Web 2.0 applications in medicine: trends and topics in the literature

Co-constructing effective collective intelligence networks in rare diseases: a mixed method approach to identify the parameters that matter for patients, professionals and policy-makers, piloted in Cyprus

BACKGROUND

Rare diseases are a particular field of public health that is characterized by scattered, often insufficient knowledge and infrastructure. The scarcity of specialized knowledge often forces clinicians and patients to an incomplete picture of the diseases and their associated risks. Effective person-centred networks appear promising for solving such real world and life-defining problems by purposely sourcing expert knowledge that is geographically-dispersed. The design and implementation of the RARE-e-CONNECT network technology is described. The project was funded to create collaborative spaces for the development of international partnerships in Cyprus' healthcare, promoting the dissemination of expert knowledge on rare diseases while saving resources through teleconsultation. Parameters that matter for patients, providers and policy-makers through the RARE-e-CONNECT experience were evaluated through a participatory mixed-method approach, consisting of (1) a needs assessment survey with 27 patients/families and 26 healthcare professionals at the two referral hospitals for the diagnosis and management of rare diseases in Cyprus; (2) interviews with 40 patients, families and patient representatives, as well as 37 clinicians and laboratory scientists, including national ERN coordinators/members; (3) activity metrics from 210 healthcare professionals and 251 patients/families/patient representatives who participated on the platform at the time of the research.

RESULTS

Our results indicate usage and intention by both healthcare professionals and patients/families to openly provide decentralized specialized information for raising suspicion amongst clinicians to facilitate the necessary referrals, as well as peer to peer psychosocial support to help cope with the everyday challenges of living with the disease. User behavior was largely affected by the prevailing social norm favoring individual practice, as well as missing policies for telemedicine and shared care. This article discusses how telehealth is inextricably linked to social, cultural, organizational, technological and policy factors affecting uptake.

CONCLUSIONS

We argue that collective intelligence tools need to be formally considered and work hand in hand with national and European policies/regulatory frameworks to promote proactiveness amongst the healthcare community with regard to the timely diagnosis of rare diseases and the facilitation of patients' pathway to specialists. Collaborative channels between countries need to be established to source collective intelligence on complex cases and save resources through teleconsultation/telementoring.

Recent trends in diabetes-related consumer health information technology research

Diabetes-related consumer health information technology (CHIT) has been designed to facilitate self-management practices, and its use has improved health outcomes for many consumers. This analysis sought to identify tendencies in diabetes-related CHIT research from 2010-2015 to help researchers find novel research topics, periodicals, collaborators, and funding agencies and experts and lay consumers to find scholarly information. Six search engines encompassing computer science, engineering, and medicine yielded potential diabetes-related CHIT publications. Abstracts and full texts were screened based on inclusion and exclusion criteria. Information on year, periodical, periodical domain, keywords, author location, author institutions, authors, and funding agencies were collected from included publications. The screening process yielded 1551 publications. Studies were published in a core of twenty periodicals, commonly comprising medicine or technology domains. "Telemedicine" was the most frequently used keyword. Harvard University, Dr. Eirik Årsand, and the National Institute of Diabetes and Digestive Kidney Diseases were the most frequent author institution, author, and funding agency, respectively, associated with publications. This analysis revealed potential for novel research on the sociology and economics of diabetes-related CHIT, among other topics. A lack of collaboration between top authors in the field indicates potential for new, impactful collaborations. Ongoing bibliometric research will be necessary to assess changes in this field. The opportunity exists to inform lay consumers and researchers through bibliometric analyses of other consumer health informatics topics.

Toward a maturity model for the application of social media in healthcare

Purpose

The advent of new technologies and change of patients’ behavioral patterns have triggered the provision of medical services through social media. Although the intersection between social media and health has received considerable research attention, there is little research on how health institutions implement social media strategy; thus a roadmap is required to navigate these technological initiatives. So, the purpose of this paper is to overcome this challenge by developing the Health 2.0 maturity model in the healthcare field.

Design/methodology/approach

To obtain this aim, the mixed method was applied in this research. In the first step, qualitative research method was used. In this step, along with comprehensive literature review, semi-structured interviews were conducted with the healthcare professionals to find the practices and capabilities of Health 2.0. In the second step, the proposed key dimensions (KD) were assessed and prioritized based on the views of the healthcare professionals using the quantitative survey method. Finally, by considering the architecture of Health 2.0 maturity model, the KDs were assigned to maturity levels based on their priority of implementation using a focus group.

Findings

The proposed maturity model is composed of six KDs and five maturity levels based on the Capability Maturity Model Integration architecture. The KDs, as well as their implementation order and weights in the proposed maturity model are presented as a roadmap for applying Health 2.0 effectively.

Practical implications

Employing the Health 2.0 maturity model enables health institutions to assess the current social media capabilities and guide them to select appropriate strategies for progress. Due to the descriptive nature of the proposed model, it allows managers to conduct process-based assessments regarding health 2.0 implementation.

Originality/value

Health 2.0 has been a recurring theme on the agenda of healthcare institutions, but no sensitive tool is available to measure its growth processes. This paper explores the much ignored but critically important subject of Health 2.0 maturity model and its implementation roadmap. The main contribution of this paper is to introduce an integrated roadmap containing the most important capabilities of Health 2.0. The proposed model is both descriptive and prescriptive in nature, and has a significant theoretical contribution to healthcare studies. This paper provides a mechanism to benchmark Health 2.0 efforts and to develop a progressive strategy that would improve its activities.

TIF 2.0: The Thal e-Course and TIF Expert Patients’ Programme for Disease-Related Education and Self-Management Skills in Thalassaemia

In response to the fundamental shift that has been taking place in the way chronic diseases are perceived and managed and the increasingly established role of patients as equal partners in the management of their condition, the Thalassaemia International Federation (TIF) has undertaken the design and development of a comprehensive online Expert Patients’ Programme (EPP) for patients with thalassaemia. Focusing particularly on β-thalassaemia, the most severe form of thalassaemia, the goal of the programme is to develop patients’ disease-related knowledge and self-care skills and enable them to co-manage their disease in a meaningful partnership with their treating physicians. An important goal of this ecourse is to empower patients to advocate for the improvement of national treatment services in every affected country. The aim of this article is threefold: (1) Relate TIF’s EPP with the goals and outcomes of other EPPs, as they are made available in the literature. (2) Describe the rationale and distinguishing features of TIF’s EPP on the basis of learning theories of knowledge acquisition and attrition, and best practices from the scientific disciplines of Human Computer Interaction (HCI) and Technology-Assisted Learning (TEL). (3) Relay the objectives of TIF’s EPP and the intended international impact in relation to TIF’s mission.

Trends and topics in eye disease research in PubMed from 2010 to 2014

Background: The purpose of this study is to provide a report on scientific production during the period 2010–2014 in order to identify the major topics as well as the predominant actors (journals, countries, continents) involved in the field of eye disease. Methods: A PubMed search was carried out to extract articles related to eye diseases during the period 2010–2014. Data were downloaded and processed through developed PHP scripts for further analysis. Results: A total of 62,123 articles were retrieved. A total of 3,368 different journals were found, and 19 journals were identified as “core journals” according to Braford’s law. English was by far the predominant language. A total of 853,182 MeSH terms were found, representing an average of 13.73 (SD = 4.98) MeSH terms per article. Among these 853,182 MeSH terms, 14,689 different MeSH terms were identified. Vision Disorders, Glaucoma, Diabetic Retinopathy, Macular Degeneration, and Cataract were the most frequent five MeSH terms related to eye diseases. The analysis of the total number of publications showed that Europe and Asia were the most productive continents, and the USA and China the most productive countries. Interestingly, using the mean Five-Year Impact Factor, the two most productive continents were North America and Oceania. After adjustment for population, the overall ranking positions changed in favor of smaller countries (i.e. Iceland, Switzerland, Denmark, and New Zealand), while after adjustment for Gross Domestic Product (GDP), the overall ranking positions changed in favor of some developing countries (Malawi, Guatemala, Singapore). Conclusions: Due to the large number of articles included and the numerous parameters analyzed, this study provides a wide view of scientific productivity related to eye diseases during the period 2010–2014 and allows us to better understand this field.

Developing a Curriculum to Promote Professionalism for Medical Students Using Social Media: Pilot of a Workshop and Blog-Based Intervention

BACKGROUND

As the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior.

OBJECTIVE

To develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students.

METHODS

This project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism.

RESULTS

A total of 72 medical students completed the survey (response rate 30%). Among the survey respondents, 71/72 (99%) reported visiting social networking sites, with 55/72 (76%) reporting daily visits. Privacy of personal information (62/72, 86%) and mixing of personal/professional identities (49/72, 68%) were the students' most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion.

CONCLUSIONS

Most medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students.