~ Presented by Fang Wu
1.Why need information systems to facilitate Health
and Clinical Management?
2. Studies of information systems for cancer and
HIV-positive patients.
3. Conclusion.
1. Why need
information systems?
1.1 A patient with a deeper understanding of diagnosis, treatment, and recovery, is much better equipment to cope with the illness.
1.2 The patients’ education benefits can be achieved in a variety ways.
1.3 What could computer based information systems help people?
2.1 A Study of Information
System for Cancer Patients
Intervention groups:
Computer-based general information group
Computer-based personalized information group
Booklet information group
Data collection
A hospital anxiety and depression scale and mental adjustment to cancer questionnaire was completed by patients at recruitment, right after the intervention, three weeks after the intervention and three months after the intervention.
2.1 A Study of Information System for Cancer Patients
(continues)
Results and Discussion:
· Patients found it more useful to have access to information directly linked to their condition than to have access to general information (either computer-based or in printed booklets).
· It could be more cost-effective to provide personalized computer based information if electronic patient record available.
2.2 Study of CHESS
(comprehensive health enhancement support system) for HIV-positive patients
Groups:
1. Have CHESS in home for six months.
2. Have CHESS in home for three months.
3. Don’t have access to CHESS.
Data collection:
Subjects (quality of life, health behavior, and health service utilization) were surveyed at intervention, two-month, five-month, and nine-month (only for the first group).
2.2 Study of CHESS
(comprehensive health enhancement support system) for HIV-positive
patients
(continued)
Results and discussion:
· Patients benefited significantly in all aspects examined in the study, including reductions in the cost of healthcare service utilization.
· After the system had been removed, only some benefits were maintained. Patients in six-month group maintain more than in three-month group.
· Web-based version of CHESS in the future?
3 Conclusion
The availability of computerized information tailored to the needs of patients – either based on the contents of their health records or on their choice of information from a carefully selected set of static information and interactive communication with experts – is of greater benefit to patients than other forms of providing information
References:
[1]
Jones R, Pearson J, McGregor S, Cawsey AJ, Barrett A, Craig N, Atkinson
JM, Gilmout WH, McEwan J. Randomized
trial of personalized computer based information for cancer patients. BMJ 1999;
16(1): 1-9.
[2]
Gustafson DH, Hawkins R, Boberg E, Pingree S, Serlin RE, Graziano F, Chan CL.
Impact of a patient-centered, computer-based health information/support system.
Am J Pre Med 1999, 16(1): 1-9.
[3]
Bental DS, Cawsey AJ, Jones R. Patient information systems that tailor to the
individual. Patient Educ Counse 1999; 36: 171>8.
[4]
Bosworth K, Gustafson DH. CHESS: providing decision support for reducing health
risk behavior and improving access to health services. Interfaces 1991; 21(3):
93-104.
[5]
Kreuter MW, Strecher VJ. Do tailored behavior change messages enhance the
effectiveness of health risk appraisal? Results from a randomized trial. Health
Educ Res 1996; 11: 97>105.
CHESS Services:
·
Questions & Answers are short answers to
commonly asked questions about HIV infection, treatments and life with HIV.
·
Instant Library includes full-text article
covering a broad range of topics drawn from scientific journals, newsletters,
and the popular press.
·
Getting Help/Support contains descriptions of
approximately 300 relevant health services, ways to find a provider, and how to
be an effective consumer.
·
Referral Directory has descriptions and ways to
contact a set of national services that offer information, support, and
referrals of value on the health problem.
·
Assessment asks questions about a
person’s lifestyle, assesses the risk, and offers specific advice on how he/she
can reduce his/her risk.
·
Decision Aid helps patients think through
difficult decisions. Users learn about the options, clarify their values, the
consequences of their actions, and the misconceptions they have.
·
Action Plan helps users plan how to
successfully implement decisions. They identify goals and resources, and learn
how to overcome obstacles.
·
Discussion Groups are facilitated online
support groups allowing patients and families with similar problems to share
information and support.
·
Ask an Expert allows patients to write a
question and receive confidential responses from experts. Experts can
depersonalize the response and place it on Open
Expert for other users to use.
·
Personal Stories are real-life accounts of
people with similar problems, living and coping with their illness.