Patient Driven Healthcare Choices: The Role of the Healthcare Industry E Loren Buhle, Jr. PhD. Creator: OncoLink, Managing Your Diabetes, Medicine Online, etc. Associate Director of Information Management, Intranet/Internet and Knowledge Engineering Area (IIKEA) SmithKline Beecham R&D

2E Loren Buhle, Jr. Ph.D. Patient ‘Drivers’ 4 Partnership with their healthcare team through information and knowledge – no ‘attending’ physicians, managing overall picture – gaps in healthcare delivery system – desire for additional choices “outside” system – virtual online community 4 Privacy, confidentiality of healthcare information. 4 Quick fix - ‘cure’ in a pill, simple treatment.

3E Loren Buhle, Jr. Ph.D. Health ‘Business’ Drivers 4 Information, Advertising of Products & Services – mainline resources: oncology, cardiology – elective medicine: weight loss, plastic surgery 4 Efficient physician time management (patient drivers) 4 Cost reduction, efficient allocation of healthcare resources 4 Patient outcomes, epidemiology, etc. 4 Education, fast, inexpensive communication – journals, news resources, clinical trial info, telemedicine, etc.

4E Loren Buhle, Jr. Ph.D. Advertising on the Internet 4 Principle vehicle for funding – poor measures of cause/effect (ROI) change prescribing patterns change/improve treatment methodology 4 Regulatory restrictions on advertising within the indication (safe and efficacious) – impact of the Internet – educational grants to sites with ‘off indication’ resources

5E Loren Buhle, Jr. Ph.D. Advertising and Public Info (for a healthcare institution) 4 Location and parking at the hospital, clinic 4 Office and clinic hours – instructions for new patients 4 Specialties of a specific hospital or clinic 4 Educational opportunities for patients and caregivers – Seminars

6E Loren Buhle, Jr. Ph.D. Physician Referral Network (Advertising) 4 Listings of physicians by specialty 4 Listings of physicians by location 4 Pictures and credentials of physicians – family practice – other interests, such as chairing support groups, etc. 4 Physician schedule management (Intranet?)

7E Loren Buhle, Jr. Ph.D. Public Health Ed & Alerts (Advertising) 4 Simple health educational material – phone numbers for poison info – head lice, simple lacerations, poison ivy 4 Instructions on food preservation 4 Vaccination Information for School 4 First Aid certification courses, CPR, etc.

8E Loren Buhle, Jr. Ph.D. CME/CNE Education of Staff (Advertising) 4 Uniform education of staff – Cost effective dissemination of education material – Monitor compliance of education 4 Specialized education for a small target audience (e.g. cardiac care) 4 Education for a widely scattered staff 4 Education for staff working different shifts

9E Loren Buhle, Jr. Ph.D. Efficient Physician Time Mgt (facilitate the process) 4 Electronic patient chart – within an institution, healthcare system, etc. 4 Electronic consultation – with library, clinical trials, medical resources – consultation with healthcare practitioners 4 Ongoing patient follow-up – minimize telephone tag with known patients – provide low resource intensive mechanism to communicate with patients

10E Loren Buhle, Jr. Ph.D. Cost reduction, efficient allocation of healthcare resources 4 Efficient scheduling of resources – physicians, facilities, pooling together scarce resources 4 Providing Resources from Remote Locations – native language psychiatrist, expert consults 4 Disease Outcomes, centralized reporting to evaluate trends, pool results 4 Electronic patient records

11E Loren Buhle, Jr. Ph.D. Patient outcomes, epidemiology, etc. (facilitate, gain knowledge) 4 Electronic patient charts – retrospective studies – integration of genomics into medicine 4 Centralized Reporting – facilitate reporting, tracking patterns of care for patients and physicians 4 Integration info, Knowledge Management – online lab results, pharmacology, medical info

12E Loren Buhle, Jr. Ph.D. Education: Fast, inexpensive communication vehicle 4 Online full-text journals 4 Online news resources (e.g. CNN, Reutershealth) 4 Clinical Trials 4 Pharmaceutical information 4 Managed Care Information 4 Government healthcare resources 4 Grant information 4 Research information

13E Loren Buhle, Jr. Ph.D. Intersection of Drivers Public and Business 4 Partnership with their healthcare team through information and knowledge – advertising, journals, online consultation with healthcare professionals – online access to their physician in some cases – visibility of other approaches to their health 4 Privacy, confidentiality of healthcare information. – challenge with electronic chart, standardization of reporting 4 Quick fix - ‘cure’ in a pill, simple treatment.