1. Accessing E-Health information and literacy for the eNomad eNomad Tony Stiller Central Queensland University - Brisbane Campus t.stiller@bris.cqu.edu.au

2. e-Health Initiative your health information Offers anywhere, anytime access: your health information will be electronically available to the right person at the right place and time Overcomes fragmentation and duplication: interconnecting the Australian health sector will remove much of the reliance on paper records and unnecessary duplication of tests you or your you your personal health outcomes More control over health outcomes: you or your carer will have electronic access to the information you need to better manage and control your personal health outcomes you will your personal health information Best practice secure messaging: you will have confidence that your personal health information is being managed within a secure, confidential and tightly controlled environment Equity for all Australians: better access to health care services in remote, rural and disadvantaged communities eNomad http://www.ehealthinfo.gov.au/what-is-e-health/benefits-of-e-health/

3. e-Health Initiative Who is involved in e-health: eNomad http://www.ehealthinfo.gov.au/what-is-e-health/who-is-involved-in-e-health/ More than 20 clinical leaders from around the country are supporting the National E-Health Transition Authority (NEHTA), providing guidance, advice and first-hand experience to spearhead the innovations and improvements that will drive increases in health quality and safety. Dozens of stakeholder groups Dozens of stakeholder groups have been consulted on the e-health journey. A formalised reference group process is conducted by NEHTA to ensure channels are available for informed feedback. Collaboration is becoming increasingly important at all stages of the e-health roll-out. We are pooling resources to learn and innovate, design and develop the infrastructure to deliver e-health.

4. e-Health Initiative for both individuals and healthcare professionals patient centric If the e-health initiative is to provide ‘significant benefits for both individuals and healthcare professionals including better management and co-ordination of care and an increase in quality and safety’ through ‘Self-care management: online services will help you better manage your own health’, i.e. patient centric, then: The individual and healthcare professionals should be engaged as stakeholders. eNomad http://www.ehealthinfo.gov.au/what-is-e-health/why-e-health/co-ordinated-care/

5. You and/or Your Carer eNomad iGeneration X-Generation Y-Generation Baby Boomers GreyNomads eNomads iGeneration X-Generation Y-Generation Baby Boomers eNomads

6. eNomad ‘an unplugged grey nomad who travels for all, or part of the year using ICTs to communicate and interact with other members of family and society as they travel to places of choice’. Stiller 2009

7. eNomad Personally Controlled e-Health Records (PCEHR)

8. Hypothesis 1: The benefits of accessing their personal electronic health record (PCEHR) will convince the eNomad to use their IHCI via the e-Health portal. Hypothesis 2: Consensus amongst healthcare professionals in developing e-Health standards will deliver accurate, secure and trusted health information.

9. Hypothesis 3: The design of the e-Health portal will meet the needs of the eNomad and will be easy to use and useful. Hypothesis 4: APIs will be added to the e-Health system and accessed via the portal to incorporate the full range of health providers and services visited by the eNomad.

10. Hypothesis 5: The eNomad will access the e-Health system where the information is secure, complete and accessible through fixed and wireless ICT devices. Hypothesis 6: An eNomad is more likely to access the e-Health portal when they can customise the content to meet their needs.

11. Hypothesis 7: There will be no e-Health divide as the eNomad will be able to access, interpret, understand, seek further information and use problem solving skills and to make informed decisions about their health status, medications and treatment options regardless of their level of health literacy.

12. Hypothesis 8: Health professionals and government agencies will not be legally liable should an inappropriate health decision result in an adverse health outcome due to the information and advice or from the eNomads low level of health literacy.

13. Hypothesis 9: “Cloud within a Cloud’ computing will provide the secure platform for the delivery of the e-Health system.

14. Theory of Planned Behaviour/Reasoned Action Source: Aizen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, p. 179-211. eNomad

15. Technology Acceptance Model eNomad Source: Adapted from Davis (1986); Davis (1989)

16. eNomad Research Model ICT adoption by grey nomads and eNomads Technology acceptance to access eHealth records (all stakeholders) Levels and format of data abstraction (all stakeholders) Behavioural intention to use ICTs for eHealth (all stakeholders) Design and development of the eHealth portal (all generations) Multi-discipline holistic approach (all stakeholders) Source: Dahlberg et al., 2003