My Health Platform is a comprehensive blended eHealth Platform to support self management by patients and health care workers. The presentation shows the first results of research carried out in the Netherlands by the University of Twente, primary care organization PoZoB and health innovation company Medicinfo. The questions that need to be answered are: does it work, does it help and does it pay. The research was presented at the Medicine 2.0 conference in London, England on September 24th, 2013

1. ePortal for self
management:
critical factors for
implementation
Medicine 2.0
London
Lisette van Gemert-Pijnen
Bart Brandenburg
September 24th, 2013

2. source: www.medicinfo.info

3. source: www.utwente.nl/igs/ehealth/

4. source: www.pozob.nl

5. 1. Why, how & what of MHP
2. Research set up
3. First results
4. Critical factors
5. Discussion

6. Photo: They’re off - Alex Evers via http://500px.com/photo/1332291
We’re off!

7. 1. My Health Platform (MHP)
Why, How & What?

8. We are sure that people who can be responsible
for their own health make better choices

9. Allways available, accessible for everyone

10. Our aim is to get healthcare into the very
best hands…
…yours!

11. My Health Platform is a comprehensive
blended ePortal for self management
11source: www.mijngezondheidsplatform.info
• Personal Health Record
• Individualized Care Plan
• Monitoring of Results
• Secure Communication
• Online coaching
• Personalized health info
• Operational since 2012
• Mainly in Primary Care

12. MHP enables patients to better self
manage their health and health care
• MHP enables patients to inform their care provider in between
visits and schedule appointments only when needed.
• Fast and continuous availability of data, information and
feedback enhance the efficiency of healthcare.
12

13. 2. Research set up:
What do we want to know?
How are we going to find out?

14. The MHP research is a continuation of
earlier Diabetes Coach research
14
Nijland et al. Factors influencing the use of a web-based
application for supporting the self-care of patients with type 2
diabetes: J Med Internet Res. 2011 Sep 30;13(3):e71.

15. It all comes down to answering three
simples questions!
15
Does IT work?
usage
usability and persuasiveness
adherence
Does IT help?
is anyone getting better
Does IT pay?
cost effectiveness
“MHP enables patients to better self
manage their health and health care”

16. A three year mixed methods approach
should help us find the answers
16
Source: MHP research plan PoZoB, University of Twente and
Medicinfo, 2012 and 2013
Does IT work?
usage
usability and persuasiveness
adherence
Does IT help?
is anyone getting better
Does IT pay?
cost effectiveness
user data
logdata
usability tests*
Interviews*
(* patients & HCW)
questionnaires
(trust, involvement,
personality)
EHR and MHP data
Health Technology
Assessment

17. 3. First results:
What do we know?
What did we learn?

18. In our research we use the eHealth
Road Map developed at CeHRes
18
Source: Van Gemert-Pijnen et al. A holistic framework to improve
the uptake and impact of eHealth technologies.
J Med Internet Res. 2011 Dec 5;13(4):e111.

19. MHP usage: what is the reach in the
population and frequency of use?
Patients in participating GP practices (6) 16.360
Participating in chronic care pathways (4) 2.142
Participating in My Health Platform (MHP) 258 (12%)
Number of MHP sessions 2719
Mean Pages per Visit MHP 10.05
Mean Time Visit MHP 0:08:16
Mean bounce rate 11.73%
19source: logdata MHP september 2012 to august 2013

20. MHP usage: what parts of the platform
are being used?
20source: logdata MHP september 2012 to may 2013
users
187
PHR
187
Coaches
38 (20%)
exercise
20 (52%)
nutrition
26 (62%)
smoking
1 (3%)
health data
187
monitoring
187
both
9 (24%)

21. MHP usage: 30% of takes place outside
office hours >> increase of accessibility?
21source: logdata MHP september 2012 to august 2013
0
50
100
150
200
250
# sessions
hours
24 hour session distribution
0
100
200
300
400
500
600
700
sat sun mon tue wed thu fri
# sessions
days of the week
session distribution over the week

22. Interviews & user tests (patients & HCW)
“Does MHP support self monitoring?”
22Source: preliminary data MHP research 2013
System Content Persuasive triggers
System logic
Order of steps not logical
Time consuming
Adding of data
Lack of integration
my health, my lifestyle,
my measurements, my.
Goal setting SMART
Better able to
prepare F2F visits
Lack of support
to understand why, when
and where self monitoring
information should be
added
Reminders &
smileys
Positive feedback
Graphs
Show your progress

23. Interviews & user tests (patients & HCW)
“Are online life style coaches helpful?”
23Source: preliminary data MHP research 2013
System Content Persuasive triggers
Lack of F2F
support
After completion of intake
Time consuming
Intake too long, drop outs
Lack of integration
Between coaches and
Personal Health Record
Intake relevant
Weekly e-mails
Exercises
Well thought out
Guidance
Logical steps after intake
Graphs
To visualize progress
Feedback & tips

24. 4. Critical factors

25. What are the critical factors of MHP
for patients?
• Tailoring content & system to needs & skills of
different users
• Persuasive triggers for navigation, understanding,
motivation
• Intra-system integration (usability and information)
• Interoperability of systems & devices
Corresponding results in MHP, eVita & Pazio research
(3 main portals for chronic care NL)
Supported by systematic reviews EHR (JMI, JMIR & JAMIA)
25Source: preliminary data MHP research 2013

26. What are the critical factors of MHP
for health care workers (HCW)?
• How to reach potential users (promo team)?
• How to engage HCW ?
• Standardized instruments for data management
• Integration offline-online care (blended care)
Corresponding results in MHP, eVita & Pazio research
(3 main portals for chronic care NL)
Supported by systematic reviews EHR (JMI, JMIR & JAMIA)
26Source: preliminary data MHP research 2013

27. time to reflect
Source: www.7ideas.net

28. Thank you!
5. Discussion
j.vangemert-pijnen@utwente.nl
bart.brandenburg@medicinfo.nl
elevenpub.com