mihealth - Service Design Leeds - October 2011

mihealth is endorsed by The Association of Breast Surgery

Jane Wood - Director

mihealth Limited

October 2011


R & D Pilot studies Implementation

The story

2001 2011

mihealth is endorsed by The Association of Breast Surgery mihealth is endorsed by The Association of Breast Surgery

What is mihealth?

A personal information resources and healthcare organiser providing patients with information and support tailored to their local places of care.

Patient centred - Connects them to the healthcare services they rely on.

National & local support - Generic and local information for

patients, their families and carers.

Personal - Tools to add personal information: • web links• diary appointments• contact details• make notes • keep track of how you are feeling


Background

• BA Hons Fine Art

• MA Multimedia Design & Production.

• Teaching & learning in FE/HE & post graduate education

Art & design, time based and interactive media.

• Research project manager - International Centre for Digital Content (ICDC)

Part of Liverpool John Moores University, developing creative new media

solutions within cultural, creative and commercial sectors.



What are the challenges for patients?

• Patients faced with big decisions and often feel they are not given enough information.

• Ability to retain and recall information greatly reduced.

• Communication in the doctor/patient relationship can be challenging.

• Cancer brings with it a new vocabulary.

• Internet and mass media offering information that is:

• Too general• Difficult to determine if it is up to date, accurate and authoritative• Contradictory

Patients become confused and often frightened and find it difficult to make informed decisions.


What is the need?

Cancer research UK


Getting started

• Funding application for £98,000

• Develop a prototype

• Pilot with NHS patients

• The Health Foundation (formerly the PPP Foundation) - Independent charity working to continuously improve healthcare in UK


Research

• My experience - 10 months of ‘belt and braces’ treatment for breast cancer.

• Exploration of current DH/NHS policy and services and plans for the future.

• Academic literature review of experiences of breast cancer patients.

• Exploration of current and emerging technologies.


Stakeholders

• Patients, carers & support group volunteers

• NHS health team

• Health information providers – NHS, Macmillan Cancer Support, Cancer Research UK, Health Talk Online

• Health researchers – Liverpool University

• Digital researchers – Iinternationlal Centre fro Digital Content

• Hewlett Packard – provided devices


Multi channel access


Working with patients

www.knowsley-cancer-support.co.uk

• Familiar environments where patients felt comfortable and well supported there.

• Mainly in the support groups that the patients attended.

• Our activities were slotted in between other activities – no special trips needed


How patients helped us:

• Interviews to identify key requirements in relation to people’s experiences.

• Identify the information that should be made available within the system.

• Paper based interfaces enabled us to discuss how applications should look and function and to identify requirements.


Patient experiences

How did you feel when you were diagnosed with breast cancer?

Tina - http://vimeo.com/mihealth/videos

Why do you think it is important to have the right information?

Maureen - http://vimeo.com/mihealth/videos

http://vimeo.com/mihealth/videos





Eileen McGovern – support group volunteerLyndale – Knowsley Cancer Support Group

The patient/doctor relationship and the assumptions made around information needs.

Eileen - http://vimeo.com/mihealth/videos




How health professionals helped us:

• Understand patient/doctor relationship and

• To structure and develop content.

• To understand the context in which information is used by health teams.

• How the system could be used within the hospital environment.


Mapping the patient journey created by Consultant Breast Surgeon


Content map to convey content to stakeholders


Patient journey progressing along the breast cancer care pathway


Connecting patients to their local healthcare services

mihealth can easily be tailored for local use making the

service relevant to individuals and their local care services

and support teams.

• Local contacts

GP’s, clinical teams, local services and support

• Local clinical information and images of surgical procedures

• Local treatment & support centres

Virtual tours – floor plans, maps, staff and treatment centres

• Any amount and information in any media can be added



How to patients become aware of the service?

• Local breast unit web site

• Breast screening/referral appointment letter

• NHS trust web site link

• Local NHS communications Team

• social media • web links• news items • press release

• Local charities and support services


Health teams introduce mihealth at the point of diagnosis and throughout each stage of the patient journey to support informed decision making


Connecting patients to their local healthcare services

mihealth can easily be tailored for local use to connect people

To their local healthcare services and health teams.

• Local contacts

GP’s, clinical teams, local services and support

• Local clinical information and images of surgical procedures

• Local treatment & support centres

Virtual tours – floor plans, maps, staff and treatment centres

• Any amount and information in any media can be added



Accessing mihealth - create a username and passwordRegister using the user identification number and create a username and password. Once you have registered log in with the user name and password you have created.


Overview of mihealth

Web based system combining:

• Text based information

• Illustrations & photographs

• Video & audio patient personal experiences

• Functions to support practical needs

• Information can be tailored for use locally.

https://www.mihealth.info/portal/


Cancer JourneyInformation is structured around the cancer journey.


PersonalisationPatients can personalise information to their own needs and stage of treatment.


Support networkHelp & support available to patients, their family and carers


LibraryAllows users to bookmark web sites and relevant resources for future reference


Diary – Calendar viewKeep a record of all of tests, treatments and medications and follow up care.



Diary Keep track of hospital and personal appointments and make notes about discussions


Diary – View all appointmentsKeep a record of all of tests, treatments and medications and follow up care.


ContactsRelevant local/regional/national contact details. Patients can add their own contacts.


Well beingRecord well being throughout the patient journey – view feelings as points in time


Well beingRecord well being throughout the patient journey – make notes about feelings


Glossary Explanation of treatment related words with links to ‘see also’ words and resources.


Search - Search the mihealth content database using key words.


NHS Pilots

Royal Liverpool & Broadgreen University Hospital NHS trust

Royal Victoria Infirmary (RVI) – Newcastle

Clive Griffith - Breast Surgeon – RVI NewcastleClinical Lead for Breast Cancer & Knowledge Management Cancer Services Collaborative

Lovely man and great champion of mihealth





The School of Population, Community and Behavioural Sciences

Liverpool University

Evaluation

• Provides a patient’s eye view of the treatment process.

• Enables patients to become active partners in their healthcare.

• Complements face-to-face interactions.

• Supports patients coping and decision-making strategies.

• Supports the needs of family, friends and carers.

• Supports the role of the Clinical Nurse Specialist

• Easy to use and navigate

• Does not require a high level of IT literacy.

Evaluation report executive summary - http://www.mihealth.info/findings.html

http://www.mihealth.info/findings.html


What patients said about mihealth

It was empowering - Well it was empowering because two days before I saw my consultant I rang the nurses and I gave her two pages of questions that had come up in the course of me reading things, of finding things, what if this? Does this apply to me and what happens if?

Local information very useful - I think the information about the actual hospital, that was more interesting to me. What was I going to go through? Who was I going to come across?

A best friend to go to - It is good to have something that is there, that you can treat as an extra friend, almost like a best friend that you can go to that’s quite intimate and discrete and that is a source of information and just for you.

Making medical terminology simple - mihealth did help, especially the glossary section, which I thought was very good, because there’s a lull with all the terminology that’s used. You seem to just know and go, ‘Oh, OK I know what that means there but forget what it is the next day.

Healthcare team contacts very useful - Also then there’s the consultants. mihealth just sort of reminds you what their names are. Because you get in a bit of a panic, you know thinking, ‘Oh dear, who did I see?’ You can actually see it written down.


Implementing mihealth

NHS

• Chesterfield Royal Hospital - Derbyshire

• Royal Free Hospital - London

• Royal Lancaster Infirmary - Lancashire

• Royal Liverpool University Hospital

• Royal Marsden NHS Foundation Trust - London

• Royal Victoria Infirmary – Newcastle

Private

• Spire Healthcare - Edinburgh


mihealth successful in increasing health literacy

Mihealth is show cased on the web site as a tool

successful in increasing health literacy

A comprehensive review of the of the best worldwide evidence of what works to engage patients & the public in healthcare

www.investinengagement.info


Jane Wood - Director mihealth Ltd

Old Broadcasting House

Woodhouse Lane

Leeds

LS2 9EN

Mobile: 07813125756

Email: [email protected]

Twitter: @ janelwood @mihealth_UK

Facebook: mihealth.UK

LinkedIn: http://uk.linkedin.com/in/janelwood

Web: www.mihealth.info

Health & Medicine

mihealth - Service Design Leeds - October 2011