Summer 2005 Edition

July 11, 2005

What does the future of health care look like? Picture this…

You have anytime-anywhere access to health information and immediate connections with clinical support. You can go online to schedule visits and immediately receive content that helps you prepare for your in-person clinical encounters. You automatically receive print and electronic after-visit summaries that review what happened at the clinic and provide effective guidance and supporting information for your follow-up.

But that’s not all…

You have secure, convenient access to your lab results with hyperlinks to information that explains what they mean. Along with electronic medication prescriptions, you can access health content on dosing, frequency, side effects, and benefits of adherence. For every procedure, you can prepare for what to expect, how to help ensure safety, and what the impact will be. For every decision, you can access the background information you need to make an informed, rational choice that incorporates your own values and preferences with the best medical evidence available.

In Seattle, the future has arrived. There, Group Health Cooperative has developed a patient-centered informatics initiative and is using information therapy as a key component of it.

Information therapy (Ix®) is the timely prescription and availability of evidence-based health information to meet individuals’ specific needs and support sound decision-making. Research suggests that Ix-focused interventions can improve quality, cost-effectiveness and patients’ overall care experiences.

In fact, empirical evidence demonstrates that Ix directly responds to the 2001 call to action issued by the Institute of Medicine (IOM) in Crossing the Quality Chasm. Specifically, self-care, self-management, shared decision making, and other Ix-related initiatives improve clinical quality and cost-effectiveness as well as patient knowledge, self-efficacy and experiences with care. Research also demonstrates that the components of information therapy help patients to:

- Ask better questions about their health and their illness.
- Better understand the answers they receive.
- Form more realistic expectations.
- Become more confident in their ability to manage their illnesses or conditions to achieve better health.
- Participate more actively in the treatment and decision-making processes.

A full review of this evidence is detailed in “The Ix Evidence Base: Using Information Therapy to Cross the Quality Chasm”. The evidence to date, however, does not tap information therapy’s full potential because most existing research has not evaluated Ix initiatives delivered via e-health technologies.

As providers and health plans apply the lessons from Ix-related care delivery strategies to e-health applications, the potential for advances in efficiency and quality explodes. So does the potential to overcome one of the greatest economic and quality-of-care challenges we face: How we manage chronic care for an aging population. The reality of limited resources and changing demographics means that simply stretching today’s “sick-care” system further is infeasible.

So what’s the solution? A new population health management paradigm that shifts the focus of control to the individual and supports that person with targeted information specific to each moment in care that he or she faces.

Health care providers and systems can now use information therapy in a way that balances the needs for mass production and customization to the individual. Innovative health care organizations are implementing strategies for “mass personalization” that effectively support each patient’s self-care and decision-making needs. By bridging the gap between dealing with the individual’s immediate symptoms and managing the population’s long-term health, personalized information prescriptions at each relevant moment in care are restoring balance to chronic care and promising improvements in both costs and outcomes.

The integration of Ix concepts and new technologies enable targeting of personal health information to factors that are related to health behavior, such as socio-economic status, self-efficacy beliefs, outcome expectations, and access to care. Research has found that personalized communications are viewed as more relevant and credible, better remembered, and are more effective in influencing health behavior than general mass health messages. These Ix and patient-centered informatics initiatives have the potential to maximize the potential of eHealth.

Joshua J. Seidman, Ph.D.
Executive Director
Center for Information Therapy
Washington, DC

Click here to learn more about information therapy or to download white papers on Ix or e-mail jseidman@healthwise.org.

The views expressed in this article are those of the author and do not imply endorsement by The Robert Wood Johnson Foundation or the Health e-Technologies Initiative.