Grant Application for Ehealth+Knowledge Translation by hhg13510

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									Health e-Technologies for
Behavior Change and Disease
Management: Opportunities and
Challenges
          David K. Ahern, Ph.D.
        National Program Director
     Health e-Technologies Initiative
     Brigham and Women’s Hospital

          Chief Science Officer
    Abacus Management Technologies
SBM 2003

       Introduction
           eHealth is a translational and
           transformative movement

           Enormous opportunities exist to
           empower consumers, improve patient-
           provider communication, and impact
           costs with eHealth

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       Introduction

           Challenges must be met and overcome
           to achieve full potential of eHealth


           Research is necessary to advance the
           field

           Online Behavior Change and Disease Management. The National Cancer Institute and The Robert Wood Johnson Foundation,
           Princeton, NJ:, 2001.


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       eHealth: The Concept
           Use of emerging interactive technologies
           to enable health improvement and
           health care services.
             Internet
             Interactive TV
             Interactive voice response systems
             PDAs
             CD- and DVD-ROMs
             Kiosks  Eng TR. The eHealth Landscape: A Terrain Map of Emerging Information an Communication
                     Technologies in Health and Health Care. Princeton, NJ: The Robert Wood Johnson
                     Foundation, 2001.                                                                       4
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       eHealth: The Potential
           Provide evidence-based, interactive
           tools to empower consumer self-
           management

           Enhance patient-provider
           communication


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       eHealth: The Potential
           Increase efficiency and reduce
           administrative costs

           Increase reach and impact of
           scientifically-proven interventions



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       eHealth: The Evidence
              Emerging programs for health behavior
              change
                      Smoking cessation
                      Physical activity
                      Nutrition
                      Weight loss

           Oenema, J., Brug, K. & Lechner, L. Web-based tailored nutrition education: results of a randomized
           Controlled trial. Health Education Research, 16(6): 647-660, 2001.
           Tate, D., Wing, R.R., & Winett, R. Using internet technology to deliver a behavioral weight-loss program.
           JAMA, 285(9), 1172-1177 March 7, 2001.

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       eHealth: The Evidence
           Emerging evidence-based programs for
           chronic illness care and disease
           management
                Back pain
                Arthritis
                Diabetes

           Lorig, K.R., Laurent, D.D., et. al. Can a back pain e-mail discussion group improve
           health status and lower health care costs: A randomized study. Arch Intern Med. Ap
           8:162(7): 792-6., 2002.
           Meigs, James, B., Cagliero, E., et. al. A controlled trial of web-based diabetes disease
           management. The MGH Diabetes Primary Care Improvement Project. Diabetes Care,
           26(3):750, 2003.
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       eHealth: The Challenges
           Keep up with rapid pace of technology
           Translation and application of evidence
           Tension between innovation and
           sustainability




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       eHealth: The Challenges
           Credibility
           Confidentiality and Privacy (HIPAA)
           Absence of a compelling business case
           High tech, low touch




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       “Low Touch”




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       eHealth: The Experience
           Dot Com Struggles
             DrKoop.com
             Channelpoint.com
             HealthScout.com
             HealthCentral.com
             etc…etc…etc…



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SBM 2003   eHealth Pessimist
           Healthy People 2010
           eHealth is a marginal communication
           channel with negligible impact on health
           care

           eHealth is largely ignored by health
           plans and providers


                                                  13
SBM 2003   eHealth Pessimist
           Healthy People 2010

           eHealth is used by the minority of high
           income and literate persons

           eHealth is not a platform for translating
           and disseminating the knowledge base
           of Behavioral Medicine

                                                     14
SBM 2003   eHealth Optimist
            Healthy People 2010
           eHealth has increased efficiency,
           improved quality, and reduced medical
           errors

           eHealth is embraced by health plans
           and providers as well as consumers


                                                   15
SBM 2003   eHealth Optimist
            Healthy People 2010
           eHealth is a prominent platform for
           translating and disseminating the
           knowledge base of Behavioral Medicine

           eHealth has increased access for
           underserved populations and helped
           reduce health disparities

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SBM 2003

       Current State of eHealth
           67% of adults (140 million people) are
           online in the US

           80% look online for health information

           96% of physicians used web-based
           technologies in 2002
                  Vital Signs. E-health in the United States. The Boston Consulting Group, January, 2003.
                  Internet and Multimedia 10: The emerging digital consumer. Arbitron/Edison Media Research, 2003.
                  Those with Internet Access Continue to Grow but at a Slower Rate. Harris Interactive Poll #8, February 5,   17
                  2003.
SBM 2003

       Current State of eHealth




                Internet and Multimedia 10: The emerging digital consumer. Arbitron/Edison Media Research, 2003.
                                                                                                                   18
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       Current State of eHealth
           53% were concerned about disruption
           of new information technologies (ITs)

           60% were concerned that ITs would
           replace in-person care, increasing split
           between patients and doctors


                   First Health Survey Shows Consumers Still Wary of Technology’s Influence Upon Health Benefits, Harris
                   Interactive, First Health Group Corp, 12/02
                                                                                                                           19
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       Current State of eHealth
           61% believe that new ITs will raise the
           cost of healthcare

           89% believe patients will end up paying




                   First Health Survey Shows Consumers Still Wary of Technology’s Influence Upon Health Benefits, Harris
                   Interactive, First Health Group Corp, 12/02
                                                                                                                           20
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           Staff
               Judy Phalen, M.P.H.
                 Deputy Director

               Jennifer Neiley, MA
             Communications Director

                   Aasha Cameron
                    Administrator
                                       22
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       RWJF Staff




                    23
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       National Advisory Committee




                                     24
SBM 2003   The Health e-Technologies
           Initiative
                     National Program Office

             Housed within the Department of
           Psychiatry at Brigham and Women’s
           Hospital
             Five-year, $10.3 million national program
           funded by a grant from The Robert Wood
           Johnson Foundation®
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           Vision Statement

       “The overarching goal of the Health e-
       Technologies Initiative is to foster
       systematic research on eHealth
       applications for health behavior change
       and chronic disease management.”



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       Vision Statement (cont.)

           “The program of funded research will
           advance discovery of scientific knowledge
           about these applications to improve
           processes and outcomes of care for
           culturally diverse groups of
           patients/consumers, and support
           provider adherence to evidence-based
           care.”
                                                   27
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           What is the Problem?

            Little known about quality and
            effects of technologies
            Need for new research
            methods for technology-based
            programs
            Need for central information
            source on research tools and
            findings                         28
SBM 2003


           Purpose

              Support scientific research

              Translate results to practice




               Ahern, D.K., Phalen, J.M., Mockenhaupt, R.E. Science and the Advancement of eHealth:
               A Call to Action. American Journal of Preventive Medicine, Vol. 24(1), 108-109, January, 2003.



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           National Program Components

           $10.3 Million over 5 years
            Grants Program ($7.25M)
            Resource and Communications
            Center and Technical Assistance and
            Direction ($2.75M)
            Assessment ($300,000)

                                                  30
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            Grants Program
           Fund descriptive studies and evaluations
           Fund evaluation, not development
           Fund providers, health care organizations,
           voluntary/community organizations
           Reach diverse and traditionally
           underserved populations


                                                   31
SBM 2003   Resource and
           Communications Center

           Rapid, online translation of results to
           practice
           Feedback between and among
           researchers and users of information
           Clearinghouse for tools, data, study
           results


                                                     32
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           Assessment

             How project contributes to
             eHealth, chronic illness care,
             health behavior




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           Stakeholder Interviews

  Established Developers /Researchers of
  Interactive Health Communications (IHCs)   9
  Programs that Have Implemented IHCs        2
  Health Plan Representatives                4
  Opinion Leaders                            12


  Total                                      27
                                                  34
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           2002 Call for Proposals
            Grants

                 Methodology and Design
                     Six-to-12 months, up to $100,000
                 Outcome Evaluation
                     Up to three years, up to $600,000




                                                         35
SBM 2003

           Application Statistics

       596 completed Letter of Intent applications
       were received.

             190 Methodology & Design category

             406 Outcome Evaluation category


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            Content Synopsis

           Most common health behaviors and disease
           states addressed:

               Diabetes
               Obesity/Weight Management
               Physical Activity
               Heart Disease
               Asthma
               Cancer
               Smoking Cessation                      37
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            Content Synopsis

           Most common technologies addressed:

               Internet
               Integrated Voice Response (IVR)
               Tele-Health/Tele-Medicine
               PDA
               CD/DVD-ROM


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           Health e-Technologies
           Initiative Home Page




                                   39
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           URL



           www.hetinitiative.org



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                 Thank You
     Contact information:
                      (617) 732-9727
                      (617) 732-9730 (f)
                      hetinitiative@partners.org

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