Patient Engagement and Health Information Technology

Angela Coulter and Ben Mearns

Applications of E-health Technologies

• Self-care advice and routine transactions

• Self-management of long-term conditions

• Enabling people to remain at home

Implementation Challenges

• Policy support for e-health technologies

• Availability of relevant technologies

• Evidence of beneficial effects

• Patients willing to use them

• Clinicians willing to use them

Internet Activities by Age Group, UK 2013

0

10

20

30

40

50

60

70

80

90

100

Reading news Social networking Travel services Internet banking Health information

Source: Office of National Statistics

16-24 25-34 35-44 45-54 55-64 65+

Access to Primary Care

• 25% of GP patients reported problems booking appointments by phone

• Only 6% booked appointments online

• Only 10% ordered prescriptions online

• Only 0.5% accessed their medical record online

• 12% of GP consultations carried out by phone

• 10% of those who cannot get a convenient GP appointment go to A&E departments

Clinicians’ Concerns

Finding Reliable Information

Policy Availability Evidence Patients Clinicians

Multi-Channel Access

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Access to Medical Records

• % general practices offering record access in 2014 = 32%

• % general practices offering record access in 2015 = 97%

• Policy • Availability • Evidence • Patients • Clinicians

Online Feedback

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Patient Decision Aids

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Technologies for Personalised Care Planning

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Health Coaching for Self-Management

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Remote Monitoring

• Policy

• Availability

• Evidence

• Patients

• Clinicians

Policy Gaps

• Shared decision making

• Health coaching

Technology Gaps

• Involving users in design, testing and implementation

• Telephone consultation systems

• Patient decision aids incorporated into EMRs

• IT systems to record patients’ self-management goals

• Self-management support

Evidence gaps

• Measuring outcomes that matter

• Effects of health information

• Multi-channel access to primary care – impact on demand

• Record access – patient use and impact

• Feedback for quality improvement

• Implementation of shared decision making

• Effects of personalised care planning

• Effects of health coaching

• Effects of telehealth

Promoting Use by Patients

• Multi-channel access to primary care

• Access to medical records

Promoting Use by Clinicians

• Signposting health information to patients

• Supporting multi-channel access to primary care

• Patient access to medical records

• Responding to patient feedback

• Patient decision aids

• Personalised care planning

• Health coaching

• Telehealth

• Support for innovation