E-HEALTH - E-SANTE - PHARMAGEEK

Use of eHealth technologies is common in the multiple sclerosis (MS) population and facilitates the exchange of health care information with providers, according to a recent study.

However, use of eHealth and mHealth technologies varies substantially with sociodemographic factors, and health care providers need to be aware of these disparities as these technologies are increasingly leveraged in health care settings.

Researchers surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry in 2017 about their use of eHealth technologies using questions adapted from the Health Information National Trends (HINTS) 4 Cycle 4 survey. They found:

• Of 6,423 participants included in the analysis, most participants were female, and white, with a mean (SD) age of 59.7 (10.1) years.
• Overall, 5,408 (84.2%) had exchanged medical information with a health professional most often using a secure online portal (1,839, 28.6%), followed by email (1,327, 20.7%).
• Of the 5,529 smartphone and tablet users, 2,556 (46.2%) used an mHealth app.

read original at https://www.mdedge.com/clinicalneurologynews/clinical-edge/summary/multiple-sclerosis/use-ehealth-technologies-common-ms

The objective of this study was to investigate how users experience the implementation of self-regulation techniques
in a Web-based intervention targeting physical activity and sedentary behavior in the general population.

Background: eHealth interventions show stronger effects when informed by solid behavioral change theories; for example,
self-regulation models supporting people in translating vague intentions to specific actions have shown to be effective in altering
health behaviors. Although these theories inform developers about which behavioral change techniques should be included, they
provide limited information about how these techniques can be engagingly implemented in Web-based interventions. Considering
the high levels of attrition in eHealth, investigating users’ experience about the implementation of behavior change techniques might be a fruitful avenue.

Results:

The techniques “providing feedback on performance,” “action planning,” and “prompting review of behavioral goals”
were appreciated by users.

However, the implementation of “barrier identification/problem solving” appeared to frustrate users; this was also reflected by the users’ website data—many coping plans were of poor quality.

Most users were well aware of the benefits of adopting a more active way of living and stated not to have learned novel information. However, they appreciated the provided information because it reminded them about the importance of having an active lifestyle. Furthermore, prompting users to self-monitor their behavioral change was not sufficiently stimulating to make users actually monitor their behavior.

Conclusions: Iteratively involving potential end users offers guidance to optimally adapt the implementation of various

Every year, more than 3 million people in Europe experience a heart attack. For half of them, this is not the first time. Most of these recurrent heart attacks can be prevented by improving the lifestyle after the first heart attack, for which patients are often offered cardiac rehabilitation. These programs consist of exercise and lifestyle recommendations. Cardiac rehabilitation is provided at specialized centers.
 
According to estimates, if all cardiac patients were to undergo cardiac rehabilitation, the mortality from myocardial infarctions could fall by 26 percent and hospital admissions by more than 30 percent. Despite these benefits, less than half of cardiac patients receive cardiac rehabilitation. This lack of participation is mainly due the distance to the cardiac rehabilitation centers, which patients experience as being too far. There are also many objections to the limited possibilities for taking an individualized program.
 
Research has shown that an internet-based rehabilitation program can achieve the same results as rehabilitation at a center. An e-health application for cardiac rehabilitation could therefore eliminate many obstacles for patients.

However, such an application is not yet available.

With Eurostar funding of € 1.9 million, a European consortium of researchers and companies will create CaRe, a mobile platform for cardiac rehabilitation.

Maria Hopman is creating this e-health program for cardiac rehabilitation together with a consortium of Danish and Swiss companies. Starting in 2021, the program will be available for physiotherapists and hospitals in Europe.

more at https://www.radboudumc.nl/en/news/2018/major-grant-for-development-of-e-health-program-for-cardiac-rehabilitation

Estonia and Finland will start exchanging digital prescriptions at the end of the year, in a groundbreaking move that Estonian Health Minister Riina Sikkut said she hoped other EU countries will follow.

Speaking to EURACTIV.com on the sidelines of the European Health Forum in Gastein, Austria, Sikkut said that in Estonia, it is common practice for healthcare professionals to use the e-health system to exchange patient medical records.

“But it is also important for people who have a need for healthcare services abroad to have his or her health data available to a doctor, nurse or a pharmacist so that they could also provide quality healthcare services and continuity of care,” she said.

The cross-border flow of data has taken centre stage in the discussion in Brussels. Right now, when citizens move to another EU member state, their healthcare data is in fact simply “lost”.

Advocates of the digitisation of healthcare say data mobility, or the “5th freedom”, in the EU could unlock the potential of innovation in the sector and make EU patients’ lives easier.

Estonia is known for its digitisation push in all sectors, and during its EU Presidency (July-December 2017), it took significant steps to create a “coalition of the willing” of EU member states to speed up healthcare data mobility in Europe.

eHealth literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information.

Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth.

This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts.

The objective of this study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC.

Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal.

Despite the transactional capabilities of eHealth, the role of “communication” in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions.

read the full study at https://www.jmir.org/2018/10/e10175/

In the new Ipsos Global Advisor survey, Britons are most positive globally about their healthcare system and - with Spain - have the highest confidence that they get the best treatment.

Some of the remarkable findings:

1. "Consumers’ assessment of the quality of their healthcare varies widely across the 28 countries covered in an Ipsos Global Advisor survey of more than 23,000 adults. Globally, 45% rate the quality of the healthcare they have access to in their country as good, 33% rate it as neither good nor poor and 23% as poor.
2. Among problems facing healthcare systems, access to treatment/long waiting times is the one consumers around the world are most likely to view as a major concern (selected by 40%), most of all in Poland (70%), Serbia (68%), Hungary (65%) and Chile (64%). Insufficient staffing is the second most cited major problem globally (by 36%), most of all in Sweden (68%), France (67%), Hungary (63%) and Germany (61%). Cost of accessing treatment third most cited problem worldwide (by 32%) – but ranks at #1 in the U.S. (64%), Malaysia (49%), India (44%), Saudi Arabia (32%), and in a statistical tie with other issues in Australia (38%).
3. Views about the future of healthcare differ widely across countries as optimism prevails in emerging countries (especially China, India, Saudi Arabia, Malaysia and throughout Latin America) while pessimism dominates in many developed countries (especially in Western Europe).
4. Globally, less than half of all participants agree that the provider they last saw know them as a person (36%), or that they know that doctor very well (37%), or that the doctor showed them emotional support (40%).
5. Globally, one half (49%) agree they get all the medical care they need while one quarter (24%) disagree and another quarter (27%) neither agree nor disagree.
6. Globally, cancer ranks as the #1 public health concern with obesity a far second.

Thinking about Telemedicine

• Globally, only 10% report having ever used telemedicine. Generally speaking, reported experience is far more common in emerging countries of Asia and the Middle East and in the United States than it is in Europe. Among the 10% who have used it, about two thirds say they would use it again and one third say they wouldn’t. Globally, 44% say they haven’t used it but would try it.
• Globally, 12% say they currently use a connected health device or tool to manage their health, 15% say they have used one, but are not using any now, and 68% say they have never used one – the other 6% do not know. The five countries where usage is highest are the same as with telemedicine: China (28%), India (23%), Saudi Arabia (22%), Malaysia (18%) and the U.S. (15%).

In an opinion piece published online in Medical Economics, part of the Modern Medicine Network, Henry Anhalt, DO discusses the current status of Precision Medicine as 2016 draws to a close. Reflecting on President Obama’s 2015 State of the Union address, in which he launched the Precision Medicine initiative – a program that aims to revolutionize health outcomes by taking a personalized approach to medicine and research – he acknowledges the ongoing debate as to whether this approach to treating disease can truly deliver on its promises. He also recognizes the uncertainty for precision medicine that lies ahead as the US enters a new presidential term.
One of the solutions Anhalt proposes is for clinicians to ask themselves how they can implement the tenets of precision medicine when treating patients in the immediate present. His suggested answers to this question included enabling patients to access their own health record data: “So they can review it when they need to and share it with others when they want”. He then discussed The U.S. Department of Veterans Affairs’ push for patient access to health records through its pioneering “Blue Button” initiative and how it is a step in the right direction towards this goal.
Another suggestion involves how the community engages study participants in research, as: “There are many ways patients today can participate in research without requiring a visit to a large research hospital.” Anhalt continues, “For example, if patients can download their health records, one easy opportunity they may have is to donate them to research. For people with Type 1 diabetes, we offer a patient platform that allows that patient to connect with others who have Type 1 diabetes and participate in online research. To truly achieve the promise of precision medicine, it’s going to require that our patients have the understanding and motivation to become citizen scientists.”
He concluded with advice for clinicians that even if today they cannot practice precision medicine in full, they should at least strive for individualized care. “As physicians, we are trained to ask questions such as, ‘What are your symptoms; how long have you had these symptoms?’ and so forth. But what are the questions we’re not asking that help us get a more holistic view of a patient’s health?” He argues that greater empathy in clinical interactions could help achieved more personalized care in the present.
Finally, Anhalt points out that, despite the wealth of precision medicine research is being done, there is a long way to go until it can be fully and successfully integrated into healthcare systems nationwide. “We’ve just scratched the surface with the Precision Medicine Initiative, and it will be interesting to see what takes place in 2017 and beyond as we focus more on patient outcomes.”

Conclusions: Caregivers of children with special healthcare needs have notable levels of psychosocial challenges and those challenges are associated with their e-health resource seeking. Although e-health interventions, including ones that focus on child health education and caregiver support, may be the future of healthcare, a concerted effort is needed to educate caregivers about the benefits of e-health.

Objectives: In this study, we explored the relationships between the psychosocial health of caregivers of children with special healthcare needs and their e-health use. Additionally, the analysis examined moderating effects of a caregiver's perceptions of e-health and his or her e-health literacy on the associations among four domains of psychosocial health and e-health use.

Materials and Methods: To date, 313 caregivers of children, 12–18 years of age, with special healthcare needs have been recruited. Covariate-adjusted multivariable regressions determined associations between psychosocial health domains of caregivers and e-health use. E-health literacy and perceptions of e-health were further tested as moderators of the relationship between psychosocial health and e-health use.

Results: Among the caregiver population, 31% had problems with social functioning, 36.1% with communication, 43.3% with family relationships, and 46.3% with worrying for their child. After adjusting for demographic variables, e-health use was associated with poorer levels of social functioning, communication, worry, and family relationship.
E-health use was also associated with e-health literacy. Perceptions of e-health significantly moderated the relationships among social functioning, communication, and e-health, with the relationship being significantly stronger in caregivers with more positive perceptions of e-health.

VISCERAL is a support action that will organize two competitions on information extraction and retrieval involving medical image data and associated text that will benchmark the state of the art and define the next big challenges in large scale data processing in medical image analysis.

Les tendances futures au niveau technologique et numérique qui influenceront le domaine de la santé dans les années à venir.

In case you haven’t heard: Samsung is now a pharmaceutical company, or at least on the point of becoming one. Subsequent to its having invested at least $2b in biopharmaceuticals, the South Korean giant will be bringing a biosimilar version of Amgen’s Enbrel to market in 2016.

That’s right.

In 2016, a company best known for its consumer electronics and heavily invested in mobile health is going to start producing pharmaceuticals, and will apparently begin by bringing a treatment to market which will presumably make it a dominant force overnight in the two disease areas in which Enbrel has indications, namely moderate to severe rheumatoid arthritis, and psoriatic arthritis.

The implications of this for legacy pharmaceutical companies are wide-reaching and significant. Let’s consider a few of them (I anticipate updating this post over the next few months):

- Samsung now has more touch points across the health ecosystem than any other pharmaceutical company. ...

- Samsung’s total focus on customer experience and design makes it a credible champion of the participatory patient’s interests. ...

- Hundreds of millions of people carry this pharmaceutical company’s brand with them day and night. ...

- Consumers will think of Samsung as a consumer electronics company that makes pharmaceuticals. ...

- Samsung will be the first consumer technology company to enter the pharmaceutical marketplace, but it will not be the last.

If this thought doesn’t focus legacy pharmaceutical companies into throwing everything they have into reforming themselves as social business, nothing will. The survival of even the largest companies is far from certain when giants such as Samsung have set their sights upon entering the industry.

Samsung doesn’t think like a pharmaceutical company.

Pharmaceutical companies better start thinking like Samsung.

Giving physicians more say in how to incorporate technology into their work is good for patients, and the field.

If you want to discourage a worker, subject them to policies and procedures that don’t make sense. This principle was first described by Frederick Herzberg, an American psychologist who developed one of the most widely studied theories of workplace motivation. Unfortunately, Herzberg’s principle is being widely applied today in medicine. Changes in healthcare payment systems, the use of information technology, and the doctor-patient relationship have left many doctors deeply discouraged.

...

It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments, and help patients.

...

What can be done? Weygandt argues that doctors need to play a more active role in all aspects of healthcare’s future, not just implementing but also designing it. Too often, such decisions are currently being made by people who do not take care of patients, and in many cases, have never cared for patients.

“Every innovation should be tested not just to see if it increases revenue or cuts costs,” he says, “but also to ensure that it enhances the doctor-patient relationship.”

Everyone involved in contemporary healthcare—patients, doctors, nurses, hospital administrators, payers, and politicians—needs to recognize the importance of preserving and promoting medical professionalism. Good medical care is an art as well as a science, and the professionalism of doctors is at its core. “Doctors should be encouraged to think first not of their own incomes but the needs of their patients, and that means designing systems that keep the patient front and center.”

...

New technology can do a better job of helping doctors practice better medicine.... But change isn’t easy. ...

As Frederick Herzberg would put it, “If we want doctors to do better work, we need to give them better work to do.” Medicine practiced well—in such a way that it really makes a difference in the lives of patients, families, and communities—is a great deal more fulfilling than medicine practiced poorly. If doctors are to enjoy the opportunity to make such a difference, they must cease to be the tools of their tools, and instead become their designers.

Definition of Health 2.0 and Medicine 2.0: A Systematic Review

ABSTRACT

Background: During the last decade, the Internet has become increasingly popular and is now an important part of our daily life. When new “Web 2.0” technologies are used in health care, the terms “Health 2.0" or "Medicine 2.0” may be used.
Objective: The objective was to identify unique definitions of Health 2.0/Medicine 2.0 and recurrent topics within the definitions.
Methods: A systematic literature review of electronic databases (PubMed, Scopus, CINAHL) and gray literature on the Internet using the search engines Google, Bing, and Yahoo was performed to find unique definitions of Health 2.0/Medicine 2.0. We assessed all literature, extracted unique definitions, and selected recurrent topics by using the constant comparison method.
Results: We found a total of 1937 articles, 533 in scientific databases and 1404 in the gray literature. We selected 46 unique definitions for further analysis and identified 7 main topics.
Conclusions: Health 2.0/Medicine 2.0 are still developing areas. Many articles concerning this subject were found, primarily on the Internet. However, there is still no general consensus regarding the definition of Health 2.0/Medicine 2.0. We hope that this study will contribute to building the concept of Health 2.0/Medicine 2.0 and facilitate discussion and further research.

(J Med Internet Res 2010;12(2):e18)

During the last decade, the Internet has become increasingly popular and now forms an important part of our daily life [1]. In the Netherlands, the Internet is even more popular than traditional media like television, radio, and newspapers [2]. Furthermore, the impact of the Internet and other technological developments on health care is expected to increase [3,4]. Patients are using search engines like Google and Bing to find health related information. In Google, five percent of all searches are health related [5]. Patients can express their feelings on weblogs and online forums [3], and patients and professionals can use the Internet to improve communication and the sharing of information on websites such as Curetogether [6] and the Dutch website, Artsennet [7] for medical professionals. The use of Internet or Web technology in health care is called eHealth [1,8].

In 2004 the term “Web 2.0” was introduced. O’Reilly defined Web 2.0 as “a set of economic, social, and technology trends that collectively form the basis for the next generation of the Internet, a more mature, distinctive medium characterized by user participation, openness, and network effects” [9]. Although there are different definitions, most have several aspects in common. Hansen defined Web 2.0 as “a term which refers to improved communication and collaboration between people via social networking” [10]. According to both definitions, the main difference between Web 1.0 (the first generation of the Internet) and Web 2.0 is interaction [11]. Web 1.0 was mostly unidirectional, whereas Web 2.0 allows the user to add information or content to the Web, thus creating interaction. This is why the amount of “user-generated content” has increased enormously [12]. Practical examples of user-generated content are online communities where users can participate and share content. Examples are YouTube, Flickr, Facebook, and microblogging such as Twitter. Twitter, for example, improves communication and the sharing of information among health care professionals [13]....

KHRESMOI, a four-year European project funded since 2010 in the 7th Framework programme aims to create a multi-lingual, multi-modal search and access system for biomedical information and documents. Visual search in radiology archives and the open-access medical literature is the subject of this article published in Health Management.

Personalized medicine is the tailoring of a medical treatment to the individual characteristics, needs and preferences of a patient. Many recent advances involve using a patient's genetic information to guide his or her treatment.

Developing a truly personalized approach to patient care will require fundamental advances in the understanding of the biological, anatomical and physiological mechanisms that underlie disease, and how they are affected by environmental, genetic, social and cultural factors.

To describe its unique responsibilities and its efforts in facilitating the advancement of personalized medicine, the Food and Drug Administration (FDA) has released a new report entitled "Paving the Way for Personalized Medicine: FDA's Role in a New Era of Medical Product Development 

The case about health apps by IMS, stated in 4 infographics, regarding patient empowerment, health information needs etc.

@IMSHealth is using Ow.ly! View all of this user's images and documents.

The case about health apps by IMS, stated in 4 infographics, regarding patient empowerment, health information needs etc.

@IMSHealth is using Ow.ly! View all of this user's images and documents.

A study found just five apps account for 15 per cent of all downloads in the healthcare category, an example say the authors of a significant skew in how the market works.

Analysis of the influence of technology and smartphones in the field of medicine and how it they can be used to look after our health. @MWCBarcelona