges in the emerging PCEH discipline and present approaches that IS researchers might take to meet these challenges and produce the exemplary studies needed to further the discipline. Our arguments and observations are supported by the fourteen articles that make up the Special Section. These fourteen articles represent four areas of emerging PCEH research, namely PCEH and the Healthcare Delivery Context; Models of Acceptance, Use, and/or Outcomes; Patient-centered Design Research; and Assessment of PCEH websites

Patient-oriented Evidence-based Treatment Decision Support System (TreatQuest®) for Lung Cancer

Involving patients in healthcare decisions makes a significant and enduring difference to healthcare outcomes. One challenge for patients is the lack of evidence-based information and tools to support their decision making. Although patients have access to significant information through internet and other sources, it is not personalized for their specific situation. This dissertation attempts to help patients acquire evidence-based information relevant to their own situation, so they can make a more informed decision in co-operation with their physicians. Lung cancer has been selected as a focus for this study because lung cancer presents very complex decision making situation and is the leading cause of cancer deaths in both men and woman in every ethnic group worldwide. The prototype decision support system for lung cancer is called TreatQuest®. This system allows users to create their own profile, access cases similar to their case, and learn about treatment options. The evidences for the treatment were extracted from public data and knowledge gained from guideline. The effectiveness of patient-oriented evidence-based approach was validated by having a group of patient use the system. TreatQuest® is one of the first system developed to support patient\u27s treatment decision process, which represent the most recent trend in delivery of healthcare services. Results from this study show that such a patient-oriented decision support system provides an effective way to help patient receive more personalized information and make informed treatments. In summary, patient-oriented evidence-based decision support systems such as TreatQuest®, can improve the decision quality for patients. Also, such systems can improve health care decisions that are made with the active participation of fully informed patients. Therefore, patient-oriented evidence-based decision support systems can have significant impact on the healthcare industry

A scoping review found increasing examples of rapid qualitative evidence syntheses and no methodological guidance

Objectives: To identify existing methodological guidance for the conduct of rapid qualitative evidence syntheses, and examples of rapid qualitative evidence syntheses to describe the methods used. Study Design and Setting: We conducted a systematic scoping review. We searched MEDLINE, CINAHL, grey literature, including PROSPERO, with no date limits and solicited examples through experts and researchers in the field. Results: We found no methodological guidance to direct the conduct of rapid qualitative evidence synthesis, and 15 examples including 13 completed reviews and two protocols. Diverse methods to abbreviate the review process were followed, which largely mirror methods developed for rapid reviews of clinical effects. Abbreviated search strategies, including date and language restrictions, were common, as was the use of a single reviewer for screening, data extraction and quality appraisal. Descriptive approaches to synthesis, such as thematic synthesis, were more common than interpretive approaches, such as meta-ethnography. Conclusion: There is a need to develop and explore methods for the synthesis of qualitative research that balance the need for rapidity with rigour. In the meantime, providing details on the methods used, shortcuts made, and the implications of such methodological choices, together with collective sharing of innovations, becomes more important under increased time constraints

If You Build It, Will They Use It? Challenges in Adoption and Use of Patient-centered E-health

Preventive healthcare services require consumers to coordinate and manage several healthcare activities with multiple service providers. In this paper, we explore the adoption and use of a patient-centered e-health system for managing personal healthcare requirements. Specifically, using the patient-centered e-health (PCEH) framework, we analyzed the data we collected from a qualitative study of consumers who participated in a preventive care program called the Health Enhancement Program (HEP) in Connecticut in the United States and the accompanying e-health service the program offered. Data from the interviews of 15 participants revealed that users found several challenges in adopting and using the e-health system when examined in the context of their lifestyle even though the system had a patient-centric design. These findings provide implications for designing and assessing patient-centered e-health to ensure that users effectively adopt and continue to use them and insights for expanding PCEH theory and practice

E-patients and Social Media: Impact of Online Experience on Perceived Quality of Care

abstract: Social media sites focusing on health-related topics are rapidly gaining popularity among online health consumers, also known as "e-patients". The increasing adoption of social media by e-patients and their demand for reliable health information has prompted several health care organizations (HCOs) to establish their social media presence. HCOs are using social media to connect with current and potential e-patients, and improve patient education and overall quality of care. A significant benefit for HCOs in using social media could potentially be the improvement of their quality of care, as perceived by patients. Perceived quality of care is a key determinant of patients' experience and satisfaction with health care services, and has been a major focus of research. However, there is very little research on the relationship between patients' online social media experience and their perceived quality of care. The objective of this research was to evaluate e-patients' online experience with an HCO's social media sites and examine its impact on their perceived quality of care. Research methodology included a combination of qualitative and quantitative approaches. Data for this study was collected from Mayo Clinic's social media sites through an online survey. Descriptive statistics were used to identify basic demographic profiles of e-patients. Linear regression analysis was used to examine the relationship between online experience and perceived quality of care. Qualitative data was analyzed using thematic analysis. Results showed a positive relationship between online experience and perceived quality of care. Qualitative data provided information about e-patients' attitudes and expectations from healthcare social media. Overall, results yielded insights on design and management of social media sites for e-patients, and integration of these online applications in the health care delivery process. This study is of value to HCOs, health communicators and social media designers, and will also serve as a foundation for subsequent studies in the area of health care social media.Dissertation/ThesisM.S.D. Design 201

Making the Case for Leveraging the Patient-Centered E-Health (PCEH) Context to Expand Information Systems Theory

Patient-centered e-health (PCEH) represents a fascinating area of digitized stakeholder interactions characterized by complex information flows, shared decision making, co-created value, and mutual interest in improving health outcomes. Such a context lies in contrast to often contentious firm-consumer relationships characterized by self-interest, surplus maximization (from both producer and consumer sides), and consumer segmentation. This article suggests that PCEH is an ideal context in which to study the emerging class of information systems that include consumers as empowered influencers, stakeholders, and decision makers, rather than only “purchasers” on the other side of the exchange relationship or “mandated” users in the enterprise context. The PCEH context is proposed as an enormous research opportunity that may significantly contribute to expanding information systems research and theory

Cancer-Related Direct-To-Consumer Advertising - A Study of its Antecedents, Influence on Patient Information Seeking Behaviors, and Contingent Effects

Direct-to-consumer advertising (DTCA) of prescription medications and healthcare facilities has generated much debate over the potential benefits and adverse consequences for the public at large, patients, clinician-patient relationships, and the overall healthcare system. This dissertation is aimed at contributing to this debate through studying the impact of DTCA in the context of cancer treatment. Study 1 assessed the reliability and validity of three candidate measures of patient-reported exposure to cancer-related DTCA across seven criteria. The study found that all three measures performed well in terms of convergent, nomological, discriminant, and face validity. Findings from this study offer support for utilizing these survey measures in future studies targeting cancer patients. Next, Study 2 examined the prevalence and correlates of cancer-related DTCA exposure in a sample of patients in Pennsylvania diagnosed with breast, prostate, or colorectal cancers. On average, patients reported modest exposure to such DTCA (median exposure was once per week). Significant correlates of exposure included cancer type, age, stage of disease, and ethnicity. Study 3 investigated the relationships between DTCA exposure and subsequent information seeking behaviors. The analyses detected a significant association between DTCA exposure and cancer patients\u27 subsequent information engagement with their clinicians at one-year follow-up. Exposure to DTCA was marginally significant in predicting information seeking from non-clinician (lay media and interpersonal) sources. Based on the Integrative Model of Behavioral Prediction, a focused analysis showed a significant indirect path between DTCA exposure and subsequent information seeking from non-clinician sources, mediated through attitudes and intention to seek from these sources. Study 4 was guided by the Structural Influence Model of Communication to explore disparities in health information seeking behaviors arising from DTCA exposure. The study found that the associations between DTCA exposure and active information seeking behaviors were not moderated by patients\u27 age, educational level, race/ethnicity, or cancer type. To conclude, these studies would likely inform the ongoing debate and future research regarding the impact of cancer-related DTCA exposure on communication outcomes and disparities

Internet interventions for improving psychological well‐being in psycho‐oncology: review and recommendations

Objective Too few cancer patients and survivors receive evidence‐based interventions for mental health symptoms. This review examines the potential for Internet interventions to help fill treatment gaps in psychosocial oncology and presents evidence regarding the likely utility of Internet interventions for cancer patients. Methods The authors examined available literature regarding Internet interventions tailored to cancer patients' mental health needs and reviewed elements of Internet interventions for mental health relevant to advancing psycho‐oncology Internet intervention research. Results Few rigorous studies focusing on mental health of cancer patients have been conducted online. A growing body of evidence supports the efficacy, accessibility, and acceptability of mental health Internet interventions for a variety of general and medical patient populations. The authors present recommendations and guidelines to assist researchers in developing, testing, and disseminating Internet interventions for cancer patients and survivors, to manage and improve their mental health. Issues unique to Internet interventions—including intervention structure, customization, provider interaction, and privacy and confidentiality issues—are discussed. These guidelines are offered as a step toward establishing a set of “best practices” for Internet interventions in psycho‐oncology and to generate further discussion regarding the goals of such interventions and their place in cancer care. Conclusions Internet interventions have the potential to fill an important gap in quality cancer care by augmenting limited available mental health services. These interventions should be developed in a manner consistent with best practices and must be empirically tested and validated. Copyright © 2011 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93546/1/pon1993.pd