Kunnen eHealth & Social Media de diabeteszorg verbeteren?

dr. Tom van de Belt

#CapSel15

August 3, 2015

@rwhooijer)

@tomvandebelt

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Medicine X Stanford US Medicine 2.0 Harvard US TEDMED Wash DC US Doctors 2.0 Paris FR World PD conference CAN National Health Debate US TEDxMaastricht NL TEDxNijmegen NL FutureMed US Saskatchewan Health Quality Council Summit CAN Cleveland Clinic Personalized Summit US IGZ conference patientveiligheid NL ....

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We can't solve problems by using the same kind of thinking we used when we

created them. - Einstein

CLO: Chief Listening Officer

Technology is a tool, not our goal

The only constant in healthcare is the patient.

Bron:&Engelen,&Derksen&Source: Engelen, Derksen (2010)

patients as partners

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eHealth & social media?

Definition of eHealtheHealth is an emerging field of medical informatics, referring to the organization and delivery of health

services and information using the Internet and related technologies.

- Pagliari et al., 2005

0

450

900

1350

1800

199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014

‘eHealth’ in Pubmed

Definition of social media‘a group of Internet-based applications that build on the

ideological and technological foundations of Web 2.0, and that allow the creation and exchange of user-

generated content’- Kaplan and Haenlein, 2010

4 C's in social media

Consume

Create

Connect

Control

- Kaplan and Haelein, 2010

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Who uses Social Media?for work?

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Use of eHealth & Social Media in Healthcare

19Van de Belt et al., JMIR, 2012

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20%of Dutch adults wish to communicate with their HCP via

a Webcam

Van de Belt et al., JMIR, 2013

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25%of Dutch adults wish to communicate with their HCP using Social Media

Van de Belt et al., JMIR, 2013

You can post whatever you want outside work, it's just your private life.

A little headache.. Does this mean that I've been drinking too much? Fortunately, it was only a little bit!

This was written by a nurse!

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If you don't brand yourself, someone else will.

- Wortel (2012)

http://www.jmir.org/2014/2/e56/

Verhoef  et  al.  2013  JMIR

more =mortality

rate (-)

- patient experience (+) - infection rates (-) - readmission rates (-)

26 Source:  http://www.ZorgkaartNederland.nl

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Social Media & eHealth for Collaboration and Creation of information.

Patient group meeting

Online forum

Phone consultation

Patient Information

Leaflet

???

7.3%

21.2%

39.4%

11.9%

20.2%

YesPartiallyNocontact needed & no infocontact needed and partial info

Patient information leaflet: ‘findability’ of answers?

(%, n=193)

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Online forum Wiki Online

Information

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Stand van zaken literatuur

Bestaand onderzoek veelal observationeel en veel beschrijvingen van één systeem of toepassing.

Nog onderzoek naar (o.a.):

-Geschiktheid eHealth voor andere doelgroepen -Effectiviteit -Langetermijneffecten -Geschikte onderzoeksmethodologie (snel veranderende wereld)

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The internet has evolved.

From Reactive... To pro-active

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Hoe onderzoek je eHealth & Social Media toepassingen?

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Experimenteel design

RCT

bron: http://plazilla.com/page/4294987824/het-levenselixir-door-de-eeuwen-heen

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vaak complexe interventies

42 Campbell et al. 2000

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www.mrc.ac.uk/complexinterventionsguidanceMRC Framework

Have you done enough piloting and feasibility work to be confident that theintervention can be delivered as intended?

Can you make safe assumptions about effect sizes and variability,and rates of recruitment and retention in the main evaluation study?

Twee belangrijke vragen:

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Casus:Effect van continue monitoring op patiëntveiligheid (bijv. reductie IC-opnames) postoperatieve patiënten.

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Casus:

Continue monitoring met ViSi Mobile

éérder opsporen klinische achteruitgang (bijv. MEWS)

Tijdiger/effectiever ingrijpen

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* Betrouwbaarheid en validiteit?

* Privacy en security: opslag gegevens in cloud?

* Haalbaarheid/Acceptatie team en patient* Barriers/facilitators voor gebruik* Ervaren meerwaarde/negatieve effecten

Mixed methods!

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Succes!