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PEOPLE-Centred (DIGITAL) Health

Who are we in the health system?  Are we patients? Consumers? Citizens, clients, Canadians?  No matter what you call us – we are people.  Unique individuals with unique interests and health care needs; and it is important that we are at the table when decisions about our care are being made. 

This is true no matter “who you are” in the system and no matter what particular care you may require or may not require yet.  As Valerie Billingham said in her session address at the 1998 Salzburg Global Seminar, Through the Patient’s Eyes,  “nothing about me without me.”[1]

We know that Canadians want to be engaged in their care.  They want to be seen and treated as active members of the health care team.  Canada Health Infoway’s (Infoway) annual survey results continue to show that Canadians who have access to digital health tools feel more informed about their care; feel more engaged in their care and feel more confident, not only about the care they are receiving but about their ability to manage their health conditions too.[2]  Providers also recognize the value of giving patients electronic access, noting an increase in patients’ level of engagement and sense of empowerment regarding their own health.[3]

There is an increasing range of digital health solutions in use across the country today, and while we continue to lag behind some of our international counterparts, it is exciting to see that the use of these tools has doubled in the past two years alone.[4] [5] Canadians report that they are able to connect with their health care team through virtual visits, by requesting prescription renewals online, by self-booking appointments, and can access and share their personal health information electronically.

As we continue to explore the future of our health system, we know the potential to improve the patient experience and health outcomes are significant.  The need to do this is paramount and should be guided by the peoples’ voices. WE need to be involved in designing, implementing, and evaluating this change.  OUR voices need to be heard.  As described by the European Patients’ Forum, “empowered patients are part of the healthcare system.   They make informed choices, have better relationships with their healthcare providers, are committed to adhering to treatment, take responsibility for their care and seek preventative measures to better manage their health.”[6]

At this year’s e-Health Conference, Infoway will be bringing ‘regular people’ to the event through paid scholarships and to participate in a panel presentation, “Hearing from Patients on What They Think of Digital Health,” which will take place on Tuesday, June 5 at 10:30 a.m. (Track: Patient Engagement Through Digital Health).

Throughout the conference there is a strong focus on this important topic:

  • Sunday Symposium (Sunday, June 4, 12:00 p.m. – 4:00 p.m.)
  • Advancing Frameworks for Patient Engagement (Monday, June 5, 4:00 p.m. – 5:30 p.m.)
  • Engaging Patients through Digital Health (Wednesday, June 7, 8:30 a.m. – 10:00 a.m.)
  • And more!

Plan to attend some of these promising sessions to learn how your colleagues in the industry are working together to include people in the future of digital health.

I invite you to also take some time to chat with our patient scholars and panelists during your time at the Conference.  Their stories and personal journeys are impactful and their perspectives, enlightening.

I look forward to continuing this discussion with you.  Feel free to connect with me on Twitter @Cassie482. See you at e-Health 2017!

Cassie Frazer has 20 years of health care experience working in numerous roles, including 12 years as a front-line Respiratory Therapist.  She has a Bachelor of Science from Queens University and a Masters in Heath Administration from the University of Toronto.  She was a co-founder of the Pan-Canadian Change Management Network, a leading contributor to the National Change Management Framework and is a certified health informatics professional. Cassie currently works for Canada Health Infoway as the Program Director for Consumer Health & Innovation.  Within the broad portfolio of digital health initiatives she manages, she is able to leverage her experience and interests in change management, health informatics and innovation.

Valerie Billingham. Through the Patient’s Eyes, Salzburg Seminar Session 356, 1998. Cited in N Engl J Med 366;9 nejm.org, March 1, 2012

[2] Canada Health Infoway. Connecting Patients for Better Health: 2016. Available at: https://www.infoway-inforoute.ca/en/component/edocman/resources/3152-connecting-patients-for-better-health-2016

[3] SRDC. Impacts of direct patient access to laboratory results – Final Report. August, 2015.  Available at:  https://www.infoway-inforoute.ca/en/component/edocman/2775-impacts-of-direct-patient-access-to-laboratory-results-final-report/download

[4] The Commonwealth Fund. Commonwealth Fund International Survey of Primary Care Physicians in 10 Nations. December 7, 2015.  Available at:  http://www.commonwealthfund.org/interactives-and-data/surveys/international-health-policy-surveys/2015/2015-international-survey

[5] Canada Health Infoway. Connecting Patients for Better Health: 2016.

[6] European Patients’ Forum – Patient Empowerment Campaign. May 2015.  Available at: http://www.eu-patient.eu/

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e-Health Annual Conference & Tradeshow 2017 | e-Health 2017 Toronto, ON

Big farma investeert steeds meer in digitale zorg

Marktonderzoeker CB Insights publiceerde onlangs een overzicht van de digitale health investeringen door big farma bedrijven. Het tempo van die investeringen loopt snel op. De wereldwijde venture capital tak van Merck deed bijvoorbeeld al vierentwintig investeringen in digital health startups (of ondernemingen die al langer bezig zijn).

Het bericht Big farma investeert steeds meer in digitale zorg verscheen eerst op SmartHealth.


What Matters in Weight Loss? An In-Depth Analysis of Self-Monitoring

Background: Using technology to self-monitor body weight, dietary intake, and physical activity is a common practice used by consumers and health companies to increase awareness of current and desired behaviors in weight loss. Understanding how to best use the information gathered by these relatively new methods needs to be further explored. Objective: The purpose of this study was to analyze the contribution of self-monitoring to weight loss in participants in a 6-month commercial weight-loss intervention administered by Retrofit and to specifically identify the significant contributors to weight loss that are associated with behavior and outcomes. Methods: A retrospective analysis was performed using 2113 participants enrolled from 2011 to 2015 in a Retrofit weight-loss program. Participants were males and females aged 18 years or older with a starting body mass index of ≥25 kg/m2, who also provided a weight measurement at the sixth month of the program. Multiple regression analysis was performed using all measures of self-monitoring behaviors involving weight measurements, dietary intake, and physical activity to predict weight loss at 6 months. Each significant predictor was analyzed in depth to reveal the impact on outcome. Results: Participants in the Retrofit Program lost a mean –5.58% (SE 0.12) of their baseline weight with 51.87% (1096/2113) of participants losing at least 5% of their baseline weight. Multiple regression model (R2=.197, P<0.001) identified the following measures as significant predictors of weight loss at 6 months: number of weigh-ins per week (P<.001), number of steps per day (P=.02), highly active minutes per week (P<.001), number of food log days per week (P<.001), and the percentage of weeks with five or more food logs (P<.001). Weighing in at least three times per week, having a minimum of 60 highly active minutes per week, food logging at least three days per week, and having 64% (16.6/26) or more weeks with at least five food logs were associated with clinically significant weight loss for both male and female participants. Conclusions: The self-monitoring behaviors of self-weigh-in, daily steps, high-intensity activity, and persistent food logging were significant predictors of weight loss during a 6-month intervention. Journal of Medical Internet Research

watch out buzz, here’s DIY Zorg.

watch out buzz, here’s DIY Zorg.
Image by mac morrison
Sandy’s latest DIY toy story lego, after lusting over the catalogue for several days.
After diy buzz/woody www.flickr.com/photos/cmmorrison/4239407509/

Moving Towards an eHealth Ecosystem

Earlier this year, major EMR vendor EPIC opened its first App Orchard, where third-party developers can build healthcare apps that can connect directly with the enterprise system using HL7 FHIR. A year before that, Cerner launched code, allowing developers to build on top of their open platform.

These events may seem insignificant to the less technical among us, but they represent a growing appreciation for greater connections across healthcare systems. Discussion about data exchange and interoperability have exploded across the industry this year, which a whole section dedicated to it at HIMSS17.

The potential here is incredible. With major vendors adopting an open attitude towards third-party developers, and modern data standards like FHIR rising in popularity, we are witnessing the growth of a healthcare ecosystem that can connect to tools designed to solve specific healthcare problems. Rather than rely on one vendor to be the jack of all trades, we can leverage the utility and expertise of third-party apps to address all aspects of patient care.

To get ready for eHealth Conference, I would like to share a couple key concepts and terms to keep in mind.


Modern interoperability is moving away from simply reading and storing data between two systems, and evolving into an environment where healthcare data is exchanged, stored, and used across multiple systems. According to HIMSS, interoperability is “the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.”

HL7 FHIR (a.k.a FHIR)

Developed by HL7, FHIR is their newest data standard that leverages web standards, with a focus on implementation. The standard framework is designed with modern technologies in mind. In a nutshell, FHIR is the language that the data must conform to. EPIC and Cerner have opened their platform for apps built on FHIR. The standard is currently in trial for use in Ontario.


What are your thoughts on interoperability? What kinds of apps do you want to see in your healthcare ecosystem? Share your comments with us on Twitter (@eHealthConf) with the hashtag #eHealth2017.

To learn more about interoperability at eHealth Conference, check out session EP02 – From mHealth to Interoperability and Beyond! on Monday.

For more reading on the topic, visit these articles:

App store for EHRs may be reality in not so distant future

Will the Epic Systems “App Orchard” Grow EHR Interoperability?

Ontario EHR Interoperability Standards

Crystal Chin works with MedStack, a health tech startup in Toronto. MedStack is a cloud-based hosting platform that simplifies building privacy compliance and interoperability in healthcare apps. Connect with her on Twitter (@_CrystalChin).

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e-Health Annual Conference & Tradeshow 2017 | e-Health 2017 Toronto, ON

Trimbos Instituut richt nieuwe apps op mentale gezondheid van (zwangere) vrouwen

De app Wellmom is bedoeld voor zwangere of pas bevallen vrouwen en helpt hen om hun geestelijke gezondheid een beetje in de gaten te houden tijdens en na de zwangerschap.

Het bericht Trimbos Instituut richt nieuwe apps op mentale gezondheid van (zwangere) vrouwen verscheen eerst op SmartHealth.


Hoofdingang Ziekenhuis Amstelland

Hoofdingang Ziekenhuis Amstelland
Image by Shirley de Jong
Hoofdingang van het Ziekenhuis Amstelland aan de Laan van de Helende Meesters in Amstelveen.

Newsroom: bloeddruk meten via je vingertop

eHealth en mHealth nieuws uit Nederland en het buitenland: alles over gezondheidsapps, wearables, persoonlijk gezondheidsdossier, fitness en wellness.

Het bericht Newsroom: bloeddruk meten via je vingertop verscheen eerst op SmartHealth.


Empowering the Health Care Consumer

Brent Diverty is the Vice President, Programs for the Canadian Institute for Health Information (CIHI) and an e-Health 2017 Ambassador. In his role at CIHI, Brent oversees CIHI’s extensive data holdings, which span the continuum of health care services and also contain related financial, pharmaceutical and workforce data.  Connect with him on Twitter @BDiverty   

Studies confirm what many health leaders have long suspected; that engaged patients have better health outcomes.  So it probably comes as no surprise that the use of consumer digital solutions across the country has doubled in the past two years.  And that begs a rhetorical question: Where would Canada’s digital health community be without the voice of the consumer?

Participants at the #eHealth2017 Sunday Symposium June 4  will have a chance to hear the consumer voice firsthand when patients join digital health experts to discuss consumer empowerment, the current state of digital health solutions, patient centred data and the vision for the future. If you’re looking for one more reason to attend #eHealth2017, you’ll find it here.

The Symposium will kick off with a lunch and presentation from keynote speaker Lygeia Ricciardi, an industry expert in consumer engagement and digital health.  She’ll explore consumer choice, patient engagement and value for money.

Value for money, along with the patient experience and health outcomes, are key health system performance themes CIHI has identified as priorities in its strategic plan. I’m excited to see these reflected in the #eHealth2017 Symposium program – and I’m certain they will make for a lively discussion. 

Following Lygeia’s presentation, participants will have an opportunity to explore one of three tracks as eHealth 2017 co-hosts Infoway, Coach and CIHI each take a deeper look at empowering the healthcare consumer through data, digital solutions and a vision for engagement. 

Don’t miss the opportunity to participate.   Register today and join in the discussion.

I look forward to seeing you at #eHealth2017!

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e-Health Annual Conference & Tradeshow 2017 | e-Health 2017 Toronto, ON