UNIT VIII: NURSING INFORMATICS (Lecture) • However, online communications

lessen personalization of
CONSUMER AND PATIENT USE OF healthcare.
INFORMATICS
 Personal Health Records
• Even if healthcare records are made
Consumerism 
electronic thru a network of
 a social and economic order that
hospital information system, many
encourages the purchase of goods and
consumers are still cautious on
services in ever-greater amounts.
relying on this systems.
 Clients have a more developed sense
• Software for medical records
and knowledge of the healthcare
management can be purchased and
delivery system.
be utilized by consumers.
 Rise in healthcare cost, availability of
• Web-based applications were also
information and medical errors have
made available.
driven this transformation.
 More emphasis is given in client
 Decision Support
education because of economic
• Portrays experiences of people who
hardships when it comes to spending
had undergone a certain procedure.
for healthcare services.
• Can be multimedia or statistical
presentation.
Common usage of computers among patients
• Focus is on information on
and consumers
conditions, diagnosis, treatment
 Information Seeking and prognosis.
• The common usage of • Downloadable applications can give
computers for healthcare consumers. more information directly to the
(Harris Interactive, 2002) information seeker.
• 2/3 of netizens have used the • Risk assessment tools are also
computer as a source of health- available at the Internet.
related information.
• The most commonly searched  Disease Management
topic is about diseases, treatments • Patients are enrolled in an online
and diet or nutritional information. disease management program and
• Looking for commonality in the participate in filling out data in an
contents of health information. online form.
Example: mayoclinic.com, mims.com • Reports of reduced hospitalization
and reduced incidence of
 Communications and Support complications of chronic disease
• Internet is used by consumers to pass by employing these technologies.
healthcare information to their
families and friends. Issues in consumer computing
• They may engage in online support for health
groups whose focus is on a particular
disease or condition or,  Variability in Quality of Information
• They may communicate directly with Available to Consumers
their healthcare providers about their • Quality controls in information
own or family member’s condition. found in the internet are not
• Less costly than a personal visit.
 present, thereby reducing deficits, and increased need for
reliability of the data. processing time impose specific
• To reduce inaccuracy, standards requirements on the design of
were developed to control the applications.
developer of health-related • Most elderly patients are
materials and the health inexperienced in using computers
information seeker. • Common web words like “URK”,
• The eight principles authority, visit {a site}, and link are not
complementarity, confidentiality, understood by Web-naïve elderly
attribution, justifiability, persons.
transparency of authorship,
sponsorship and honesty.  Impact on Relationship with
Healthcare Providers
 Uneven Accessibility Across Age, Ethnic • Patients are now less dependent
and Socioeconomic Groups on clinician’s advice.
• Majority of Internet users are • The information that our patient
better educated, wealthier, gathers empowers him and
younger, urban and largely wished to participate in his
Westerners. healthcare.
• Access of electronic health • Online support groups can make
services are limited only to those patients as co-practitioners of
who are literate and have the health.
computer resources. • Support groups offer more
• Social and public health knowledge to validate the disease
consequences are more process, treatment and
emphasized to clients who does outcomes.
not have access to technology or • Establishes three-way
Internet. partnership: patient, provider and
technology
 Educational and Cultural Barriers
• Even among those who have Nursing in patient computerization
access to the Internet, literacy,  Deep expertise in patient education
language preference and cultural  Cultural diversity in the workforce and a
background can be barriers for strong ethic of cultural sensitivity.
using Internet for health.  Strong background in both patient- and
• Solutions for such barriers include community-focused research.
better writing techniques and  Strong heritage of patient advocacy and
greater use of interactivity. patient empowerment.

 Physical and Cognitive Disabilities Decision support for consumers

• Disabilities have prevented the  Patients that were more informed of
access of online health their condition, the more they
information. participate in decision making for their
• Elderly users have even more healthcare.
specialized needs.  Consequently, they appreciate more
• Diminished visual acuity and the quality of the health service they
color discrimination, memory receive.
  Decisions range from a simple
treatment to a life-changing disease
management option.

Health-related decision making

 Health-related decision making is a
challenging task for a patient.
 Decision-making itself is a complex,
perceptual, cognitive and social
process.
 Decision-making about healthcare is
complicated because the substance of
the problem is complex and exceeds
the knowledge and education of most
laypersons.
 Health-related decision making is
complicated by social mechanisms.

Shared decision making

 Patients are best able to determine
which values should govern their care.
 Related to this model is the concept of
informed consent which implies that
patients should be well informed of
their condition, treatment, and
probable outcomes.
 Patient preferences are also important
inputs into healthcare decision making.

Challenges of patient preference in healthcare

 More biases
 Minimal effectiveness
 Stress
 Traditional models of care.
 Preference assessment as an iterative
process.

Computer Technology and patient decision

making
 The Stanford Center was a pioneer in
the use of computers and the Internet
for low-cost elicitation of patient
preferences for health states.
 Computer programs can aid in decision
making, but not at all times.