Digital Learning, Health, and Literacy: A Vision from Thailand (October 10, 2020)
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The document discusses the role of digital health and information technology (IT) in improving healthcare delivery in Thailand, emphasizing the need for effective use of technology rather than mere implementation. It highlights various components of health informatics, digital literacy, and health literacy, stressing the importance of understanding how these elements contribute to patient care and health system quality. Furthermore, it outlines the challenges faced in integrating health IT across various healthcare settings, including data silos and poor data quality.
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Digital Learning, Health, and Literacy: A Vision from Thailand (October 10, 2020)
- 1. 1 Digital Learning, Health, and Literacy: A Vision from Thailand Nawanan Theera-Ampornpunt, M.D., Ph.D. October 10, 2020 www.SlideShare.net/Nawanan UNSW ASEAN Conference 2020
- 2. 2 The “What” of Digital Health
- 3. 3 Use of information and communications technology (ICT) in health & healthcare settings Source: The Health Resources and Services Administration, Department of Health and Human Service, USA Slide adapted from: Dr. Boonchai Kijsanayotin Health IT
- 4. 4 Use of information and communications technology (ICT) for health; Including • Treating patients • Conducting research • Educating the health workforce • Tracking diseases • Monitoring public health. Sources: 1) WHO Global Observatory of eHealth (GOe) (www.who.int/goe) 2) World Health Assembly, 2005. Resolution WHA58.28 Slide adapted from: Mark Landry, WHO WPRO & Dr. Boonchai Kijsanayotin eHealth
- 9. 9 “Big data is like teenage sex: everyone talks about it, nobody really knows how to do it, everyone thinks everyone else is doing it, so everyone claims they are doing it...” -- Dan Ariely @danariely (2013) Substitute “Big data” with “AI”, “Blockchain”, “IoT” of your choice. -- Nawanan Theera-Ampornpunt (2018)
- 10. 10 Hype vs. Hope Jeremy Kemp via http://en.wikipedia.org/wiki/Hype_cycle http://www.gartner.com/technology/research/methodologies/hype-cycle.jsp
- 11. 11 “Smart” Machines or Overreliance on Technology? https://www.bbc.com/news/business-47514289 https://www.standardmedia .co.ke/article/2001318679/e thiopian-airlines-crash- investigators-reach- conclusion
- 13. 13 To really answer the “What” of Digital Health, we need to understand the “Why”
- 14. 14 • “Don’t implement technology just for technology’s sake.” • “Don’t make use of excellent technology. Make excellent use of technology.” • “Health care IT is not a panacea for all that ails medicine.” (Hersh, 2004) Some “Smart” Quotes
- 15. 15 To treat & to care for their patients to their best abilities, given limited time & resources Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen) What Clinicians Want?
- 16. 16 Why Aren’t We Talk About These Words? http://hcca-act.blogspot.com/2011/07/reflections-on-patient-centred-care.html
- 17. 17 The Goal of Health Care The answer is already obvious... “Health” “Care”
- 18. 18 • Safe • Timely • Effective • Patient-Centered • Efficient • Equitable Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p. High Quality Care
- 19. 19 19 19 WHO (2009) Components of Health Systems
- 20. 20 20 20 WHO (2009) WHO Health System Framework
- 21. 21 (IOM, 2001)(IOM, 2000) (IOM, 2011) Landmark Institute of Medicine Reports
- 22. 22 • Humans are not perfect and are bound to make errors • Highlight problems in U.S. health care system that systematically contributes to medical errors and poor quality • Recommends reform • Health IT plays a role in improving patient safety & quality Summary of These Reports
- 24. 24 Areas of Health Informatics Patients & Consumers Providers & Patients Healthcare Managers, Policy- Makers, Payers, Epidemiologists, Researchers Copyright Nawanan Theera-Ampornpunt (2018) Clinical Informatics Public Health Informatics Consumer Health Informatics
- 25. 25 Incarnations of Health IT Clinical Informatics Public Health Informatics Consumer Health Informatics HIS/CIS EHRs Computerized Physician Order Entry (CPOE) Clinical Decision Support Systems (CDS) (including AI) Closed Loop Medication PACS/RIS LIS Nursing Apps Disease Surveillance (Active/Passive) Business Intelligence & Dashboards Telemedicine Real-time Syndromic Surveillance mHealth for Public Health Workers & Volunteers PHRs Health Information Exchange (HIE) eReferral mHealth for Consumers Wearable Devices Social Media Copyright Nawanan Theera-Ampornpunt (2018)
- 26. 26 Where We Are Today... Copyright Nawanan Theera-Ampornpunt (2018) Clinical Informatics Public Health Informatics Consumer Health Informatics Technology that focuses on the sick, not the healthy Silos of data within hospitalPoor/unstructured data quality Lack of health data outside hospital Poor data integration across hospitals/clinics Poor data integration for monitoring & evaluation Poor data quality (GIGO) Finance leads clinical outcomes Poor IT change management Cybersecurity & privacy risks Few real examples of precision medicine Little access to own health data Poor patient engagement Poor accuracy of wearables Lack of evidence for health values Health literacy Information Behavioral change Few standards Lack of health IT governance
- 27. 27 Overview of Thailand’s National Health IT Reform Intra-Hospital IT • Electronic Health Records & Health IT for Quality & Safety • Digital Transformation • AI, Data Analytics • Hospital IT Quality Improvement (HA-IT) Inter-Hospital IT • Health Information Exchange (HIE) Extra-Hospital IT • Patients: Personal Health Records (PHRs) • Public Health: Disease Surveillance & Analytics Patient at Home Copyright Nawanan Theera-Ampornpunt (2019)
- 28. 28 Strategic Operational ClinicalAdministrative LIS Health Information ExchangeBusiness Intelligence Word Processor Social Media PACS Personal Health Records Clinical Decision Support Systems Computerized Physician Order Entry Electronic Health Records Admission-Discharge-Transfer Master Patient Index Enterprise Resource Planning Vendor-Managed Inventory Customer Relationship Management 4 Quadrants of Hospital IT Copyright Nawanan Theera-Ampornpunt (2013)
- 29. 29 Hospital A Hospital B Clinic D Policymakers Patient at Home Hospital C HIE Platform Health Information Exchange (HIE)
- 30. 30 Healthtech Startup Ecosystem www.facebook.com/HealthTechThailand/ No endorsements implied
- 31. 31WHO & ITU Achieving Health Information Exchange (HIE)
- 32. 32 Toward a Smart Health Thailand
- 34. 34 Information Literacy • Goes beyond skill-based computer literacy model, by including softer skills such as: –Evaluation of information –Recognition of information need Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008.
- 35. 35 Digital Literacy • Gilster (1997): “An ability to understand and to use information from a variety of digital sources” • Gilster: DL “is about mastering ideas, not keystrokes” • Bawden (2008), referring to Gilster’s definition: “Simply literacy in the digital age” Gilster (1997) Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008.
- 36. 36 Digital Literacy (Bawden, 2008) Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008. 4 generally agreed components of DL 1. Underpinnings • Literacy • Computer/ICT Literacy 2. Background Knowledge • The World of Information • Nature of Information Resources 3. Central Competencies • Reading & Understanding Digital & Non-Digital Formats • Creating & Communicating Digital Information • Evaluation of Information • Knowledge Assembly • Information Literacy • Media Literacy 4. Attitudes & Perspectives • Independent Learning • Moral/Social Literacy
- 37. 37 Health Literacy • “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan & Parker, 2000; Selden et al., 2000; HHS, 2000)
- 38. 38 Health Literacy Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.
- 39. 39 Health Literacy Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.
- 40. 40 Health Literacy Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.
- 41. 41 Health Literacy Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.
- 42. 42 Health Literacy Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.