UNIT VIII: NURSING INFORMATICS (Lecture)
lessen personalization of
CONSUMER AND PATIENT USE OF
INFORMATICS
Consumerism 
 a social and economic order that
encourages the purchase of goods and
services in ever-greater amounts.
 Clients have a more developed sense
and knowledge of the healthcare
delivery system.
 Rise in healthcare cost, availability of
information and medical errors have
driven this transformation.
 More emphasis is given in client
education because of economic
hardships when it comes to spending
for healthcare services.
Common usage of computers among patients
and consumers
 Information Seeking
• The common usage of
computers for healthcare consumers.
(Harris Interactive, 2002)
• 2/3 of netizens have used the
computer as a source of health-
related information.
• The most commonly searched
topic is about diseases, treatments
and diet or nutritional information.
• Looking for commonality in the
contents of health information.
Example: mayoclinic.com, mims.com
 Communications and Support
• Internet is used by consumers to pass
healthcare information to their
families and friends.
• They may engage in online support
groups whose focus is on a particular
disease or condition or,
• They may communicate directly with
their healthcare providers about their
own or family member’s condition.
• Less costly than a personal visit.
• However, online communications
healthcare.
 Personal Health Records
• Even if healthcare records are made
electronic thru a network of
hospital information system, many
consumers are still cautious on
relying on this systems.
• Software for medical records
management can be purchased and
be utilized by consumers.
• Web-based applications were also
made available.
 Decision Support
• Portrays experiences of people who
had undergone a certain procedure.
• Can be multimedia or statistical
presentation.
• Focus is on information on
conditions, diagnosis, treatment
and prognosis.
• Downloadable applications can give
more information directly to the
information seeker.
• Risk assessment tools are also
available at the Internet.
 Disease Management
• Patients are enrolled in an online
disease management program and
participate in filling out data in an
online form.
• Reports of reduced hospitalization
and reduced incidence of
complications of chronic disease
by employing these technologies.
Issues in consumer computing
for health
 Variability in Quality of Information
Available to Consumers
• Quality controls in information
found in the internet are not
 present, thereby reducing
reliability of the data.
• To reduce inaccuracy, standards
were developed to control the
developer of health-related
materials and the health
information seeker.
• The eight principles authority,
complementarity, confidentiality,
attribution, justifiability,
transparency of authorship,
sponsorship and honesty.
 Uneven Accessibility Across Age, Ethnic
and Socioeconomic Groups
• Majority of Internet users are
better educated, wealthier,
younger, urban and largely
Westerners.
• Access of electronic health
services are limited only to those
who are literate and have the
computer resources.
• Social and public health
consequences are more
emphasized to clients who does
not have access to technology or
Internet.
 Educational and Cultural Barriers
• Even among those who have
access to the Internet, literacy,
language preference and cultural
background can be barriers for
using Internet for health.
• Solutions for such barriers include
better writing techniques and
greater use of interactivity.
 Physical and Cognitive Disabilities
• Disabilities have prevented the
access of online health
information.
• Elderly users have even more
specialized needs.
• Diminished visual acuity and
color discrimination, memory
deficits, and increased need for
processing time impose specific
requirements on the design of
applications.
• Most elderly patients are
inexperienced in using computers
• Common web words like “URK”,
visit {a site}, and link are not
understood by Web-naïve elderly
persons.
 Impact on Relationship with
Healthcare Providers
• Patients are now less dependent
on clinician’s advice.
• The information that our patient
gathers empowers him and
wished to participate in his
healthcare.
• Online support groups can make
patients as co-practitioners of
health.
• Support groups offer more
knowledge to validate the disease
process, treatment and
outcomes.
• Establishes three-way
partnership: patient, provider and
technology
Nursing in patient computerization
 Deep expertise in patient education
 Cultural diversity in the workforce and a
strong ethic of cultural sensitivity.
 Strong background in both patient- and
community-focused research.
 Strong heritage of patient advocacy and
patient empowerment.
Decision support for consumers
 Patients that were more informed of
their condition, the more they
participate in decision making for their
healthcare.
 Consequently, they appreciate more
the quality of the health service they
receive.
  Decisions range from a simple
treatment to a life-changing disease
management option.

Health-related decision making

 Health-related decision making is a
challenging task for a patient.
 Decision-making itself is a complex,
perceptual, cognitive and social
process.
 Decision-making about healthcare is
complicated because the substance of
the problem is complex and exceeds
the knowledge and education of most
laypersons.
 Health-related decision making is
complicated by social mechanisms.

Shared decision making

 Patients are best able to determine
which values should govern their care.
 Related to this model is the concept of
informed consent which implies that
patients should be well informed of
their condition, treatment, and
probable outcomes.
 Patient preferences are also important
inputs into healthcare decision making.

Challenges of patient preference in healthcare

 More biases
 Minimal effectiveness
 Stress
 Traditional models of care.
 Preference assessment as an iterative
process.

Computer Technology and patient decision

making
 The Stanford Center was a pioneer in
the use of computers and the Internet
for low-cost elicitation of patient
preferences for health states.
 Computer programs can aid in decision
making, but not at all times.