Welcome to Patient-Centered Care, Supporting Patient Driven Care Coordination. This is lecture b, which will discuss patient preferences for information sharing. This unit will cover the following learning objectives. One, explaining importance of patient-driven care coordination. Two, list ways a patient can use technology to drive care decisions. And three, describe the concept of patient-initiated information exchange. This unit will explore the use of technology to support and enable patient-driven coordinated care. How can patients be supported to share health information with health care providers? Technology must be designed to match patient needs, wants and abilities. Patient preferences guide the type of tools that are developed and implemented by health care providers. In addition, preferences guide how information is shared with patients. Most people in the US use technology in their daily lives for banking, shopping, communicating, learning and managing life's details. Use of technology has been slow to cross over into health care, but use is rapidly increasing. In fact, over 60% of adults now track at least one health metric using a mobile health app. In addition to health apps, some tools that are used for health information sharing include email, web based patient portals, secure text messaging and patient initiated registries. In order to support patient and population health, organizations have been formed to inform and support patient participation in their healthcare and information sharing. Some of these organizations are the Society for Participatory Medicine, Patient Safety and Quality Healthcare. And the Office of the National Coordinator for Health Information Technology, functioning within the US Department of Health and Human Services. Patients are interested in collecting and sharing their personal health data. A 2015 national survey shows that a majority of patients would use personal monitoring devices and 57% of the respondents would should share that information with their health care professionals. In that same survey, participants were asked about their attitudes towards partnership with their clinicians to improve their health. 88% of the survey respondents believed that working with their healthcare provider as a partner would improve their health. The use of the patient portal and other health information sharing technology allows the patient to choose who and how to share information with family and friends. Although race and financial status had an insignificant impact on information sharing, there were differences in information sharing preferences by age. This means that when developing strategies to support patient information sharing, the age of the patient must be considered. As a group the elderly are less inhibited about sharing their health information with family, friends and the public. Even though the elderly share their information with their family, they wish to retain control of their healthcare as much as possible. Sharing of information can lead to control struggles over healthcare decisions. For the elderly, the information sharing and health management process should remain fluid as the elderly's condition and self management abilities change. There is an inability to adjust the level of health information that is shared with family, as most current PHRs and patient portals often have a broad based, all or nothing approach to sharing. Adults are more engaged in using health information technology, and are comfortable with tracking and sharing information with their health care team. However, adults prefer to keep heath details private and tend to be more reluctant to share personal health information with their families and friends. However, adults are comfortable sharing their health goals with the public. Over 84% of teenagers research health concerns using the Internet. However, most do not feel comfortable sharing health concerns or health information with others using social media. Teens and students were reluctant to share health information with friends and family for fear of being judged. But far more likely to share with their family than the public. In one study, 88% of teens stated that they did not feel comfortable sharing their health concerns or health information using social media. And in contrast with adults, teens and students were less likely to share their health goals publicly. There are still barriers to overcome in order to fully realize seamless sharing of patient data based on preferences of each demographic group. Some of these barriers include incentives for providers to change their practices and accommodate information sharing. Physicians practicing under the physician directed care model may view information sharing as a challenge to their authority. Thus, inhibiting information sharing. As the physician culture changes from physician directed care to partnership based care, the patient culture is changing. Patients must feel enabled to share information, ask questions and express thoughts and opinions about their healthcare options. This concludes lecture B of supporting patient driven care coordination. To summarize, although tools are emerging that support easier access to information sharing, there are technical and cultural barriers yet to be addressed. In addition, patient preferences for information sharing are influenced by the age and demographics of the patient and family. And this must be taken into consideration when developing tools and processes for information sharing.
