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Engaging Patients with Chronic
      Diseases Using ICT:
A Multicultural Approach in B.C. Canada

     World of Health IT Conference, Barcelona
                    March 17, 2010

                Kendall Ho, MD FRCPC
            Director, eHealth Strategy Office
   Faculty of Medicine, University of British Columbia
If you build it, will they come?



                                                  Engaging
                                                  Public in
                                                  ICT Use in
                                                  CDM?



Dyersville, Iowa (filming of “Field of Dreams”)
Engaging Public: Chronic Diseases

• Accurate & quality health information
• Enable self-care & health partnerships
  •   Impact on chronic disease management
  •   Health consumers & health professionals
  •   Between generations & care givers
  •   Peer to peer




                                                3
British Columbia,
 Canada



                                        Home Language:
                                  English              51%
Serving multicultural public?     Chinese              21.6%
   •Language marginalization      Punjabi              8.2%
   •Computer skills               Korean               2.7%
   •Hunger for health knowledge   Filipino (Tagalog)   2%
                                  Persian (Farsi)      1.7%
                                  Vietnamese           1.3%
                                  Spanish              1.2%
iCON: Goals

1. Provide access to culturally relevant health
   information in Chinese language
2. Use multi-channel engagement to reach a
   variety of community members’ needs/
   preferences
3. Gather and incorporate data to ensure
   community-driven content and format




                                         6
Health Forum, Vancouver
                          7
Live Forum Component

• Chinese and South Asian doctors, nurses,
  dietician, pharmacists…
   • Diabetes: September 2007 (~700 attendees)
   • Healthy Heart: April 2008 (~1000 attendees)
   • Dementia: October 2008 (~700 attendees)
   • Dementia: March 2009 (~750 attendees)
   • Liver Disease: November 2009 (~1,450 attendees)

• Medical & university students
• Surveys, focus groups, interviews


                                                   8
Web component

• Culturally appropriate and language translated:
   • Traditional and simplified Chinese characters
   • Punjabi

• Chronic disease management content:
   •   Symptoms
   •   Self-management            Culturally relevant and
   •   Diet                     translated health resources
   •   Local resources
   •   Interactive feedback
   •   Online survey…
www.iconproject.org
Public Engagement - Highlights


 • Over 95% of the surveys turned in first language

 •   Female 65% Male 35%
 •   Average 65 years (mid-30s to late 90s)
 •   1/3 Patients
 •   1/3 Interested in prevention
 •   1/3 Caregivers
Findings: What does self care mean?


•     Trying to make healthy choices but need culturally relevant resources
      available in own language
•     Becoming better informed so they will have to “use the system less”
•     Having sufficient knowledge to be conversant with health professionals
•     Helping family members care for themselves

                           Health info Sources:
    “The problem with doctors is that           Necessary Ingredient:
                                                  Culturally relevant
    we only go for a check-up once,
                           •Doctors, HPs         resources available
    but our condition may•Newspapers, books in own language
                            change
    before or after, even if we are well
                           •Internet (41%)
    at our appointment…and he says
    “ok” – we don’t know for sure….”
Findings: Personal Health Record
                       Good idea to keep own record? (Q#10)

                           Maybe                No

                            10.6%               3.1%
DO YOU THINK IT IS A
GOOD IDEA TO KEEP A
RECORD OF YOUR OWN
HEALTH WITH YOU?




                                                Yes

                                                86.3%
Findings: Personal Health Record

• 75% see an advantage in electronic PHR
• 80% would like to learn electronic PHR
• 88% would like a template
                         Themes:
     When a patient keeps his or her own record it
     facilitates knowledge and self-management.
     When both patient and physician keep a record it
     facilitates comparison and validation of information.
Insights: Public Engagement Evaluation

• Common Desire: engaged, empowered, contribute

• Evaluation builds trust and partnerships

• Evaluation promotes authenticity, mutual
  understanding

• Through engagement, evaluation can build capacity
iCON…What’s next?

 Digital Access through Web 2.0 Network (DAWN)
   Public Health Agency of Canada funded
   Reaching population in non-urban B.C.
      Videoconferencing, web/pod casting
      Blogs
      Youtube
      Wiki
      Smart phones
     …
“Dizzy Gillespie”: lessons
• They're not particular about whether you're
  playing a flatted fifth or a ruptured 129th as long
  as they can dance to it. of
                     Essence
                   Engagement
• How do you know they like your music? If I got
  their toes tapping, then I know I’ve got them




                                            17
Multicultural Engagement in ICT

•   Build content to invite
•   Build community to engage
•   Build evaluation to understand
•   Build personal tools to transform
Contact Information

                eHealth Strategy Office
    Faculty of Medicine, UBC, Vancouver, Canada

MISSION: IT to enable education, service,
  research and knowledge translation

Kendall Ho: Director & Associate Professor, Emergency Medicine
Kendall.Ho@ubc.ca
www.eHealth.med.ubc.ca
Facebook: Kendall Ho
Thank-you to….

•   Michael Smith Foundation for Health Research
•   Technology Enabled Knowledge Translation Investigative Centre
•   BC Ministry of Health
•   Vancouver Coastal Health Authority
•   Fraser Health Authority
•   Public Health Agency of Canada
•   Safeway Canada
•   SUCCESS, Progressive Intercultural Community Services Society
•   The many health professionals, students and community members
                              Project Team
•   Francis Ho           •   Shinie Tan          • Francisco Grajales III
•   Kendall Ho           •   Janice Tian         • Jasmin Abizadeh
•   Jennifer Cordeiro    •   Elizabeth Stacy     • Nelson Shen
•   Noreen Kamal         •   Helen Novak Lauscher

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Engaging Patients with Chronic Diseases Using ICT: A Multicultural Approach in B.C. Canada

  • 1. Engaging Patients with Chronic Diseases Using ICT: A Multicultural Approach in B.C. Canada World of Health IT Conference, Barcelona March 17, 2010 Kendall Ho, MD FRCPC Director, eHealth Strategy Office Faculty of Medicine, University of British Columbia
  • 2. If you build it, will they come? Engaging Public in ICT Use in CDM? Dyersville, Iowa (filming of “Field of Dreams”)
  • 3. Engaging Public: Chronic Diseases • Accurate & quality health information • Enable self-care & health partnerships • Impact on chronic disease management • Health consumers & health professionals • Between generations & care givers • Peer to peer 3
  • 4. British Columbia, Canada Home Language: English 51% Serving multicultural public? Chinese 21.6% •Language marginalization Punjabi 8.2% •Computer skills Korean 2.7% •Hunger for health knowledge Filipino (Tagalog) 2% Persian (Farsi) 1.7% Vietnamese 1.3% Spanish 1.2%
  • 5.
  • 6. iCON: Goals 1. Provide access to culturally relevant health information in Chinese language 2. Use multi-channel engagement to reach a variety of community members’ needs/ preferences 3. Gather and incorporate data to ensure community-driven content and format 6
  • 8. Live Forum Component • Chinese and South Asian doctors, nurses, dietician, pharmacists… • Diabetes: September 2007 (~700 attendees) • Healthy Heart: April 2008 (~1000 attendees) • Dementia: October 2008 (~700 attendees) • Dementia: March 2009 (~750 attendees) • Liver Disease: November 2009 (~1,450 attendees) • Medical & university students • Surveys, focus groups, interviews 8
  • 9. Web component • Culturally appropriate and language translated: • Traditional and simplified Chinese characters • Punjabi • Chronic disease management content: • Symptoms • Self-management Culturally relevant and • Diet translated health resources • Local resources • Interactive feedback • Online survey…
  • 11. Public Engagement - Highlights • Over 95% of the surveys turned in first language • Female 65% Male 35% • Average 65 years (mid-30s to late 90s) • 1/3 Patients • 1/3 Interested in prevention • 1/3 Caregivers
  • 12. Findings: What does self care mean? • Trying to make healthy choices but need culturally relevant resources available in own language • Becoming better informed so they will have to “use the system less” • Having sufficient knowledge to be conversant with health professionals • Helping family members care for themselves Health info Sources: “The problem with doctors is that Necessary Ingredient: Culturally relevant we only go for a check-up once, •Doctors, HPs resources available but our condition may•Newspapers, books in own language change before or after, even if we are well •Internet (41%) at our appointment…and he says “ok” – we don’t know for sure….”
  • 13. Findings: Personal Health Record Good idea to keep own record? (Q#10) Maybe No 10.6% 3.1% DO YOU THINK IT IS A GOOD IDEA TO KEEP A RECORD OF YOUR OWN HEALTH WITH YOU? Yes 86.3%
  • 14. Findings: Personal Health Record • 75% see an advantage in electronic PHR • 80% would like to learn electronic PHR • 88% would like a template Themes: When a patient keeps his or her own record it facilitates knowledge and self-management. When both patient and physician keep a record it facilitates comparison and validation of information.
  • 15. Insights: Public Engagement Evaluation • Common Desire: engaged, empowered, contribute • Evaluation builds trust and partnerships • Evaluation promotes authenticity, mutual understanding • Through engagement, evaluation can build capacity
  • 16. iCON…What’s next?  Digital Access through Web 2.0 Network (DAWN)  Public Health Agency of Canada funded  Reaching population in non-urban B.C.  Videoconferencing, web/pod casting  Blogs  Youtube  Wiki  Smart phones …
  • 17. “Dizzy Gillespie”: lessons • They're not particular about whether you're playing a flatted fifth or a ruptured 129th as long as they can dance to it. of Essence Engagement • How do you know they like your music? If I got their toes tapping, then I know I’ve got them 17
  • 18. Multicultural Engagement in ICT • Build content to invite • Build community to engage • Build evaluation to understand • Build personal tools to transform
  • 19. Contact Information eHealth Strategy Office Faculty of Medicine, UBC, Vancouver, Canada MISSION: IT to enable education, service, research and knowledge translation Kendall Ho: Director & Associate Professor, Emergency Medicine Kendall.Ho@ubc.ca www.eHealth.med.ubc.ca Facebook: Kendall Ho
  • 20. Thank-you to…. • Michael Smith Foundation for Health Research • Technology Enabled Knowledge Translation Investigative Centre • BC Ministry of Health • Vancouver Coastal Health Authority • Fraser Health Authority • Public Health Agency of Canada • Safeway Canada • SUCCESS, Progressive Intercultural Community Services Society • The many health professionals, students and community members Project Team • Francis Ho • Shinie Tan • Francisco Grajales III • Kendall Ho • Janice Tian • Jasmin Abizadeh • Jennifer Cordeiro • Elizabeth Stacy • Nelson Shen • Noreen Kamal • Helen Novak Lauscher