We should look to automation to relieve the current pressures on healthcare

by c 20/04/2017

Automation may address these pressures in primary care, while also reconfiguring the work of staff roles and changing the patient-doctor relationship.

by c 20/04/2017

Image by TheeErin (Flickr CC BY-NC-ND 2.0), who writes: “Working on a national cancer research project. This is the usual volume of mail that comes in two-days time.”

In many sectors, automation is seen as a threat due to the potential for job losses. By contrast, automation is seen as an opportunity in healthcare, as a way to address pressures including staff shortages, increasing demand and workloads, reduced budget, skills shortages, and decreased consultation times. Automation may address these pressures in primary care, while also reconfiguring the work of staff roles and changing the patient-doctor relationship. In the interview below, Matt Willis discusses a project, funded by The Health Foundation, which looks at opportunities and challenges to automation in NHS England general practice services. While the main goal of the project is to classify work tasks and then calculate the probability that each task will be automated, Matt is currently conducting ethnographic fieldwork in primary care sites to understand the work practices of surgery staff and clinicians. Since the first automated pill counting machine was introduced in 1970 the role of the pharmacist has expanded to where they now perform more patient consultations, consult with primary care physicians, and require greater technical skill (including a Pharm.D degree). While this provides one clear way in which a medical profession has responded to automation, the research team is now looking at how automation will reconfigure other professions in primary care, and how it will shape its technical and digital infrastructures. We caught up with Matt Willis to explore the implications of automation in primary care. Ed.: One finding from an analysis by Frey and Osborne is that most healthcare occupations (that involve things like social intelligence, caring etc.) show a remarkably low probability for computerisation. But what sorts of things could be automated, despite that? Matt: While providing care is the most important work that happens in primary care, there are many tasks that support that care. Many of those tasks are highly structured and repetitive, ideal things we can automate. There is an incredible amount of what I call…

Health, Wellbeing

Psychology is in Crisis: And Here’s How to Fix It

by David Sutcliffe 23/03/2017

It seems that in psychology and communication, as in other fields of social science, much of what we think we know may be based on a tenuous empirical foundation.

by David Sutcliffe 23/03/2017

“Psychology emergency” by atomicity (Flickr).

Concerns have been raised about the integrity of the empirical foundation of psychological science, such as low statistical power, publication bias (i.e. an aversion to reporting statistically nonsignificant or “null” results), poor availability of data, the rate of statistical reporting errors (meaning that the data may not support the conclusions), and the blurring of boundaries between exploratory work (which creates new theory or develops alternative explanations) and confirmatory work (which tests existing theory). It seems that in psychology and communication, as in other fields of social science, much of what we think we know may be based on a tenuous empirical foundation. However, a number of open science initiatives have been successful recently in raising awareness of the benefits of open science and encouraging public sharing of datasets. These are discussed by Malte Elson (Ruhr University Bochum) and the OII’s Andrew Przybylski in their special issue editorial: “The Science of Technology and Human Behavior: Standards, Old and New”, published in the Journal of Media Psychology. What makes this issue special is not the topic, but the scientific approach to hypothesis testing: the articles are explicitly confirmatory, that is, intended to test existing theory. All five studies are registered reports, meaning they were reviewed in two stages: first, the theoretical background, hypotheses, methods, and analysis plans of a study were peer-reviewed before the data were collected. The studies received an “in-principle” acceptance before the researchers proceeded to conduct them. The soundness of the analyses and discussion section were reviewed in a second step, and the publication decision was not contingent on the outcome of the study: i.e. there was no bias against reporting null results. The authors made all materials, data, and analysis scripts available on the Open Science Framework (OSF), and the papers were checked using the freely available R package statcheck (see also: www.statcheck.io). All additional (non-preregistered) analyses are explicitly labelled as exploratory. This makes it easier to see…

Health, Wellbeing

Is internet gaming as addictive as gambling? (no, suggests a new study)

by David Sutcliffe 04/11/2016

New research suggests that very few of those who play internet-based video games have symptoms suggesting they may be addicted.

by David Sutcliffe 04/11/2016

New research by Andrew Przybylski (OII, Oxford University), Netta Weinstein (Cardiff University), and Kou Murayama (Reading University) published today in the American Journal of Psychiatry suggests that very few of those who play internet-based video games have symptoms suggesting they may be addicted. The article also says that gaming, though popular, is unlikely to be as addictive as gambling. Two years ago the APA identified a critical need for good research to look into whether internet gamers run a risk of becoming addicted and asked how such an addiction might be diagnosed properly. To the authors’ knowledge, these are the first findings from a large-scale project to produce robust evidence on the potential new problem of “internet gaming disorder”. The authors surveyed 19,000 men and women from nationally representative samples from the UK, the United States, Canada and Germany, with over half saying they had played internet games recently. Out of the total sample, 1% of young adults (18-24 year olds) and 0.5% of the general population (aged 18 or older) reported symptoms linking play to possible addictive behaviour—less than half of recently reported rates for gambling. They warn that researchers studying the potential “darker sides” of Internet-based games must be cautious. Extrapolating from their data, as many as a million American adults might meet the proposed DSM-5 criteria for addiction to online games—representing a large cohort of people struggling with what could be clinically dysregulated behaviour. However, because the authors found no evidence supporting a clear link to clinical outcomes, they warn that more evidence for clinical and behavioural effects is needed before concluding that this is a legitimate candidate for inclusion in future revisions of the DSM. If adopted, Internet gaming disorder would vie for limited therapeutic resources with a range of serious psychiatric disorders. Read the full article: Andrew K. Przybylski, Netta Weinstein, Kou Murayama (2016) Internet Gaming Disorder: Investigating the Clinical Relevance of a New Phenomenon.…

Health, Methods, Social Data Science, Wellbeing

Facts and figures or prayers and hugs: how people with different health conditions support each other online

by admin 07/03/2016

Online support groups are one of the major ways in which the Internet has fundamentally changed how people experience health and health care.

by admin 07/03/2016

Online forums are important means of people living with health conditions to obtain both emotional and informational support from this in a similar situation. Pictured: The Alzheimer Society of B.C. unveiled three life-size ice sculptures depicting important moments in life. The ice sculptures will melt, representing the fading of life memories on the dementia journey. Image: bcgovphotos (Flickr)

Online support groups are being used increasingly by individuals who suffer from a wide range of medical conditions. OII DPhil Student Ulrike Deetjen’s recent article with John Powell, Informational and emotional elements in online support groups: a Bayesian approach to large-scale content analysis uses machine learning to examine the role of online support groups in the healthcare process. They categorise 40,000 online posts from one of the most well-used forums to show how users with different conditions receive different types of support. Online support groups are one of the major ways in which the Internet has fundamentally changed how people experience health and health care. They provide a platform for health discussions formerly restricted by time and place, enable individuals to connect with others in similar situations, and facilitate open, anonymous communication. Previous studies have identified that individuals primarily obtain two kinds of support from online support groups: informational (for example, advice on treatments, medication, symptom relief, and diet) and emotional (for example, receiving encouragement, being told they are in others’ prayers, receiving “hugs”, or being told that they are not alone). However, existing research has been limited as it has often used hand-coded qualitative approaches to contrast both forms of support, thereby only examining relatively few posts (<1,000) for one or two conditions. In contrast, our research employed a machine-learning approach suitable for uncovering patterns in “big data”. Using this method a computer (which initially has no knowledge of online support groups) is given examples of informational and emotional posts (2,000 examples in our study). It then “learns” what words are associated with each category (emotional: prayers, sorry, hugs, glad, thoughts, deal, welcome, thank, god, loved, strength, alone, support, wonderful, sending; informational: effects, started, weight, blood, eating, drink, dose, night, recently, taking, side, using, twice, meal). The computer then uses this knowledge to assess new posts, and decide whether they contain more emotional or informational support. With this approach we were able to determine the emotional or informational content of 40,000…

Health, Social Data Science, Wellbeing

How can big data be used to advance dementia research?

by admin 16/03/2015

As dementia is believed to be influenced by a wide range of social, environmental and lifestyle-related factors, this behavioural data has the potential to improve early diagnosis

by admin 16/03/2015

Image by K. Kendall of "Sights and Scents at the Cloisters: for people with dementia and their care partners"; a program developed in consultation with the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Alzheimer's Disease Research Center at Columbia University, and the Alzheimer's Association.

Dementia affects about 44 million individuals, a number that is expected to nearly double by 2030 and triple by 2050. With an estimated annual cost of USD 604 billion, dementia represents a major economic burden for both industrial and developing countries, as well as a significant physical and emotional burden on individuals, family members and caregivers. There is currently no cure for dementia or a reliable way to slow its progress, and the G8 health ministers have set the goal of finding a cure or disease-modifying therapy by 2025. However, the underlying mechanisms are complex, and influenced by a range of genetic and environmental influences that may have no immediately apparent connection to brain health. Of course medical research relies on access to large amounts of data, including clinical, genetic and imaging datasets. Making these widely available across research groups helps reduce data collection efforts, increases the statistical power of studies and makes data accessible to more researchers. This is particularly important from a global perspective: Swedish researchers say, for example, that they are sitting on a goldmine of excellent longitudinal and linked data on a variety of medical conditions including dementia, but that they have too few researchers to exploit its potential. Other countries will have many researchers, and less data. ‘Big data’ adds new sources of data and ways of analysing them to the repertoire of traditional medical research data. This can include (non-medical) data from online patient platforms, shop loyalty cards, and mobile phones — made available, for example, through Apple’s ResearchKit, just announced last week. As dementia is believed to be influenced by a wide range of social, environmental and lifestyle-related factors (such as diet, smoking, fitness training, and people’s social networks), and this behavioural data has the potential to improve early diagnosis, as well as allow retrospective insights into events in the years leading up to a diagnosis. For example, data on changes in shopping…

Governance & Security, Health, Wellbeing

Unpacking patient trust in the “who” and the “how” of Internet-based health records

by Ulrike Rauer 03/03/2014

Key to successful adoption of Internet-based health records is how much a patient places trust that data will be properly secured from inadvertent leakage.

by Ulrike Rauer 03/03/2014

In an attempt to reduce costs and improve quality, digital health records are permeating health systems all over the world. Internet-based access to them creates new opportunities for access and sharing—while at the same time causing nightmares to many patients: medical data floating around freely within the clouds, unprotected from strangers, being abused to target and discriminate people without their knowledge? Individuals often have little knowledge about the actual risks, and single instances of breaches are exaggerated in the media. Key to successful adoption of Internet-based health records is, however, how much a patient places trust in the technology: trust that data will be properly secured from inadvertent leakage, and trust that it will not be accessed by unauthorised strangers. Situated in this context, my own research has taken a closer look at the structural and institutional factors influencing patient trust in Internet-based health records. Utilising a survey and interviews, the research has looked specifically at Germany—a very suitable environment for this question given its wide range of actors in the health system, and often being referred to as a “hard-line privacy country”. Germany has struggled for years with the introduction of smart cards linked to centralised Electronic Health Records, not only changing its design features over several iterations, but also battling negative press coverage about data security. The first element to this question of patient trust is the “who”: that is, does it make a difference whether the health record is maintained by either a medical or a non-medical entity, and whether the entity is public or private? I found that patients clearly expressed a higher trust in medical operators, evidence of a certain “halo effect” surrounding medical professionals and organisations driven by patient faith in their good intentions. This overrode the concern that medical operators might be less adept at securing the data than (for example) most non-medical IT firms. The distinction between public and private operators is…

Health, Methods, Social Data Science

Can Twitter provide an early warning function for the next pandemic?

by Patty Kostkova 14/10/2013

While traditional surveillance systems will remain the pillars of public health, online media monitoring has added an important early-warning function, with social media bringing additional benefits to epidemic intelligence.

by Patty Kostkova 14/10/2013

Communication of risk in any public health emergency is a complex task for healthcare agencies; a task made more challenging when citizens are bombarded with online information. Mexico City, 2009. Image by Eneas.

Ed: Could you briefly outline your study? Patty: We investigated the role of Twitter during the 2009 swine flu pandemics from two perspectives. Firstly, we demonstrated the role of the social network to detect an upcoming spike in an epidemic before the official surveillance systems—up to week in the UK and up to 2-3 weeks in the US—by investigating users who “self-diagnosed” themselves posting tweets such as “I have flu/swine flu.” Secondly, we illustrated how online resources reporting the WHO declaration of “pandemics” on 11 June 2009 were propagated through Twitter during the 24 hours after the official announcement [1,2,3]. Ed: Disease control agencies already routinely follow media sources; are public health agencies aware of social media as another valuable source of information? Patty: Social media are providing an invaluable real-time data signal complementing well-established epidemic intelligence (EI) systems monitoring online media, such as MedISys and GPHIN. While traditional surveillance systems will remain the pillars of public health, online media monitoring has added an important early-warning function, with social media bringing additional benefits to epidemic intelligence: virtually real-time information available in the public domain that is contributed by users themselves, thus not relying on the editorial policies of media agencies. Public health agencies (such as the European Centre for Disease Prevention and Control) are interested in social media early warning systems, but more research is required to develop robust social media monitoring solutions that are ready to be integrated with agencies’ EI services. Ed: How difficult is this data to process? E.g.: is this a full sample, processed in real-time? Patty: No, obtaining all Twitter search query results is not possible. In our 2009 pilot study we were accessing data from Twitter using a search API interface querying the database every minute (the number of results was limited to 100 tweets). Currently, only 1% of the ‘Firehose’ (massive real-time stream of all public tweets) is made available using the streaming API. The searches have…

Health, Wellbeing

Searching for a “Plan B”: young adults’ strategies for finding information about emergency contraception online

by Eszter Hargittai 15/10/2012

While the Internet is a valuable source of information about sexual health for young adults, difficulty in searching and evaluating credibility may prevent them from finding useful information in time.

by Eszter Hargittai 15/10/2012

People increasingly turn to the Internet for health information, with 80 percent of U.S. Internet users (59 percent of adults) having used the Web for this purpose. However, because there is so much health content online, users may find it difficult to find reliable content quickly. Research has also shown that websites hosting information about the most controversial topics—including Emergency Contraceptive Pills, ECPs—contain a great number of inaccuracies. While the Internet is a potentially valuable source of information about sexual health topics for young adults, difficulty in searching and evaluating credibility may prevent them from finding useful information in time. Emergency contraception has long been heralded as a “second chance” for women to prevent pregnancy after unprotected intercourse. However, the commercial promotion and use of ECPs has been a highly contentious issue in the United States, a fact that has had a significant impact on legislative action and accessibility. Due to their limited window of effectiveness and given that people do not tend to obtain them until the moment when they are needed urgently, it is essential for people to be able to find accurate information about ECPs as quickly as possible. Our study investigated empirically how over 200 young college students (18-19 years old) at two college campuses in the Midwestern United States searched for and evaluated information about emergency contraception. They were given the hypothetical scenario: “You are at home in the middle of summer. A friend calls you frantically on a Friday at midnight. The condom broke while she was with her boyfriend. What can she do to prevent pregnancy? Remember, neither of you is on campus. She lives in South Bend, Indiana.” All of the students had considerable experience with using the Internet. Worryingly, a third of the participants, after looking for information online, were unable to conclude that the friend should seek out ECPs. Less than half gave what we consider the ideal response: to…

Health, Publications, Wellbeing

eHealth: what is needed at the policy level? New special issue from Policy and Internet

by Rik Crutzen 24/05/2012

Policymakers wishing to promote greater choice and control among health system users should take account of the limits to empowerment as well as barriers to participation.

by Rik Crutzen 24/05/2012

The explosive growth of the Internet and its omnipresence in people’s daily lives has facilitated a shift in information seeking on health, with the Internet now a key information source for the general public, patients, and health professionals. The Internet also has obvious potential to drive major changes in the organisation and delivery of health services efforts, and many initiatives are harnessing technology to support user empowerment. For example, current health reforms in England are leading to a fragmented, marketised National Health Service (NHS), where competitive choice designed to drive quality improvement and efficiency savings is informed by transparency and patient experiences, and with the notion of an empowered health consumer at its centre. Is this aim of achieving user empowerment realistic? In their examination of health queries submitted to the NHS Direct online enquiry service, John Powell and Sharon Boden find that while patient empowerment does occur in the use of online health services, it is constrained and context dependent. Policymakers wishing to promote greater choice and control among health system users should therefore take account of the limits to empowerment as well as barriers to participation. The Dutch government’s online public national health and care portal similarly aims to facilitate consumer decision-making behaviour and increasing transparency and accountability to improve quality of care and functioning of health markets. Interestingly, Hans Ossebaard, Lisette van Gemert-Pijnen and Erwin Seydel find the influence of the Dutch portal on choice behaviour, awareness, and empowerment of users to actually be small. The Internet is often discussed in terms of empowering (or even endangering) patients through broadening of access to medical and health-related information, but there is evidence that concerns about serious negative effects of using the Internet for health information may be ill-founded. The cancer patients in the study by Alison Chapple, Julie Evans and Sue Ziebland gave few examples of harm from using the Internet or of damage caused to their relationships…