Tag: internet

The Doctor Will See You Now…Online

Gina Tripicchio is a nutrition doctoral student interested in childhood obesity intervention, school-based wellness programs and technology integration for health promotion. 

Everyone has felt the dread of the unknown while waiting in the doctor’s office. How long will this take? How much will this cost? The new movement of Telemedicine could be a solution to the expenses and inefficiencies of the current healthcare system.

Telemedicine (also called TeleHealth, Connected Health, TeleNursing) is the use of technology to deliver healthcare remotely. Patients save time commuting and can choose providers based on comfort or experience, rather than location. Costs are much lower, averaging $40 per visit.

The ubiquitous nature of technology, of course, applies to telemedicine. Services are available from computers, tablets and smartphones, making care-on-the-go truly possible. The potential to reach rural communities and developing countries where care is often most needed is also exciting.

Telemedicine services are ideal for common illness such as allergies, respiratory infections, pink eye, and minor injuries. Doctors can diagnose and prescribe medications, and insurance companies are rapidly providing telemedicine options for their clients. Patients can access doctors for chronic disease management and preventative care, reducing overall healthcare costs and reserving emergency rooms for urgent medical needs.

Challenges do exist, such as scheduling virtual patients, reimbursing practitioners and ensuring patient confidentiality. As with any novel approach to care, there are physicians who support the use of telemedicine and those who feel that losing face-to-face contact will disrupt the valuable relationship between physicians and their patients.

As people continue to rely on technology more, will telemedicine become the prescription for the ailments of the current healthcare system?


Online Health Records Increase Child Well-Visits

One of the upcoming areas in health information is the creation of online health records. While there are still many debates about privacy and confidentiality, the reality is, health information is coming into the digital age, and before too long everyone could have access to their health records over the web. In the meantime, however, research is being conducted to examine the positives and negatives of putting health information online.

A recent positive for online health information came from a study that investigated the effects of online health record usage on children’s well-visit attendance. The research found that healthcare locations that offered parents online access to their children’s health records had higher rates of well-visit attendance and vaccination management than healthcare locations that did not offer online health record access.

With access to post-visit instructions, immunization records, and tools for managing appointments, the study discovered that 82% of babies in a Northwestern healthcare location had gone to all of their recommended well-visits, compared to 64% of babies in a Northwestern healthcare location where the parents did not have access to online health records.

While more work needs to be done to determine whether or not online health record access is the cause of the increase in well-visits attendance and vaccine management, it cannot be denied that online access to health records is a useful tool – particularly for busy parents.


Post courtesy of:

–          “Online health records tied to more well-child visits” By Genevra Pittman

–          Tom, J. O., Chen, C., & Zhou, Y. Y. (2013). Personal Health Record Use and Association with Immunizations and Well-Child Care Visits Recommendations. Journal of Pediatrics. doi:10.1016/j.jpeds.2013.08.046

What’s in a Name

To implement the Patient Protection and Affordable Care Act, states are creating online exchanges in which people can shop for health insurance. Designed to act as the go-to insurance marketplace for millions of people from diverse backgrounds, the exchanges will provide each consumer with the range of coverage options available in his/her state.

Some states are currently grappling with how to make the exchanges sound less bureaucratic, lest people be deterred from using them by flashbacks to experiences waiting in interminable lines at the DMV and other government agencies. Those overseeing the health insurance exchange rebranding process in participating states hope the new names will convey a sense of cultural relevance and caring, no small feat when the populations served by the exchanges are so diverse. They also note their desire for the new names to sound fresh, dynamic, and innovative while still maintaining clarity about what the exchanges are.

Outcomes aside, the process of rebranding has provided people with an opportunity to engage with the exchanges in a playful way. For example, one person suggested the name “Avocado” for the California exchange, and a person in Maryland proposed “www.icantbelieveitsthiseasytobuyhealthinsurance.com.”

Branding can influence consumer’s perceptions of a broad range of products, from school lunches to bank services. Do you think branding matters for health insurance exchanges? Would consumers use them out of necessity regardless, or might cultivating a positive image increase the number of people seeking new insurance?

What other steps besides an engaging name can states take to cast the insurance exchanges in a positive light?

Moving beyond awareness

We’ve posted about health awareness campaigns and months before at Upstream and whether or not they’re effective (Pinkwashing for Breast Cancer awareness, to name one). And again, April is another health awareness month (National STD Awareness Month) with several campaigns bringing light to the issue. I ran across one this week: the fourth annual Get Yourself Tested campaign. It’s a joint initiative of MTV and the Kaiser Family Foundation to increase STD testing among sexually active young people (those 24 and younger). The CDC and Planned Parenthood Federation of America also support the initiative.

One thing that struck me about this campaign is that it combines awareness tools at the national level (PSAs on MTV channels), but then also collaborates with health centers on the ground to get the word out and testing rates up. This seems like a great idea to me, and maybe a method that can simultaneously spread the message while taking concrete action steps to ensure people not only heard that message, but are engaging in the behaviors that it promotes.

What do you think of this dual effort? If campaigns seek to raise awareness at multiple levels and work with organizations where the positive health behavior can be carried out (STD testing, in this case), is this starting to move beyond awareness? And what does moving beyond awareness mean to you?

Get Yourself Tested logo courtesy MTV It’s Your Sex Life.com

Less treatment makes for a happier patient

A recent article in the New York Times offers this novel item–patients want less care. Yes, less. In the article, Dr. David Newman recites two anecdotal stories of patients declining antibiotics and a CT scan, both of which carried risks but no obvious benefit. The article quotes Dr. Michael Barry, president of the Informed Medical Decisions Foundation that promotes sound medical thinking, as saying:

People are more receptive to conversations about medical interventions having both pros and cons…Traditionally, newer and more aggressive interventions were often assumed to be better…When patients are fully informed, they tend to be more conservative.

Why is it that patients are more conservative with their own care? Unnecessary medical treatment is prevalent and, the article estimates, may constitute as much as one third of U.S. medical spending. More important than the financial costs are the health risks of unnecessary treatment. What patient would take a medicine or undergo a procedure where the harms and uncertainties outweighed the clear benefits? Patients don’t want to pay the monetary and health costs of unnecessary treatment.

An aspect of the article that I find relevant to my own current coursework is that patients who use decision aids, communication tools meant to help patients decide on a treatment or no treatment by explaining potential benefits, harms and uncertainties and clarifying the patient’s values regarding his care, are more likely to decline invasive procedures and instead opt for more conservative choices. The article also noted that patients reported better communication, fewer conflicts, and a better understanding of risks.

Finally, the article doesn’t touch on this, but I’m guessing this shift in patient preference has occurred because patients now have more access to health news and information via online sources and have become wary consumers of health as a result (I hesitate to say savvy due to the amount of misinformation that circulates the web).

So what does this mean for health communication? I’m a proponent of patient empowerment – better care results when the patient understands his values and can communicate to the physician his preference in his care, in other words, when the patient is an active participant in the doctor-patient relationship. Decision aids certainly seem to be a way to encourage this empowerment, but are there other ways that this could be achieved? If patients have become wary – or savvy, depending on how you look at it – due to online health information, is there a way we could harness this resource to encourage active participation in the doctor-patient relationship?

Image attribution: kurhan on stock.xchng

Girl checking panda's health with stethescope

Waiting for the ACA

In the coming months, while we wait for the Supreme Court to hand down its decisions in the Affordable Care Act (ACA) hearings, all of our healthy and unhealthy, insured and uninsured lives continue.

Two articles in this week’s New York Times highlight a health topic that goes undiscussed in the ACA debates, yet is central to the future health of individuals and our country: child health. While conservatives and liberals duke it out on the public stage over measures that, not too long ago, they would have agreed on (health insurance mandates were the brainchild of Republicans in the 1990s), the one health topic that brings the vast majority of Americans together is sadly overlooked.

Who does not support health insurance and health coverage for children? We know they will need care throughout their young lives, and beyond. So why is it so hard to see all U.S. citizens as grown up children that all require medical support at some point. (If you don’t and you make it to 90 years old – congratulations. Consider yourself more than lucky.)

The ACA debates are political, partisan, and grossly abused. Where are the health communicators providing clear, conscice, factual information on the issues? Do you know a good online resource for the ACA facts, not the rhetoric?

(For more thoughts on the ACA, see Marie’s post about ACA and attitudes towards prevention.)

Photo courtesy of Stuart Miles.

Who uses health communication resources?

In my health communication google news alert, I recently received a message about a site dedicated to health communication resources: C-Hub. The site hosts a number of these materials, related to health and development and focusing on areas such as HIV and AIDS, Sexual and Reproductive Health, Environmental Health, Maternal and Child Health and others. Some of the resources available include an “Anti-Homophobia PSA” and a “Voluntary Medical Male Circumcision Communication Toolkit.”

While interesting, C-Hub isn’t alone in being a site dedicated to hosting health communication materials in one place for various people to access. Some others I’m aware of include the Knowledge Management for Health-focused K 4 Health (more to come about knowledge management in a later post), the aptly named Health Communication Resources or HCR, and resources on the Centers for Disease Control’s Gateway to Health Communication and Social Marketing website.  From just these few sites, it seems there are a wealth of health communication materials available on the web for practitioners, teachers, researches, communication professionals and other interested parties to peruse and use.

But does anyone use them? I’ve visited some of these sites several times (notably K 4 Health) and searched and downloaded resources of interest, but never actually put them into practice (this could also reflect on the fact I’m still in the beginning stages of my health communication professional life, or that I’m lazy). But I wonder, are others more inclined to actually use these resources, or are there many people like me? Those who are interested, but just don’t have the time (or drive) to use any of the many resources available to us.

What do you think? Are there any health communication resources websites you frequent? If so, do you use any of the materials from them? And do you think it’s helpful or confusing to have a wealth of websites dedicated to these materials? Should sites start working together to streamline where resources are available, or should there be even more sites like this out there?

Image courtesy C-Hub screenshot

Laughing boy with glass of milk

Milking it

I admit it: I just spent 20 minutes on “The Breakfast Project” website, the new online-arm of the dairy industry’s Milk Mustache campaign. The new campaign launches this week.

I didn’t grow up drinking milk, I still don’t eat as much dairy as the average American, and as a nutrition researcher, I KNOW there are other ways to get those “9 essential nutrients” that America’s Milk Processors tout in all their ads.

But the new ad campaign has three things going for it that are hard to resist:

1) Salma Hayek is the new beautiful face of the campaign, along with other celebrities that are meant to reach the majority of the American audience (sports fans, Latinos, moms, white middle America…the list goes on)

2) The online campaign, in English and Spanish, is sleek, well designed, interactive and has a large presence on Facebook. They are reaching their audience from so many angles: TV, print media, in-store/school campaigns, websites, social media.

3) The campaign couches milk as an important part of breakfast, and the ads really are pushing America to eat breakfast. The nutritionist in me is shouting HURRAY because the “eat a healthy breakfast” message is so important.

And then there’s the catch. While the dairy industry is promoting their product (milk has its merits, industrial milk has its problems, and the majority of the world is lactose intolerant–all for another post), they are also promoting less-than-healthy breakfast ideas. The pictures on their website are gorgeous, but among the Top 10 breakfast items to consume with milk are yogurt (your body will only absorb so much calcium in one go), bacon (really?!), and cold cereals. Cereals rank #1 on the dairy industry’s breakfast list, but the majority of cereals in American grocery stores contain more added sugars than a kid (or adult) should consume in a day (assuming you eat more than the single 3/4 cup serving–see Allison’s post for serving size commentary). Yes, they suggest fruit, eggs and toast too, but they are equated with waffles dripping with syrup and breakfast sausages.

So here we are: the dairy industry spends $60 million per year on the milk mustache campaign. This year, that $60 million is promoting a public health cause, sort of. How do we deal with advertising that gets part of the health message out there, but then falls short? Should public health have some say in advertising that blurs the lines between profit-driven industry and health communication?

Image courtesy of photostock

A very personal blog

This week I’ve had a bit of an obsession: reading a deeply personal blog (a friend shared with me) about a former Peace Corps Volunteer’s experience of contracting HIV during her service in Zambia, being sent home early because of this, and how she’s dealing with her new illness upon her return home. The blog is called, “No Going Back. There is Only Forward,” and you can read it here.

This blog resonates with me as someone who did Peace Corps in another African country and has worked a lot with people living with HIV and AIDS, but I think it’s also an honest account of what it means to live with HIV for this person. She talks about how she got HIV, what the first few months living with it have been like, talking to counselors after discovering her status, deciding which treatment to take and many other issues. It’s a wealth of information mixed with her own story that I find intriguing, heartbreaking and informative to read.

I think the blog also is interesting from a health communication standpoint of what this type of open, frank communication can mean for educating about HIV (or any longterm illness that could also be talked about in this way) and decreasing stigma in the process. I  also like how the blog has a poll on the right side about HIV-related issues (“Have you ever been tested for HIV?” was one poll) that the blog readers can vote on. The author then publishes the results once they’re in with a little commentary, which I find another great education tool.

If you get a chance to read the blog, let us know what you think. Is it good to talk about HIV, or any illness, in this frank way? Can educating about certain health issues be better served if more people living with them just talked about them? Or are those people placing themselves at risk for judgment and discrimination, so maybe it’s not worth it?

Image courtesy Getty Images.com

Fighting the flu with storytelling

We at Upstream have talked and posted many times about various videos that encourage individuals to engage in healthier behaviors, and whether or not they’re effective. I too found another such video launched by the National Health Services (NHS) in Leeds, U.K. The video is for the “Flu Wiped me Out” campaign, and features a mom, Kirsty Gamble, telling about how she became “wiped out” when she came down with the flu one year. She primarily focuses on what having the flu meant for her as someone with asthma who also had to look after her family. The video is below:


While I like this video, I wonder about its effectiveness for encouraging a lot of people to get the flu shot. The video focuses a lot on the flu’s effect on Kirsty as someone with asthma and a long-term health condition, so it leaves people like me, who don’t have long-term conditions, wondering if I still need a flu shot. But the video does use a real story and person in lieu of one a marketing campaign wrote and hired an actor for. What about you? Do you prefer a personal storytelling approach in marketing campaigns? Would you rather see someone’s real experience highlighted, even if it might not match your own, or do you think it’s better to craft fictional stories with characters who may be more generic and possibly with a situation that speaks to a wider array of people?

Image courtesy fotosearch.com