Information Therapy: Patient Education at its Best

MDNG Primary Care, August 2008, Volume 10, Issue 8

Better patient education may help alleviate the rising cost of healthcare and lead to better health outcomes, because it helps patients make more informed decisions about their healthcare.

Better patient education may help alleviate the rising cost of healthcare and lead to better health outcomes, because it helps patients make more informed decisions about their healthcare. Although patients are taking a much more active role in maintaining their health than they were even five years ago, they still need guidance and education from their physicians; information therapy (Ix) can be an important part of this.

As the number of primary care physicians and nurses decreases, time becomes a precious commodity. In order to see as many patients a day as possible, physicians are often unable to spend enough time making sure their patients understand everything that was discussed during their visit and the instructions they were given. This is important because several studies have demonstrated that “people only really remember half of what they hear in the doctor’s office and what they do remember, they get wrong,” says Jan Oldenburg, Practice Leader, Health Portfolio, Kaiser Permanente Internet Services Group.

One way to alleviate this problem is through information therapy (Ix). The Center for Information Therapy, an independent organization originally founded by Healthwise, defines Ix as “the timely prescription and availability of evidence-based health information to meet individuals’ specific needs and support sound decision making. Ix prescriptions are specifically targeted to an individual’s needs at a particular moment in care and are delivered as part of the process of care.” They are an easy, safe, and cost-eff ective way for physicians to give patients health information—whether it is in print or posted online—that they can review after their visit.

Technology’s role

A physician may give his or her patient information during an appointment to review when he or she gets home, but how does the physician know if the patient actually looked at it? “If we provide information therapy where we tell patients to go to a website or give them brochures, it doesn’t mean it happened,” says Moe Ajam, PhD, president of Th e Patient Education Institute. “We have to simplify the information so it reaches all patients, and this is a very diffi cult job considering the diff erent learning styles and educational levels of patients.” Although brochures and lists of websites could qualify as Ix and may off er more detailed, clinical information, educational information presented in a fun, interactive way is more likely to keep a person’s attention; this is the advantage that comes with using technology like the Internet. “Technology itself can’t solve the problem, but technology can be an incredibly valuable tool,” says Seidman.

Who’s leading the charge?

Many companies and organizations are developing Ix tools to present healthcare information to people using interactive technology through the Internet. Two groups leading the charge are Healthwise and The Patient Education Institute. Healthwise is a nonprofit organization that focuses on developing Ix tools to help people make better health decisions. “Our expertise at Healthwise is really taking the medical information and transferring it into a very accessible and useable form for the consumer,” says Healthwise Chief Medical Offi cer Steven Schneider, MD. “As we transfer information to a consumer we have to think, ‘What are they going to understand?’ and ‘What are they really going to want to know?’” The company offers a number of Ix tools, including Healthwise Knowledgebase and Ix HealthMastery Campaigns.

The Knowledgebase includes information on nearly 8,000 healthcare topics and includes such tools as a Drug Interaction Checker; Decision Points, which help patients make decisions about tests and treatment options; Actionsets, which help them make informed choices about managing chronic illnesses and take control over their health; Illustrations; Custom Connections, which feature customized links and messages from outside organizations; and Topic Development Process, which helps patients maintain up-to-date information through the assistance of the Healthwise Medical Review Board. Ix HealthMastery Campaigns are “ongoing, online self-management programs for people with complex, high-priority health issues” that “combine disease management interventions and live coaching practices in an online, interactive program so [physicians] can cost-eff ectively reach a larger population.”

“Information therapy hooked with technology allows us to take advantage of the automation and [easily] move information back and forth between the doctor and the patient,” says Schneider. The Patient Education Institute develops webcasts, illustrated handouts, and other Ix tools “to empower patients and healthcare providers through evidence-based patient education software that is engaging, eff ective, and ready to integrate with evolving clinical systems.” Its flagship product, X-Plain includes “interactive patient education programs that use illustrations and animations to simplify concepts, narration to read the text, and questions to verify understanding.”Featured topicsinclude diagnosis and therapy, patient population groups classifi ed by age and gender, health and wellness, topics not usually discussed, surgery and invasive procedures, and disorders and conditions by body location or system. There are two types of tutorials: public tutorials, which allow anyone to access healthcare information; and clinical tutorials, which are implemented in the clinical setting and require patients to complete programs designated by their physician. “Technology has been instrumental in making [Ix] efficient, taking the redundancy out of it, and automatically documenting it,” says Ajam. Our healthcare system has many problems that need to be addressed. Some of the biggest problems include cost, quality of care, and staffing needs. Obviously, they will not be fi xed overnight, but physicians who use Ix might find that it can actually help alleviate some of the cost, quality of care, and staffi ng pressures by encouraging patients to take a more active role in their healthcare.

Ix benefits

Physicians who use Ix will find that it can help with some of the most important aspects of practicing medicine: cost, quality of care, staffi ng, and patient education.

Saves money

The rising cost of healthcare is putting the squeeze on patients and doctors. One way to help solve this problem is through more eff ective patient education (ie, Ix). “Many experts agree that [information therapy] is one of the best costeff ective ways of controlling major healthcare problems by providing information and ensuring that the patient understands it,” says Ajam.

Improves quality of care

Physicians are seeing more patients a day than ever before, which might make monitoring patients’ progress diffi cult; Ix can help improve quality of care. Patients now receive physicianapproved resources to learn not only about a specifi c medical condition or medical procedure, but also prevention methods and how to change lifestyle behavior. A well-informed patient is a better patient because they can make better personal health decisions. Information therapy is “part of the way that a doctor can help ensure that the [patient] actually understands the informational instructions that he or she has been given,” says Oldenburg.

Helps with staffing shortage

The decreasing number of physicians will have an enormous impact on the quality of care and cost as the population ages. Ix helps with this, because physicians are able to provide further patient education outside of the offi ce, allowing for enhanced self-care. “As we give consumers these tools for managing their care and for connecting with other people, it really creates a lot of opportunities for more eff ective and effi cient care delivery,” says Seidman.

Provides reliable resources

With the advent of the Internet, people have access to thousands of healthcare websites, many of which present unreliable information. This is a concern of physicians, because a lot of people use the Internet to look up healthcare information on their own. A Pew Internet survey in October 2006 found “about 85 million Americans look for health information online without consistently examining the quality or appropriateness of the information they find.” The question is, “do they know how to determine if a website posts the most reliable and up-to-date information?” Ix is one way to make sure the right person receives the right information at the right time from his or her physician. “The transfer of information is the most important thing that happens in healthcare,” says Schneider. “I think that [Ix] is going to be the core piece of every medical interaction.”

The future of Ix

Information therapy might not be the end-all solution to the problems within our healthcare system, but it is certainly a step in the right direction. “I think what’s guiding this trend is that patient education [leads to] better health outcomes, increases patient satisfaction, and reduces medical errors and perhaps liability,” says Ajam. Since its introduction to the healthcare system, Ix went from physicians giving out pamphlets and handouts to physicians prescribing interactive, online health programs; Ix has evolved as technology has evolved. “Technology enhances our ability to present people with the right information at the right time,” says Oldenburg. As technology advances, Ix will continue to evolve as a cost-eff ective tool that helps with staffi ng needs and helps improve quality of care.