Category Archives: Pharmacist

Social determinants of Health and ICT for Health (eHealth) conceptual framework

Lately I have been designing, launching and gathering an online panel survey to a representative sample of Internet users in 14 European countries (approximately 14,000 responses). To ground the questionnaire I have developed a conceptual framework inspired and based on the two main sources. On the one hand, the Marmot Review team:

On the other hand, a Framework for Digital Divide Research developed by Jan van Dijk in several publications:

In a recent presentation about Health and Web 2.0 I tried to match both frameworks and I have posted about Inverse care law 2.0  several times using different scientific and statistical sources.  It is worth pointing out (and obviously reasonable) that I have not found any references or mentions to ICT for Health in the literature about social determinants of Health gathered through Marmot Review team website.

a-conceptual-framework-for-action-on-the-social-determinants-of-health-discussion-paper-for-the-commission-on-social-determinants-of-health

However, both frameworks (see red boxes in both figures) mention individual and social characteristics as social determinants of health and of the Internet usage. Furthermore, van Dijk includes HEALTH and ABILITY as a personal category (and I have added Health as a sphere of participation in Society and emphasis the Divides).

deeping-digital-divide

Based on and inspired by this two frameworks I have developed Social determinants of Health and ICT for Health (eHealth) conceptual framework.

social-determinants-of-health-and-ict-for-health-conceptual-framework

All concepts and boxes  of this framework are based on scientific references and the relationships established by arrows have been empirical or theoretical driven. I’m currently working on it, however I have shared this framework to gather inputs to improve it. I would love to know your comments and ideas.

UPDATE: Citizens and ICT for Health in 14 EU countries: results from an online panel survey

The integration of Information and Communication Technology into Community Pharmacists practice

Although I have not posted about Pharmacists and the use of the Internet and I have not found many research on this topic,  it’s clear that these health professionals are playing an important role in healthcare. Therefore, they also have a role in relationship with the Internet, specially Community Pharmacists, who are probably the most accessible health professional and are daily dealing with all kind of patients. Health promotion, Health prevention, Health Literacy, patients’ education,… are just some of the fields where Community Pharmacists can encourage patients to become more engaged in their own health care or their relatives health care.

Following our analysis of the integration of Information and Communication Technologies into medical practice and into nursing practice, we have analysed Community Pharmacists. The specific objectives were to develop and characterise a typology of CPs based on their ICT utilization and to identify factors that can enhance or inhibit the use of these technologies.

Cluster one consists of CPs whose information needs place a greater emphasis on international and national information; on activities related to professional education and information from the Pharmacists Association as well as workplace and pharmaceutical industry. This group also emphasizes ICT use for activities such as information search, communication and the dissemination of information as well as for corporate activities. This group is thus referred to as representing ‘integrated Community Pharmacist’. The label is used descriptively in order to capture the sense that for this group ICT are a mundane and valued resource. Cluster two is characterised by notably different features to the previous one. The second profile represents those CPs placing less emphasis on ICT so are consequently labelled as ‘non-integrated Community Pharmacist‘.

Statistical analysis of the relationship between these profiles  revealed that ‘integrated Community Pharmacist‘ are more likely to start using Internet at an earlier stage, to consider it very useful, to use this tool on a daily basis, to have a blog and to consider Internet health information very relevant. No significance association related to age, gender or pharmacy ownership was found.

Further analysis of the relationship between the two profiles and the pharmacist-patient relationship resulted in ‘integrated Community Pharmacist‘ being more likely than ‘non-integrated Community Pharmacist‘ to recommend that patients go online to find health information and to have more patients that discuss such information during a consultation. ‘Integrated Community Pharmacist‘ are also more likely to believe that patients going online for health information improve their autonomy and their quality of life as well as improving both the health professional/patient relationship and  the pharmacist/patient relationship. Finally, ‘integrated Community Pharmacist‘ are more likely to be found on the Internet searching or providing advice on professional forums. Additionally, drivers for ICT use such as improving communication with other health care professionals and improvement in work productivity are likely to have a higher impact on ‘integrated Community Pharmacist‘ while barriers such as lack of training or lack of time are less likely to challenge them.

It was observed that factors related with ‘intensive use of Internet’ (every day), ‘emphasis on Internet for communication and dissemination’ as well as information needs from the Pharmacists Professional Association play a positive and significant role in the probability of being an ‘integrated Community Pharmacist‘. Recommending patients going on-line for health information and discussing or sharing patients’ Internet health information findings also have a positive and significant role.

Acknowledgements

The research reported is part of a broad study supported by Departament de Salut de la Generalitat de Catalunya (Catalonia Health Department) and directed by Prof. Manuel Castells. Survey launched is a result of collaboration between the Internet Interdisciplinary Institute at Open University of Catalonia and the Pharmacist Association of Barcelona (Col.legi Oficial de Farmacèutics de Barcelona).

Health professionals, email use and URL prescription

Lately, I have been checking and reading some scientific papers about health communication from:

The aim is to write a paper based on the presentation done with Michael Hardey:

The purpose of this paper is  to identify how health professionals view public use of the Internet and whether new forms of communication are emerging with the following objectives:

  • To identify the utilisation, experience, expertise, barriers and expectations that doctors, nurses and community pharmacists have with the Internet and the email.
  • To identify the experience and expectations that doctors, nurses and community pharmacists have with patients using the Internet.
  • To identify factors that can enhance the integration of the recommendation of health information available on the Internet and the email within the health professional / patients relationship.

Any reference, suggestion, recommendation… about the presentation will be appreciated.

Health and the Network Society: Spanish/Catalan book launched

I’m delighted to present my book: Health and the Network Society published by Ariel now available at the book stores. I perfectly know that it would not become a best-seller but I hope it could contribute just a little to foster new debates and further research on ICT and Health.Health systems are embedded within technological, economic, social and cultural changes of our current social structure: the network society. This book is based on empirical research about the transition of the Catalan health system towards the network society. The results show how the interaction between the technological, economic, organizational, social and cultural dimensions are facilitating the emergence of new profiles of citizens, patients and healthcare professionals. The determinants that shape these new profiles allow us to identify the inhibitors and drivers of Industrial healthcare systems towards the Network healthcare systems.

Innovative health technologies: health systems in transition Synthesis

I have collected all the presentations in the same post to summarise the information. Thank you very much indeed to all the participants for these inspiring and wonderful days. I would like also to express my gratitude to Internet Interdisciplinary Institute (IN3) for its support.

Workshop: Innovative health technologies: health systems in transition
Supported by: Internet Interdisciplinary Institute (IN3)
Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary
Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and
Technology Studies Unit, Department of Sociology, University of York)
Data: 26th and 27th November
Place: Meeting room -1A , UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3,
08860 Castelldefels (Barcelona)

26th November

27th November

Internet information and email: shaping professional / patients relationship

“Innovative health technologies: health systems in transition Workshop”

Supported by: Internet Interdisciplinary Institute (IN3)

Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and Technology Studies Unit, Department of Sociology, University of York)

Data: 27th November

Place: UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3, 08860 Castelldefels (Barcelona)

Francisco Lupiáñez-Villanueva and Michael Hardey – Health professionals, the Internet and Internet informed patients

The practice of medicine and health care has been increasingly influence by and made use of the Internet as a source of information, communication and social interaction. This paper examines how doctors, nurses and community pharmacists use the Internet and how this shapes their interaction with patients. It is based on data from surveys of doctors, nurses and pharmacists working within the Catalan National Health Care System (CNHS) that were carried out during 2006. The consequent data provides an extensive and detailed quantitative database that is amenable to multivariate statistical analysis. This analysis is described and from it the manner in which the different health professions engage with Information and Communication Technologies (ICTs) and the Internet is identified.  It is suggested that the Internet should now be understood as part of mundane work and that professionals have recognised that it can be an important source of information and support for patients. There appears to be a cumulative effect whereby the more engaged with ICTs practitioners become the more likely they recognise and respond to patients who want to discuss and use resources and information from the Internet.

Workshop: Innovative health technologies: health systems in transition

I’m deligthed to announce the “Innovative health technologies: health systems in transition Workshop”

Supported by: Internet Interdisciplinary Institute (IN3)

Organized by: Francisco Lupiáñez-Villanueva (Internet Interdisciplinary Institute –UOC) and Michael Hardey (Hull/York Medical School – Science and Technology Studies Unit, Department of Sociology, University of York)

Data: 26th and 27th November

Place: UOC IN3 building. Av. Canal Olímpic, s/n. Edifici B3, 08860 Castelldefels (Barcelona)

Description

Digital technologies and the Internet are increasingly changing how people understand their health, how health care is organised and delivered to patients and opening up new scientific approaches and innovations. For example, health care records are being digitised and made available though various devices to users in most nations with a centralised health care system. Developments in genetics, imaging technologies, cloning and stem cell research are changing how health is understood and the treatments available to individuals. Such changes in the organisation of health and medical knowledge are increasingly engaging with the public through information that is made available on the Internet.

The Internet is now a vast repository of information about health and well-being.  Supported by Web 2.0 resources, the Internet has increasingly included information about health, illness and lifestyles provided by individuals.  As more of the public become connected through computers and mobile devices new opportunities are created for the publication of health information and advice.  However, the diversity of health information raises questions about quality and the impact incorrect or poor information may have on individuals.  There is already evidence that the doctor-patient relationship is changing in the face of developments in Information and Communications Technologies.  In addition, while people are the advice people may choose to follow may not necessarily result in health behaviours.  For example, men defined as obese may share information available on the Internet to remain ‘big and fat’ despite medical advice to the contrary.

The desire to provide a seamless inter-agency service built around the needs of individual people (and more broadly clients and patients of national health and welfare services) is a common aspiration in most countries with a centralised welfare system.  Developments in Telecare have seen the growth of ‘smart homes’ that enable people to live safely at home through various monitoring and intervention systems.  Such monitoring devices are also being used by people in pursuit of healthy bodies through exercise.  The iPod or iPhone can, for example, be used to monitor running and other physical activity. These technologies raise questions to do with the privacy and ownership of information.  In other words information technology has become both directly and indirectly part of everyday life for many people and those who play a part in their lives.

In this broad context, the aim of this workshop is seeking to understand how, for whom and to what extend changes in the material conditions of health information and communication is transforming the generation of medical knowledge, the conception of health and the demand and provision of healthcare delivery.

To reach this aim, the workshop is organized in discussion sessions where social researchers will present their recent research results, methodologies and experiences with enough time for rich interaction among the participants.

Program

26th Thursday

10:00 – 10:15 Opening session
10:15 – 12:00 Presentations

  • Andrew Webster – Innovation in health: a social science perspective
  • Michael Morrison – ‘Measuring Innovation – a brief introduction to the REMEDiE project’
  • Laura Machin – Cord blood banking: initial observations

12:00 – 12:15 Coffer-break
12:15 – 13:45 Presentations

  • Mariann Hardey – Private medical care and the Web
  • Eulàlia Hernádez – Providing resources for caregivers trough the Internet.

13:45 – 15:00 Lunch
15:00 – 16:45 Presentation

  • Flis Henwood – ‘Health-e discourse? Engaging the community in e-health developments for obesity self-management’
  • Sue Ziebland – Knowledge is Power? The role of health information

16:45 – 17:00 Coffer-break
17:00 – 17:30 Conclusions of the day

27th Friday

10:00 – 10:15 Opening session
10:15 – 12:00 Presentations

  • Imma Grau – Studying Virtual Communities for patients with chronic illnesses, in Forumclinic
  • Daniel López – Reframing telecare: an ethical discussion concerning ageing-in-place, independence and care.
  • Darren Reed – Performativity of Data

12:00 – 12:15 Coffer-break
12:15 – 13:45 Presentation

  • Michael Hardey – Consuming professions: user-review websites and health services
  • Francisco Lupiáñez-Villanueva and Michael Hardey – Health professionals, the Internet and Internet informed patients

13:30 – 15:00 Lunch
15:00 – 16:00 Conclusions of the workshop

Thanks indeed to the participants, to IN3 for the support and to Laura Vidal for her wonderful organization work. See also information available at IN3.

Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration

I have finished to check the proof of my article entitled Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration for Informatics for Health and Social Care (An International Journal of Informatics in Health Care).

Here goes the abstract:

The Internet has become one of the main drivers of e-health. Whilst its impact and potential is being analysed, the Web 2.0 phenomenon has reached the health field and has emerged as a buzzword that people use to describe a wide range of online activities and applications. The aims of this article are: to explore the opportunities and challenges of the Web 2.0 within the health care system and to identify the gap between the potential of these online activities and applications and the empirical data. The analysis is based on: online surveys to physicians, nurses, pharmacist and patient support groups; static web shot analysis of 1240 web pages and exploration of the most popular Web 2.0 initiatives. The empirical results contrast with the Web 2.0 trends identified. Whereas the main characteristic of the Web 2.0 is the opportunity for social interaction, the health care system at large could currently be characterised by: a lack of interactive communication technologies available on the Internet; a lack of professional production of health care information on the Internet, and a lack of interaction between these professionals and patients on the Internet. These results reveal a scenario away from 2.0 trends.

The article has been done with Miquel Angel Mayer and Joan Torrent, colleagues from Interdisciplinary Research Group on ICTs (i2TIC), and will be published on September 2009.

Healthcare system 2.0: from industrial healthcare to network healthcare

I just want to share my presentation “Healthcare system 2.0: from industrial healthcare to network healthcare”. It could be also entitled “From information to interaction, from citizen to networked citizen, from physicians to networked physicianas… Healthcare in transition to Network Society”. I have to congratulate  Kroniker, Sanidad 2.0 and Healthcare Department of Euskadi, specially Dr. Rafael Bengoa, for their wonderful job as organizers and support of the conference.

My presentation was based on a research carried out in Catalonia. Our analysis suggests a transition from industrial healthcare system to network healthcare systems with clear gaps and divides:

  • From plane and low quality health web pages (more than 50% of the 1240 web pages analysed) to interactive health websites (just 5% of them)
  • From excluded citizens who do not have access to ICT, do not use the Internet and do not care about them, to network citizens, who have access to many ICT devices and use the Internet to read/write, share ideas and socialize.
  • From traditional physicians (70%) to network physicians (30%), who use Hospital Information System intensively, who use the Internet to spread information, to search national and international research information, to communicate with patients and healthcare professionals to sum up the Internet is embedded on their work routines as interactive space.

As you have already noticed the presentation is in Spanish. I have translated the last two slides. The first one summarizes the drivers of this transition from citizens and healthcare professionals point of view:

transition

The second one is  a framework for policy-makers to manage this change developed by Ismal Peña, another member of Interdisciplinary Research Group on ICTs (i2TIC), based on Measuring digital development for policy-making: Models, stages, characteristics and causes. The role of the government

framework ICTlogy

We have to keep working into this framework to adapt it better to healthcare system. Although I think It perfectly fixes within the healthcare system.

Mapping the transition of the Catalan Health system to Network Society. A work in progress. How was research developed?

From May to September,  I’m a visiting researcher at Science and Technology Studies Unit (SATSU).

SATSU, in the Department of Sociology, “is a specialist unit dedicated to rigorous analysis of the social dynamics informing contemporary and prospective science and technology. It has an established international reputation as a centre of excellence in three areas: the sociology of the biosciences, mobilities, informatics and space, and science and technology governance. the Department of Sociology” directed by Andrew Webster.

As a part of my visiting at SATSU, Darren Reed has invited me to teach a seminar in his course entitled Exemplary Empirical Studies in Social Informatics in the MSc Social Informatics and Management. My intervention was about how the research I have been involved in the past years was developed. So it is not about the research results but about research processes. Here goes the slides:

Finally, I would like to thank  all the wonderful people I have met at SATSU for their kindness.  It was so easy to settle into the unit. Of course, special thanks indeed to Michael Hardey.