Technology Corner: September/October 2014
When we first started using the Web waaayyyyyyy back in the mid-1990s, we found that the majority of our usage was in one direction, where we primarily acted as consumers of content. Roughly 20 years ago, the Web as we knew it then was largely made up of sites that were developed and maintained by companies, organizations, agencies, or government bodies. These groups created the content that you and I consumed. We also found ourselves exploring the early days of Web-based commerce through sites like eBay and Amazon. And of course, the Web brought easy access to email communication for the masses. This was the Web of the 1990s and early 2000s, known as Web 1.0.
Today, we are immersed in a completely different Web experience, known as Web 2.0. This modern-day Web is very different from the Web 1.0 world. Individuals have literally thousands of free tools available to create and share Web-based content. Whereas organizations spent large amounts of money to create content in the Web 1.0 world, anyone reading this article can build an engaging Web experience using free tools right now. And you can interact with the individuals who read your site. Web 2.0 tools have shifted the Web from a one-to-many model, where the average person primarily consumed content, to a many-to-many model, where the average person can create content and interact with others who consume it.
So who’s connecting on the Web? According to the Pew Research Center’s data, 87% of American adults have used the Internet. This means that nearly every American adult has used the Internet at some time. Pew has also found that users of the Internet would find the Internet more difficult to give up than their smartphones, email, television, landline phones, and social media. While you may not be familiar with the specific findings in the Pew data, you can likely relate to how integral the Internet has become in our everyday lives.
Here are a few more interesting findings from Pew. Seven in 10 Americans have looked online for health information. For years, we have described a systematic approach to creating a Web front for a pharmacy. It begins with the minimum of providing contact and address information and a listing of services offered. As you add functionality, partnering with trusted content providers or simply linking to reputable content is high on our list of recommendations for your consideration. The Pew data supports our assertion that the relatively simple act of providing useful content can have an important impact on the patients you serve: the majority of them are looking online for health information. If you are interested in additional details on what Americans look for online, visit www.pewinternet.org.
We have previously written about various Web 2.0 tools (ComputerTalk, September/October 2013) and how they can be used in a pharmacy setting. We also devoted an entire article (ComputerTalk, May/June 2012) to the OpenNotes project and its potential implications for pharmacy. We encourage you to refer to those articles for detailed information on specific Web 2.0 tools. If you want to see how a health system is using Web 2.0 to engage patients, check out the Mayo Clinic’s Social Media Health Network. In fact, the Mayo Clinic has the most popular provider channel on YouTube.
Here are Some Thoughts for You to Consider
Twenty-four percent of Internet users who have looked for health information on behalf of someone else (known as “online caregivers”) have consulted specific medication or treatment reviews.
More than 20% of online caregivers have consulted provider rankings or reviews, while 19% have consulted reviews of medical facilities.
It’s not just the young crowd that is online: 88% of those in the 50-to- 64-years age group are online, and 57% of those over 65 are online.
And while we firmly believe that mobile health represents a huge opportunity to engage patients, in some cases, patients prefer the simplicity of portals, secure messaging, and texting for health-related communication.
The term Health 2.0 is applied to the use of Web 2.0 tools in the course of health or wellness activities. An important aspect of Health 2.0 is to engage the patient as an active participant in decisions regarding his or her own care. Health 2.0 is also characterized by patients bringing data to the discussion, so to speak. This means that patients collect important health-related data through their normal course of activities. Those data are then shared with a trained professional (such as a pharmacist) to provide the professional with longitudinal insight into what the patient experiences outside of the four walls of a healthcare setting. A personal health record (PHR) is the ideal location for a patient to store these data and then provide access on a person- by-person basis. Your patients can get a free PHR from numerous online sources. Does your pharmacy system provide a PHR, or a place for patients to — at a minimum — let you know about OTC or prescription medications they get from other sources? Maybe you have veterans who use mail order for select medications but come to you for others?
Are all patients interested in measuring their blood pressure, blood glucose, or peak flow at home and uploading it to a Web-based tool? Most likely not. Patient activation is the term for a patient’s understanding of their role in their own care and their ability to take on that role. Research has shown that patients with higher activation have better health outcomes and those with lower activation are associated with higher costs to the healthcare system. There are commercially available tools to measure patient activation. Short of buying and administering the tool to every patient,it’s important to recognize that different patients will have different desires and capacities to interact with your pharmacy in the online environment. Most are probably using your app-based or online refill request feature. Some probably never will. The takeaway for enhancing your operations is to get to know your patients, their needs, and their capacities to use the tools you can select to offer them.
We are very interested in your stories (successful and maybe not successful) about using Web-based tools to engage and help your patients. If you give us permission, we would be happy to share your stories (de-identified) in a future issue so that your colleagues can share in your successes and learn from your speed bumps. CT
Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, and Bill G. Felkey, M.S., is professor emeritus, Harrison School of Pharmacy, Auburn University. They can be reached at firstname.lastname@example.org and email@example.com, or write on their blog at www.pharmacyinformatics.com.