Now that seemingly everybody, from young to old, has embraced the revolution
in electronics gadgets, researchers at Johns Hopkins Bloomberg School of Public
Health decided to find out whether electronic tools and technology applications
are really helping improve the health care process. What they found was that
electronic gadgets, health software applications and online health-oriented
Websites—what they call consumer health informatics—do indeed improve the
health care process, especially regarding adherence to medication regimes and
to ensure success in tough-to-achieve clinical outcomes like smoking cessation.
Rather than do yet another primary research program to investigate a
particular medical application, Johns Hopkins researchers instead analyzed the
published results of 146 studies that focused on patient use of electronic
tools. Their question was this: Does health information technology (health IT)
benefit from this electronics revolution?
The study was performed by Johns Hopkins' Evidence-based Practice
Center with support from the
government's Agency for
Healthcare Research and Quality (AHRQ). The resulting 549-page report
offers the first comprehensive survey of health informatics as it applies to
consumers directly interacting with e-health applications.
For the purposes of the study, health informatics was defined as the use of
an electronic tool that provides interactive medial information that is
personalized to the patient's history and that helps the patient better manage
his or her health or health care. Examples of e-health included in the study
were online health "calculators," decision support software that aids
in making treatment choices, and both e-mail and text messaging services that
are now available for a variety of maladies, including smoking, diabetes,
cancer, exercise and mental health disorders.
The report goes into detail about each of the maladies being addressed by
consumer health informatics, asking the same key questions regarding whether
consumer health informatics contributed to a positive clinical outcome (whether
it helped or not), whether there was evidence of misinformation that harmed
consumers and whether there was a positive economic impact (reduced costs to the
consumer).
Overall, the report concludes that there was significant positive impact
demonstrated for smoking, diabetes, cancer, diet, exercise, physical activity
and mental health maladies. None of the 146 studies found any evidence of harm
coming to patients as a result of misinformation or other negative effects.
Regarding economic impact, however, the jury is still out, since not enough
evidence was found to support a conclusion one way or the other.
The grand conclusion of the 549-page report regarding consumer health
informatics (CHI) was that "despite study heterogeneity, quality
variability, and some data paucity, available literature suggests that select
CHI applications may effectively engage consumers, enhance traditional clinical
interventions, and improve both intermediate and clinical health outcomes."