Co Production of Health

Module details

Title

Co Production of Health

Type

Specialist

Module code

SBI123

Credits

10

Requirement

Compulsory

Aim of this module

Trainees completing this module will understand how patients, carers and the general public make use of health information individually, with peers and with healthcare professionals. The module will cover the context of health, care and wellbeing, including understanding the significance of the patient journey. The module will also cover technology, new innovations and other enablers of the co-production of health, including issues around access to and the availability of systems and information; skills development; access to or shared records (Personal Health Records); and communication (between doctor and patient or peer to peer). Consideration will be given as to how patients use information resources; models of ‘information needs’ and decision-making behaviour, including relevant studies on the quality of information online. Access to and availability of systems, including user interface and experience matters and the broader context relevant to these subjects – the changing nature of the clinician/patient relationship and the role of patient’s self-care – will be included. Additionally, the module will cover different paradigms for considering the role of the internet in healthcare, including internet interventions and ideas of ‘Web 2.0’, and will introduce m-health, the role of mobile health and other connected devices in healthcare. During this module, trainees will be expected to contribute to, write and deliver policy on the provision of information for patients/public and on patient/public-accessible systems. Trainees will be expected to apply and develop their knowledge and understanding of the patient perspective on the use and application of health informatics science within the health and social care context. This will include the key factors in the co-production of health and care between patients/public and healthcare services, and the role of technology in these relationships.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1, 2, 3, 4, 5	Competency Apply information governance principles and best practice in the workplace, including confidentiality.	Action View
# 2	Learning outcome 1	Competency Specify the essential components of an effective patient information/engagement strategy.	Action View
# 3	Learning outcome 1	Competency Work with a clinical team and/or users to gain a wider view of the effectiveness of a patient information and engagement strategy, and design a solution to address any issues raised.	Action View
# 4	Learning outcome 1	Competency Critically appraise a patient information/engagement strategy.	Action View
# 5	Learning outcome 1	Competency Present your findings to colleagues and patients, making recommendations for revision of the patient information strategy.	Action View
# 6	Learning outcome 2	Competency Design and carry out an audit of resources available for patients, ensuring any necessary approvals are in place.	Action View
# 7	Learning outcome 2	Competency Analyse and interpret the data from the audit and prepare a written report, including an action plan and proposing solutions to any problems identified.	Action View
# 8	Learning outcome 2	Competency Present the findings from the audit to an audience of peers.	Action View
# 9	Learning outcome 2	Competency Work within the multiprofessional team, building and sustaining professional relationships.	Action View
# 10	Learning outcome 3	Competency Specify the characteristics of effective online or electronic health resources.	Action View
# 11	Learning outcome 3	Competency Design, document and undertake an evaluation of online or electronic health resources.	Action View
# 12	Learning outcome 3	Competency Appraise the approach taken and document this and the conclusions of the evaluation for presentation to peers.	Action View
# 13	Learning outcome 3	Competency Advise health professionals and patients making decisions about the use of electronic health resources for diagnosis and monitoring purposes.	Action View
# 14	Learning outcome 4	Competency Write a proposal to enable you to meet with patients or patient groups to discuss their views with respect to a health informatics initiative and gain the necessary approvals.	Action View
# 15	Learning outcome 4	Competency Apply an appropriate data collection method or methods.	Action View
# 16	Learning outcome 4	Competency Analyse and present your conclusions to the owner of the initiative and to the survey’s participants.	Action View
# 17	Learning outcome 5	Competency Critically evaluate a range of information/resources/internet/behavioural change apps and identify those that should be recommended to health professionals and patients, considering the underpinning evidence base.	Action View
# 18	Learning outcome 5	Competency Interpret data to provide diagnostic and therapeutic advice to health professionals with respect to the appropriate use of information resources/internet interventions/behaviour change apps to support diagnosis and long-term treatment plans.	Action View
# 19	Learning outcome 5	Competency Work with colleagues and within multidisciplinary teams to ensure information is used appropriately to formulate specific and appropriate management plans for patients using electronic health resources and, where appropriate, agreed timescales with the patient and colleagues.	Action View

Assessments

You must complete:

• 3 case-based discussion(s)
• 3 of the following DOPS/ OCEs:

Undertake an audit of resources available to patients on a specific pathway	DOPS
Compare and contrast local patient engagement strategy with others and discuss these with a patient engagement lead.	DOPS
Investigate how patients experiences are collected and measured and present findings	DOPS
Consider an information governance ethics request and detail your recommendations around this.	DOPS
Map the flow of information between healthcare professionals during a patient pathway or part of one for long pathways, noting how much flows via ICT, written notes, verbal communication and the patients experience	OCE
Observe and present observations regarding the use of healthcare technology in a home environment, especially regarding barriers to its use	OCE
Participate in an MDT meeting where the results of a clinical audit is discussed	OCE

Learning outcomes

1. Critically evaluate a patient information/engagement strategy (a strategy developed by a clinical team or an organisation to provide information for or otherwise engage with a particular patient/carer group) with particular reference to how patients were included in the development and how they have used the information or other resources.
2. Perform an audit of resources available for patients, evaluate and present the results within a multidisciplinary team, and set out an action plan to address issues identified and discuss the role of audit in quality management within the clinical setting.
3. Assist in evaluating online or electronic health resources that can be used in a range of situations, including to support health professionals and patients making decisions about the use of electronic health resources for diagnosis and monitoring purposes.
4. Meet with patient(s) to discuss their views with respect to a health informatics initiative and present the outcome to your colleagues and patient representatives.
5. Advise health professionals with respect to the use of information resources/internet interventions/behaviour change apps that should be recommended to patients within your scope of practice.

Learning outcomes

1. Appraise online health-related resources supporting
   • Provision of information on healthcare interventions (treatments, operations and procedures).
   • Public health and patient advisory/support resources.
   • Patient engagement and involvement solutions (such as patient opinion, patients like me, etc.).
2. Evaluate a patient information strategy (a strategy developed by a clinical team or an organisation to provide information for a particular patient/carer group).
3. Discuss the content of an electronic health resource and relate the above activities to national policy.
4. Synthesise theoretical and stakeholder perspectives that relate to patients’ involvement in their care, including patient safety and information governance.
5. Review patient engagement and involvement processes and frameworks in specific diseases/conditions (such as cancer or long-term conditions).
6. Discuss the role of innovation in healthcare and appraise a new technology enabling patient/public involvement in their health.
7. Describe and discuss the issues and standards relating to the design and implementation of technology solutions to be used by members of the public.
8. Apply theories of literacy and health literacy.
9. Apply theories of behaviour change to the design of a resource or technology.
10. Assess the implications for shared decision making/care of a resource or technology.
11. Explain different models of patient access to their records and the implications for different stakeholders.

Indicative content

• Context of health broadly, including care, wellbeing and health promotion
• Significance of the patient journey (and what it means for a patient’s information needs and health understanding)
• The role of patient-reported outcomes
• The patient’s role in safety
• Issues of equity (e.g. the ‘digital divide’; equity in treatment and access); and sustainability
• Technologies that enable the co-production of health (primarily the internet and mobile phone technologies (SMS, smart phone apps), mobile health, Web 2.0
• Access to and the availability of systems and information
• Skill development covering:
• ideas of language literacy and numeracy
• health literacy and information literacy
• patient access to and/or control of healthcare records (shared records)
• Personal Health Records
• Risk management approaches
• Communication and information exchange (e.g. doctor/patient e-mail communication or videoconferencing)
• Peer-to-peer communications (including online support groups and the role of social media, such as Twitter and Facebook)
• Future and emerging technologies (e.g. health avatars)
• How patients use information resources: those developed by the NHS and healthcare professionals; those developed by charities and advocacy groups; peer support networks; commercial sites; and wikis (notably Wikipedia).
• Models of ‘information needs’ and decision-making behaviour
• Relevant studies on the quality of information online and of ‘infodemiology’
• Access to and availability of systems, including user interface and experience matter

 The broader context relevant to these subjects:

• the changing nature of the clinician/patient relationship
• the role of patient’s self-care (workload issues, where responsibilities and liabilities lie)
• the nature of trust and the ‘consumer’ perspective in modern healthcare.

Example topics might include:

• How might an individual seeking to improve their health use websites and smart phone apps to support behaviour change?
• What is the significance of email spam offering (supposed) medical products for sale?
• Use of SMS for promoting family planning services in the developing world
• Use of telehealth and telecare technologies in developing countries where health infrastructure is remote or undeveloped
• What are the implications for a patient in the use of a wearable technology (e.g. sensor monitoring heart rate, etc.)?

Activities

• With permission, observe healthcare professionals negotiating shared care with patients in the context of digital technology. Critically appraise the communication/interaction, seeking the views of both the patient and the health professional, and identify factors that have a positive impact on the negotiation and areas that could be improved.
• Visit a range of clinical environments in primary and secondary care, and if possible in the home environment, where patients with chronic diseases are encouraged to take an active role in their care (e.g. diabetes clinics), and identify barriers to the use of telehealth and telecare technologies and the implications for a patient in the use of wearable technology (e.g. sensor monitoring heart rate, etc.) or mobile technology (e.g. apps, etc.).
• Attend a multidisciplinary team meeting where the use of clinical information from an audit is presented and discussed, and critically reflect on the role of the Clinical Scientist within multidisciplinary teams.
• Attend multidisciplinary clinical research meetings and critically evaluate how the research outcomes will inform the critical evaluation of practice of the multidisciplinary team and your personal practice, and discuss your experience with your training supervisor.