The Internet and Access to Quality Healthcare Information
The idea of the “empowered healthcare consumer” should not be taken lightly. Individuals have a vested interesting in obtaining the “best possible care” for their conditions. This is also likely to be true for those without insurance and the indigent. But, medical consumers are not the only ones who can benefit from Internet based research.
Physicians can also use information presented over the Internet for decision support and/or clinical research purposes in their practice. Generally, healthcare professionals require real-time information synthesis while they carry out diagnosis, treatment, and follow-up. In the past, healthcare professionals relied on memory, colleagues, their own experience, and printed publications as a source of decision-making and information acquisition.
Although there are other sources, The Agency for Healthcare Research and Quality (AHRQ) is considered a reliable source of up-to-date evidence-based clinical information. Analysts with medical expertise and understanding of Internet use are accumulating results of clinical trials. Given the monumental task of sifting through and absorbing relevant medical data, however, it can be difficult to search for and absorb an increasingly abundant body of knowledge. The real issue is how can this information be delivered more effectively to and consumed by those who need it.
Regardless of whether the user is a medical consumer or a medical professional, a key issue regarding content, above and beyond its availability and timeliness, lies in cost-effective processes for aggregation, synthesis, and "meaningful use."
Health Information and Data Exchange
In 2004, Dr. William Yasnoff spoke about a vision for development of a national database that would provide up-to-date, “womb to tomb” medical literature for adults and physicians.
Now, five years later, even though there is significant discussion about Health Information Exchanges (HIE) and some progress has indeed been made, we’re still NOT there. We need a "road map." We don’t have access to comprehensive patient histories, regardless of location, and we don’t yet have 24/7 access to relevant healthcare information in an easy-to-use format.
In 2004, each point in the process of health care delivery maintained its own set of coding standards; medical/health records contained procedures, treatments, and prescription drugs that were coded according to different medical vocabularies.
Five years later, we now have adoption of a common vocabulary such as the comprehensive standard medical vocabulary SNOMED, among other standards for health data exchange. As the Chair of HITSP, John Halamka is working with a team of experts to establish data exchange standards for electronic health records.
Only when we begin using a common standard, will the accumulation of large amounts of data on a national basis become viable. The lack of universal coding standards, while not prohibiting the collection of relevant clinical information, generally makes the process more difficult, costly, and time consuming.
To summarize, Clay Shirky co-author of Collecting And Sharing Data For Population Health: A New Paradigm, states....
Health information technology (IT) has great potential to transform health care and [improve] population health goals in clinical research, quality measurement, and public safety. To fully realize the benefits of health IT for population health, we must focus on new models that maximize efficiency, encourage rapid learning, and protect patients' privacy."
I agree... it's not the technology that provides improved health outcomes for the population... It's the use of that information by people who have effective processes in place to deliver quality health care to the population.
And, of course.... that data must be protected with effective privacy and security measures... check out the online HIPAA Survival Guide if you are looking for a place to get grounded.
The Part 4 in this series will cover Usability of the Internet, including recommendations for website ease-of-use and definitions of infrastructure.
Visit ePatient Dave's website where he also talks about the quality and use of health care information online in a post entitled "Trying to Measure the Quality of Health Information on the Internet: Is It Time to Move On?"
Thanks to ePatient Dave for a link to an editorial piece in The Journal of Rheumatology on the same topic. I especially liked the quote at the beginning of the article...
"Be careful about reading health books. You may die of
a misprint. — Mark Twain"
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