I loved the pragmatism in the abstract of a paper from Israel’s Clalit Health Services – the country’s largest and the second largest world-wide – on “e-Health, m-Health and healthier social media reform: the big scale view”.
Authors Yossi Bahagon and Orit Jacobson declare that, “In the upcoming decade, digital platforms will be the backbone of a strategic revolution in the way medical services are provided, affecting both healthcare providers and patients. ”
But they point out that negotiating the not necessarily parallel interests of patients and medical professionals demands that ehealth applications must present true added value for both. The fundamental question that must be answered, they say, is “What’s really in it for me?”.
It’s particularly difficult, they suggest, because “Medical teams are further subdivided into physicians, nurses, pharmacists and administrative personnel—each with their own driving incentive.”
And if resistance to change is an obstacle in many fields,they suggest, it is particularly problematic in the conservative health industry.
The paper points out the importance of harnessing the persuasive power of as many people as possible as change agents – in the case of Clalit, more than 40,000 employees.
“Successful recruitment has the potential of converting each patient-medical team interaction into an exposure opportunity to the new era of participatory medicine via e-health and m-health channels,” the authors write.
There certainly does seem to be rather a lot in it for users of the Israeli operation’s ehealth application, which “focuses on deepening patient involvement in managing health, through personalised digital interactive tools”.
Its personal health record layer (what the patient can see) “presents patients with their own medical history as well as the medical history of their preadult children, including diagnoses, allergies, vaccinations, laboratory results with interpretations in layman’s terms, medications with clear, straightforward explanations regarding dosing instructions, important side effects, contraindications, such as lactation etc., and other important medical information. All personal e-Health services require identification and authorisation.
“The personal knowledge layer (what the patient should know) presents patients with personally tailored recommendations for preventative medicine and health promotion. For example, diabetic patients are push notified regarding their yearly eye exam. The various health recommendations include: occult blood testing, mammography, lipid profile etc. Each recommendation contains textual, visual and interactive content components in order to promote engagement and motivate the patient to actually change his health behaviour.”
Then there is the personal health services layer (what the patient can do). It enables patients to schedule clinic visits, order chronic prescriptions, e-consult their physician via secured e-mail, set SMS medication reminders, e-consult a pharmacist regarding personal medications. Consultants’ answers are sent securely to the patients’ personal mobile device.
On December 2009 CHS launched secured, web based, synchronous medical consultation via video conference. By May 2011, 11,780 e-visits were being performed monthly.
Its m-Health platform is used by more than 45,000 unique users, with 75,000 laboratory results views per month, 1100 m-consultations per month and 9000 physician visit scheduling per month.
“The Bio-Sensing layer (what physiological data the patient can populate) includes diagnostic means that allow remote physical examination, bio-sensors that broadcast various physiological measurements, and smart homecare devices, such as e-Pill boxes that gives seniors, patients and their caregivers the ability to stay at home and live life to its fullest. Monitored data is automatically transmitted to the patient’s Personal Health Record and to relevant medical personnel.”
Developers are also looking at embracing social media, although there does not yet appear to a conclusive view on precisely what patients might share.