Technology in the American Healthcare Context Bradford W. Hesse, PhD Chief, Health Communication and Informatics Research Branch
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Technology in the American Healthcare Context
Bradford W. Hesse, PhDChief, Health Communication and Informatics Research Branch
Stresses on Healthcare ❑ Aging demographics
❑ Increasing chronic disease
❑ Complexity in care
❑ Increase for diseases in remission
❑ Shrinking work force
❑ Rise in treatment costs
Stresses on the Healthcare System: The Case of Cancer
New Sociotechnical Models Needed to Deal with Crisis
Source: Office of the National Coordinator for Health Information Technology (2015). Connecting Health and Care for the Nation: A 10-year Vision to Achieve an Interoperable Health IT Infrastructure. Washington, DC, Department of Health and Human Services,: 13.
HITECH Act of 2009 Was Passed to Improve Quality of Healthcare
A Core Element of Meaningful Use is Patient Engagement
“The single most unused person in health care is
the patient”*
*Cutler, D. Why medicine will be more like Walmart, MIT Technology Review, September 20, 2013
The Role of Patient Empowerment.
Engaged Patients Lower Health Care Costs
Healthy People 2020 Encourages Use of Health Comm & IT for Patients / Public
HP 2020 Goal: Internet Access
Source: Hesse, B. W., et al. (2014). "Meeting the healthy people 2020 goals: using the Health Information National Trends Survey to monitor progress on health communication objectives." J Health Commun 19(12): 1497-1509.
How about subpopulations?Age
Education
Source: Hesse, B. W., et al. (2014). "Meeting the healthy people 2020 goals: using the Health Information National Trends Survey to monitor progress on health communication objectives." J Health Commun 19(12): 1497-1509.
Gender
Race /Ethnicity
How is the Public Using the Internet?
51%$
58%$
78%$ 79%$
0%$
10%$
20%$
30%$
40%$
50%$
60%$
70%$
80%$
90%$
2003$ 2004$ 2005$ 2006$ 2007$ 2008$ 2009$ 2010$ 2011$ 2012$ 2013$ 2014$
Percen
t'Online'Po
pula/o
n'(18+)'
Year'
Looked$for$Health$Info$Online$
How is the Public Using the Internet?
51%$
58%$
78%$ 79%$
48%$ 47%$
55%$
77%$
0%$
10%$
20%$
30%$
40%$
50%$
60%$
70%$
80%$
90%$
2003$ 2004$ 2005$ 2006$ 2007$ 2008$ 2009$ 2010$ 2011$ 2012$ 2013$ 2014$
Percen
t'Online'Po
pula/o
n'(18+)'
Year'
Looked$for$Health$Info$Online$
Went$Online$First$(for$cancer$info)$
How is the Public Using the Internet?
51%$
58%$
78%$ 79%$
48%$ 47%$
55%$
77%$
7%$10%$
14%$
19%$
30%$
9%$13%$ 15%$
18%$20%$
0%$
10%$
20%$
30%$
40%$
50%$
60%$
70%$
80%$
90%$
2003$ 2004$ 2005$ 2006$ 2007$ 2008$ 2009$ 2010$ 2011$ 2012$ 2013$ 2014$
Percen
t'Online'Po
pula/o
n'(18+)'
Year'
Looked$for$Health$Info$Online$
Went$Online$First$(for$cancer$info)$
Email$Physician$
Order$Medicines$Online$
Awareness & Use of Electronic Health Information Exchange
56%$
82%$
88%$85%$
88%$
48%$
63%$66%$
61%$ 62%$
14%$
19%$
28%$
0%$
10%$
20%$
30%$
40%$
50%$
60%$
70%$
80%$
90%$
100%$
2003$ 2004$ 2005$ 2006$ 2007$ 2008$ 2009$ 2010$ 2011$ 2012$ 2013$ 2014$
Percen
t'Pop
ula-
on'(1
8+)'
Year'
Docs$have$EHRs$
Important$PHI$Shared$Electronically$
Keep$track$of$PHI$
HITECH Act
How is the Public Accessing Net? The Rise of Mobile
22%#
47%#
40%#
74%#70%#
66%#62%#
0%#
7%#
46%#50%#
56%#58%#
0%#
10%#
20%#
30%#
40%#
50%#
60%#
70%#
80%#
2003# 2004# 2005# 2006# 2007# 2008# 2009# 2010# 2011# 2012# 2013# 2014#
Percen
t'Pop
ula-
on'(1
8+)'
Year'
Broadband#Access#
Mobile#Access#
Example of Health System Innovation
“We use online Personal Action Plans (health alerts, data visualizations, reminders, personalized content, email), and results are impressive:”
-President’s Cancer Panel,San Francisco, CA
March 26, 2015
Nirav ShahVP & COO,
Kaiser So Cal
Health IT Improved Adherence
“Within 90 days of identifying a care gap … 6X pap screens completed, … 6X mammograms completed, … 10 X CRC screening completed”
Nirav ShahVP & COO,
Kaiser So Cal
Enabling a Learning Health System
Using data-driven “dashboards,” Kaiser was able to identify missing clinical actions and then flag populations at risk for follow-up action.
Patient’s Electronic Health Record
Dashboard for Population Management
Nirav ShahVP & COO,
Kaiser So Cal
Where are we going?
The Internet of Everything
Dramatic Increases in Adherence
June 2015, Office Behavioral and Social Science Research NIH-OD
The Consumer Electronics Market Aids in Prevention
Creating a self-improving healthcare system with patients as partners
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