E-Health Workshop Session 1:
Empowering patients, carers and
members of the public to look after
their own health
Delivering Better Health Services – The Fifth
National SDO Conference
Dr Henry Potts, Centre for Health Informatics
and Multiprofessional Education (CHIME),
University College London (UCL)
In-depth study of three eHealth approaches to the
enhancement of clinical care
and its
NHSdelivery
SDO: EH95 “A study of the use of e-Health
solutions in the management and treatment of
disease and in facilitating change in the
organisation and delivery of services.”
Henry Potts1, Justin Keen2, Jackie Nicholls1,
David Patterson1, Ann Blandford1, Chris Martin1,
Tracy Denby2
1University
College London, 2University of Leeds
System 1: Monitoring and adjustment of
anti-coagulation therapy
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Anti-coagulant therapy to reduce chance of stroke
Optimised prescription requires an individual and
closely monitored drug regime
Instead of frequent out-patient appointments,
patients attend community pharmacies or nurse-led
clinics at GP surgeries – pharmacists and nurses
acts as supplementary prescribers
Patient home testing being introduced
Uses an electronic health record shared with
hospital and a decision support tool to guide
prescription decisions
System 2: Electronically mediated diabetes
care
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At Airedale Primary Care Trust, Bradford
GPs and secondary care settings, including
diabetes services at Airedale General
Hospital, use shared electronic health record
SystmOne electronic health record from
Phoenix – off-the-shelf product
recommended under Connecting for Health
System 3: Risk communication in
cardiovascular disease
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Laindon Model decision support tool models
survival based on cardiovascular disease risk
factors (including smoking, blood pressure,
BMI, age…)
Used in a GP consultation to aid risk
communication and shared decision-making
Distributed to all GP practices in Thurrock
PCT
Methods
Mixed methods, inductive approach
 Main data collection consists of ethnographic
observational work in the service contexts,
supplemented by interviews
 Based around the patient journey
 Combined with mini-studies focusing on
particular issues
 Consider both the patient experience and the
healthcare professional experience
Workshop: chair’s duties
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Introduce some new work
Ask questions
Challenge assumptions
Patient education and Internet use in
diabetes
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Part of WINDFAL programme to support
diabetes care at Whittington Hospital
Building locally-relevant online resources for
patients, including information,
communication with healthcare professionals
and peer support
Educational sessions for patients include
sessions on how to use the Internet well and
safely
Questions
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What do healthcare professionals want?
What do patients want?
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Everyone wants reliable, high-quality, reputable
online resources, but what does that mean?
Is e-health more of the same or is it
transformational?
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Does e-health support a general move towards
greater patient involvement in their own
healthcare, or does e-health drive that process,
allowing entirely novel forms of patient
involvement in their own healthcare?
Challenging assumptions
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All facts are the same
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Empowerment
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Medical facts vs. practical tips vs. experiences
We’re playing catch-up for many people: e.g.
10,000,000s of people have joined online support
groups (Pew Research Center, 2005)
Good information is all you need
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Poor meta-knowledge/meta-cognition means
good information gets wrongly interpreted
Workshop tasks
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What do patients want to
know?
What impacts on a patient’s
understanding of and
response to information?
What are a patient’s belief
systems?
How does the wider social
and public context impact
on these beliefs?
How does all of the above
impact on negotiating the
management plan?
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Think of a time when you or
a relative was ill
What sort of things were
you thinking (or worrying)
about?
What did you expect from
the healthcare professionals
you encountered?
What did they say or do that
helped?
Did they say or do anything
that didn’t help?