Where can teens find health information? A survey of web portals designed for teen health information seekers

The Web is an important source for health information for most teens with access to the Web (Gray et al, 2005a; Kaiser, 2001). While teens are likely to turn to the Web for health information, research has indicated that their skills in locating, evaluating and using health information are weak (Hansen et al, 2003; Skinner et al, 2003, Gray et al, 2005b). This behaviour suggests that the targeted approach to finding health information that is offered by web portals would be useful to teens. A web portal is the entry point for information on the Web. It is the front end, and often the filter, that users must pass through in order to link to actual content. Unlike general search engines such as Google, content that is linked to a portal has usually been pre-selected and even created by the organization that hosts the portal, assuring some level of quality control. The underlying architecture of the portal is structured and thus offers an organized approach to exploring a specific health topic. This paper reports on an environmental scan of the Web, the purpose of which was to identify and describe portals to general health information, in English and French, designed specifically for teens. It answers two key questions. First of all, what portals exist? And secondly, what are their characteristics? The portals were analyzed through the lens of four attributes: Usability, interactivity, reliability and findability. Usability is a term that incorporates concepts of navigation, layout and design, clarity of concept and purpose, underlying architecture, in-site assistance and, for web content with text, readability. Interactivity relates to the type of interactions and level of engagement required by the user to access health information on a portal. Interaction can come in the form of a game, a quiz, a creative experience, or a communication tool such as an instant messaging board, a forum or blog. Reliability reflects the traditional values of accuracy, currency, credibility and bias, and in the web-based world, durabililty. Findability is simply the ease with which a portal can be discovered by a searcher using the search engine that is most commonly associated with the Web by young people - Google - and using terms related to teen health. Findability is an important consideration since the majority of teens begin their search for health information using search engines (CIBER, 2008; Hansen et al, 2003). The content linked to by the portals was not evaluated, nor was the portals’ efficacy as a health intervention. Teens looking for health information on the Web in English have a wide range of choices available but French-language portals are much rarer and harder to find. A majority of the portals found and reviewed originated from hospitals, associations specializing in a particular disease, and governmental agencies, suggesting that portals for teens on health related topics are generally reliable. However, only a handful of the portals reviewed were easy to find, suggesting that valuable resources for teens remain buried in the Web

[Editorial] Marketing as an integrator in integrated care

Purpose: Integrated care requires solutions that cannot be delivered without addressing the underlying multidisciplinary problems. Yet with a few notable exceptions, there is a lack of coordination between disciplines, to effectively integrate knowledge. The main aim of this special section is to provide a platform that explicitly coordinates and curates multidisciplinary research aimed at providing a shared understanding and knowledge base that directly addresses the fragmentation in this field, with an explicit focus on the role of Marketing as a key but often neglected partner. We identify four big challenges (Self, Society, Micro Systems and Macro Systems) to which Marketing can contribute, illustrating these potential contributions through the articles and accompanying practitioner commentaries of this special section. Methodology: Ferguson demonstrates how reflexive introspection can be used, beyond its therapeutic benefits, to bring a deeper understanding of the meaning of illness and treatments from a patient’s perspective. Orazi and Newton establish experimentally the positive impact of collaborative sources on health messaging receptivity. Taiminen, Saramieni and Parkinson survey physicians to evaluate acceptance of/barriers to incorporating digital self-services into overall care delivery. Cruz, Snuggs and Tsarenko utilise interviews to understand the patient’s negotiation of the service labyrinth and fragmentation. Findings: We demonstrate the scope and flexibility of marketing theories and methods and how these can be applied to the four main challenges of integrated care: Self; Society; Micro Systems; Macro Systems. Research Implications: We identify directions for future research as a means of stimulating fruitful multidisciplinary partnerships in the four key challenge areas. It is only by collaborating across disciplines that we can really develop and provide insights that inform policy, practitioners, society and consumers on how to future-proof our care services. Originality/Value: In addition to publishing new research, this special section directly encourages multidisciplinary collaboration between marketing, as a neglected partner, and health/social care disciplines by showcasing the theories and methods that can be used to address our identified four key challenges to integrated care. In a novel approach, practitioner commentaries evaluate the value of each study, placing them in the wider integrated care context and hence pointing out further directions for development

The Epital Care Model: A New Person-Centered Model of Technology-Enabled Integrated Care for People With Long Term Conditions.

BACKGROUND: There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs). It remains to be determined how a new care model can be introduced that supports the intentions of the World Health Organization (WHO) to have integrated people-centered care. OBJECTIVE: To design, pilot, and test feasibility of a model of health care for people with LTCs based on a cocreative, iterative, and stepwise process in a way that recognizes the need for person-centered care, and embraces the use of digital technology. METHODS: The overall research method was inspired by action research and used an agile, iterative approach. In 2012, a living lab was established in a Danish municipality which allowed for the freedom of redesigning health care processes. As the first step, a wide group of stakeholders was gathered to create a layout for the reorganization of services and development of technology, based on established principles for innovative management of people with chronic conditions. The next three steps were (1) a proof of concept in 2012, (2) a pilot study, and (3) a feasibility study from 2013 to 2015, in which a total of 93 chronic obstructive pulmonary disease (COPD) patients were enrolled. Citizens were provided a tablet-based solution for remote follow-up and communication purposes, and access to a 24/7 response and coordination center that coordinated both virtual and face-to-face support for COPD management. In step five the initial model was extended with elements that support continuity of care. Beginning in the autumn of 2013, 1102 frail elderly individuals were included and offered two additional services: an outgoing acute medical team and a local subacute bed function. RESULTS: Based on the findings from the iterative process, and evolving technology and workflow solutions, we propose a robust and feasible model that can provide a framework for developing solutions to support an active life with one or more LTCs. The resulting Epital Care Model (ECM) consists of six stages, and serves as a template for how a digitally-enhanced health service can be provided based on patients' medical needs. The model is designed to be a proactive, preventive, and monitoring health care system that involves individuals in the management of their own health conditions. CONCLUSIONS: The ECM is in accordance with WHO's framework for integrated people-centered health services, and may serve as a framework for the development of new technologies and provide a template for future reorganization

Digital Health and Self-Management in Idiopathic Inflammatory Myopathies:A Missed Opportunity?

Purpose of review: This paper explored the potential of digital health in idiopathic inflammatory myopathies (IIMs), with a focus on self-management. Digital self-management technology includes tailored treatment plans, symptom tracking, educational resources, enhanced communication, and support for long-term planning.Recent findings: After arguing the importance of digital health in IIMs management, from diagnosis until treatment, our literature review revealed a notable gap in research focusing on the efficacy of digital self-management interventions for individuals with IIMs, with no randomised controlled trials or observational studies addressing this topic. Summary: Our review further highlighted the significant unmet need for research in self-management interventions for individuals with IIMs. The absence of studies underscores the necessity for collaborative efforts to address this gap and develop personalised, effective strategies for managing IIMs using digital technology. Individuals with IIMs deserve tailored self-management approaches akin to those available for other rheumatic and musculoskeletal diseases.<br/

The future of the healthcare industry : how will digital transformation create better healthcare?

This dissertation focuses on the analysis of the opportunities raised by emerging tech dynamics to improve care delivery. Specifically, it focuses on assessing its impact in the main healthcare activities covered in the prevention and diagnosis stages through the lens of three main stakeholder groups - the patients, the health professionals and the health service’s experts. In order to reach these objectives, an exploratory and qualitative research was conducted through the analysis of primary and secondary data, collected from existing literature and semi-structured interviews with the considered stakeholder groups. The conclusions suggest that tech dynamics can bring significant impact to the healthcare industry through three main key applications: (1) information generation, which have a major impact in the activities covered in the prevention stage; (2) information treatment, impacting both activities covered in prevention and diagnosis; and (3) experience improvement, mainly useful in activities that require in person interactions. By applying the tech dynamics into medical practice, the stakeholders may benefit from enhanced user experience, productivity and cost reductions which ultimately has a positive impact into the improvement of the quality of care delivered. Moreover, this impact is extended through other stakeholders in the life-science such as insurance companies and pharmaceuticals.Esta dissertação centra-se na análise das oportunidades que surgiram do desenvolvimento de novas dinâmicas tecnológicas no sentido de melhorar a prestação de cuidados de saúde. Em concreto, tem como foco a avaliação do impacto destas dinâmicas nas principais atividades médicas, desde a prevenção até ao diagnóstico e incluindo os três principais stakeholders - pacientes, médicos e administrativos. Neste sentido, foi realizada uma pesquisa exploratória e qualitativa com base na análise de dados primários e secundários, dados estes que foram recolhidos através de entrevistas semi-estruturadas com os stakeholders acima identificados e segundo a literatura já existente relativa ao tema. As conclusões sugerem que estas novas dinâmicas podem resultar num impacto significativo para a indústria da saúde através de três principais aplicações: (1) geração de informação, que tem um grande impacto nas atividades abrangidas pela fase de prevenção; (2) tratamento de informação, que impacta as atividades abrangidas pelas fases de prevenção e diagnóstico; e (3) melhoria da experiência do paciente, que é principalmente relevante nas atividades com maior interação pessoal. Com a aplicação destas dinâmicas tecnológicas na saúde, os diferentes stakeholders podem ser beneficiados através de: uma melhor experiência para o paciente, uma maior produtividade e reduções de custos que, em última análise, tem um impacto positivo na melhoria da qualidade dos cuidados prestados. Adicionalmente, estes impactos abrangem ainda outros agentes ligados à indústria da saúde, tais como companhias de seguros e farmacêuticas

Integrated and patient-centred management of Parkinson’s disease:a network model for reshaping chronic neurological care

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Artificial Intelligence for Global Health: Learning From a Decade of Digital Transformation in Health Care

The health needs of those living in resource-limited settings are a vastly overlooked and understudied area in the intersection of machine learning (ML) and health care. While the use of ML in health care is more recently popularized over the last few years from the advancement of deep learning, low-and-middle income countries (LMICs) have already been undergoing a digital transformation of their own in health care over the last decade, leapfrogging milestones due to the adoption of mobile health (mHealth). With the introduction of new technologies, it is common to start afresh with a top-down approach, and implement these technologies in isolation, leading to lack of use and a waste of resources. In this paper, we outline the necessary considerations both from the perspective of current gaps in research, as well as from the lived experiences of health care professionals in resource-limited settings. We also outline briefly several key components of successful implementation and deployment of technologies within health systems in LMICs, including technical and cultural considerations in the development process relevant to the building of machine learning solutions. We then draw on these experiences to address where key opportunities for impact exist in resource-limited settings, and where AI/ML can provide the most benefit.Comment: Accepted Paper at ICLR 2020 Workshop on Practical ML for Developing Countrie