Research

Hospital Report Releases e-Scorecard and First Report on Mental Health

E-Scorecard

In a giant leap forward in reporting on hospital performance, the Hospital Report Research Collaborative (HRRC) recently launched its exciting new e-Scorecard. The e-Scorecard, a web-based password-protected database and analysis tool, allows participating hospitals to:

• view their actual performance scores for each indicator
• compare their performance to other hospitals and the Provincial average
• develop customized analyses and reports
• track performance over time

The HRRC will also provide: 1) new and improved Executive Reports, which replace the trademark blue books and provide indicator scores linked to hospital strategic priorities in a more concise format; 2) Technical Reports, which provide detailed methods for each quadrant of the scorecard; and 3) PowerPoint presentations, to aid hospitals in disseminating key messages within their organizations.

The Rehabilitation e-Scorecard was released on June 21, 2005 followed by the Executive Report on June 27, 2005 . The Hospital Report 2005: Rehabilitation will be made public following a news release by the Ministry of Health and Long-Term-Care and the Ontario Hospital Association in mid-July. The remaining 2005 Reports – Acute Care, Emergency Department Care and Complex Continuing Care – will be released publicly in the Fall 2005 after hospitals have received their e-Scorecards and Executive Reports for these sectors.

Hospital Report 2004: Mental Health

Released on May 26, 2005 , the Mental Health report examines the performance of 11 psychiatric hospitals and 45 acute-care facilities in five regions in Ontario , the north, the east, the Greater Toronto Area, the south and the southwest. The results are reported by region rather than by hospital, but the next report in 2007 will provide detailed performance data for individual hospitals. While mental health care performance overall was found to be very high, four areas for improvement were identified: increased patient participation, greater continuity of care, decreased regional variation and increased use of evidence-based care approaches.

More information about e-Scorecard and Hospital Reports (1998-2004) can be accessed through the HRRC website.

New Publications in Health Informatics and eHealth

This spring has seen a spate of publications by HPME faculty on health informatics and access to health data, information and knowledge by a variety of stakeholders. Consumers, care providers, decision-makers and researchers have unique concerns in accessing and using health data. The field of informatics is highly interdisciplinary, involving the health sciences, computer science and information science. Two new books have been released on the involvement of patients in their own care and the delivery of health care. Gunther Eysenbach 's textbook, “Consumer Health Informatics” is designed for medical IT specialists, researchers and health care providers in understanding and designing consumer informatics tools and strategies. Kevin Leonard 's “A Prescription for Patience” discusses the effects of changing technology on a number of industries, including health care. Pat Baranek's report, “Data, data everywhere…Improving access to population health and health services research data in Canada ” provides an extensive review of the current status of population-based health and health services databases and their potential for health research. In the current issue of Nursing Leadership , Lynn Nagle discusses the need for greater involvement of nurses in the development of information management systems and as nursing informatics researchers. Adelsteinn Brown, Lead of Information Management on the Health Results Team provided an update on information and transformation at the May 11, 2005 Breakfast with the Chiefs. A brief synopsis is provided below along with full-text access to each article or presentation.

Gunther Eysenbach and Consumer Health Informatics

Gunther Eysenbach, Associate Professor in HPME and Senior Scientist with the Centre for Global eHealth Innovation, is one of five leaders in the field of health informatics who edited the textbook, “Consumer Health Informatics: Informing Consumers and Improving Health Care”. This book includes case studies, models of patient education and behaviour change, patient-provider communication, issues of privacy and confidentiality, evaluation of health informatics, and more. It is the first textbook to explore issues around consumer access to health information. To find out more, or to order, see Springer Online. Dr. Eysenbach is featured as this month's Research and Teaching profile of the month (see below).

Kevin Leonard 's Prescription for Patience

Kevin Leonard, Professor in HPME and Research Scientist with the Centre for Global eHealth Innovation, is a leader in patient rights and advocacy in the area of health information. His new book, “A Prescription for Patience: A Guide to Improving Our Health Care System” (Adobe PDF), presents the effects of changing information technologies on education, banking, sports/entertainment and healthcare. Dr. Leonard seeks improvements in our healthcare system through greater consumer involvement in their own health and the delivery of services, including the development of electronic patient records. This engaging book combines Dr. Leonard's academic expertise with his unique storytelling style. Published by White Knight Publications in Toronto, it can be ordered through www.chapters.indigo.ca. Proceeds from the book will go towards the development of a National Patient Advocacy Group.

Lynn Nagle on Nursing Informatics

As the Senior Vice President, Technology and Knowledge Management at Mount Sinai Hospital , Lynn Nagle is responsible for information and communication technology and information management. In the current issue of Nursing Leadership (Vol. 18 No. 1 2005), Dr. Nagle builds a case for nursing informatics as a means for nurses to become involved in building and evaluating the systems that they will be the largest users of on the front-line. According to Nagle, nursing specific knowledge is needed through the development of the nursing informatics field and nursing knowledge needs to be shared and integrated with other disciplines. Dr. Nagle is Assistant Professor in HPME and Nursing, the Canadian nursing representative to the International Medical Informatics Association Special Interest Group on Nurse Informatics, and the founding president (past) of the Canadian Nursing Informatics Society.

Pat Baranek Reviews Population and Health Services Databases

Pat Baranek, Professor in HPME and health policy and research Consultant, co-authored the April 2005 report, “Data, Data, Everywhere... Improving Access to Population Health and Health Services Research Data in Canada”. This extensive review of Canadian health information databases was prepared for the Canadian Policy Research Networks in collaboration with the BC Centre for Health Services and Policy Research. The final report is the outcome of an RFP issued by the Canadian Institute for Health Research, Canadian Population Health Initiative (CIHI), Health Canada and Statistics Canada in 2002. While numerous health databases exist in Canada , most data is collected for the purposes of surveillance and operations, rather than health research. Secondary analysis of data requires complex arrangements for researchers to access and use existing data, resulting in a fragmented system of access. Based on forty-three key informant interviews, this report provides a number of recommendations to improve access while strengthening privacy safeguards, such as the development of privacy guidelines or standards, and inventories of databases and data access activities. Dr. Baranek is the coauthor of numerous other books and publications on health policy and research, including “Reforming Home and Community Care in Ontario” with Raisa Deber and Paul Williams (2004) and “First Do No Harm: Making Sense of Reform: Remedies in Canadian Health Care” (2003) with Terry Sullivan.

Adalsteinn Brown: Information Management Update

On May 11, 2005, Dr. Adalsteinn Brown presented an update on role of Information Management in Transformation to the Breakfast with the Chiefs. The provincial government's transformation agenda relies on information for accountability, decision-making and evaluation. The aim of the Information Management strategy is to build an information management system that produces better data, more integrated performance measurement for change and supports evidence-based decision-making within LHINs and the Ministry of Health and Long-Term Care. The complete presentation and webcast are available on the Longwoods website: www.longwoods.com/website/events/breakfast/BC05_May11/.

Research and Teaching Profile

Faculty associated with the Department of Health Policy, Management and Evaluation (HPME) are involved in a broad range of research activities with a variety of organizations. Success of the HPME Knowledge Transfer initiative is dependent on presenting our stakeholders with a unified, clear image of the depth and breadth of Departmental expertise. To promote greater internal awareness of the knowledge developed through HPME, faculty research profiles are a regular feature of the newsletter.

This issue of the HPME newsletter features a research profile for Dr. Gunther Eysenbach, Senior Scientist at the Centre for Global eHealth and Innovation.

+ + PROFILE OF THE MONTH + +

Gunther Eysenbach, MD, MPH

Dr. Gunther Eysenbach is Associate Professor in the Department of Health Policy, Management and Evaluation and Senior Scientists at the Centre for Global eHealth Innovation at the Toronto Research Institute/Toronto General Hospital. As coordinator of the Eysenbach Research Group at the Centre, he is pursuing projects involving consumer health informatics, population health technology, electronic publishing, usability of eHealth systems and knowledge translation. Dr. Eysenbach is recognized by many as one of the leading researchers in the field of eHealth and Internet and Medicine.

Education and Work Background

Dr. Eysenbach obtained his MD From Freiburg, Germany in 1999 and his Master of Public Health from Harvard in 2003. He has conducted medical research and undertaken clinical training in London , UK and Munich , Heidelberg and Erlangen/Nuremberg, Germany . He founded and headed the first research group on cybermedicine and eHealth worldwide at the University of Heidelberg between 1999 and 2001. In 2002, he moved to Toronto to help HPME's Alex Jadad start up the Centre for Global eHealth Innovation.

Research Activities

Before moving to Toronto , Dr. Eysenbach was the Principal Investigator of a major research project funded by the European Union to establish an international trustmark for health information published on the Internet. This project (“MedCERTAIN”), which concluded in 2002, was the pilot for a more extensive collaboration between Germany , France and Spain to rate, evaluate and accredit health information websites. The goal of the new international consortium, “MedCIRCLE”, is to guide consumers to trustworthy health information and to establish a global web of trust for networked health information. Members use a common machine-processable language to rate, describe, annotate or endorse other websites, enabling intelligent software tools to aggregate ratings from different perspectives. Developed under the leadership of Dr. Eysenbach, MedCircle was awarded the prestigious German Janssen Cilag Future Award in 2004. Sometimes referred to in Germany as the “Health Nobel Prize”, the Future Award honors persons, organizations and mechanisms which improve health care with socially effective innovations.

Dr. Eysenbach is the author and editor of over 120 publications, including papers in leading scientific journals such as BMJ, JAMA and Lancet . He has received numerous awards and distinctions and has been called “one of the most productive researchers, editors, and publishers in the online health field” (Ferguson Report's Distinguished Achievement Award). Dr. Eysenbach's ongoing interest in consumer access to high quality health information has lead to his most recent accomplishment, the publication of “Consumer Health Informatics” . To read more about this book, see above (Zita please link). He also is editor of the Journal of Medical Internet Research, and open access peer-reviewed transdisciplinary journal on health and health care in the Internet age. This is the first international scientific peer-reviewed journal on research, information and communication in health care using Internet and information and communication technologies (e-Health).

Dr. Eysenbach is currently the Principal Investigator of the following projects based out of the Centre for Global eHealth Innovation:

• Bullying Media Study
• Journal of Medical Internet Research
• MedCIRCLE
• Mental eHealth
• Open Access Science Information System
• Personalized Information Platform for Life and Health Services
• Sushi-Q
• eGuides
• I3MPACT Impact of Internet Instructions on Men With Prostate Cancer

Selected Publications

The following full-text articles can be downloaded in PDF format:

Eysenbach G , Köhler C. Health-Related Searches on the Internet. JAMA 2004; 291: 2946.

Eysenbach G , Powell J, Englesakis M, Rizo C, Stern A. Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions. BMJ 2004;328:1166-1170.

Eysenbach G. The Semantic Web and healthcare consumers: a new challenge and opportunity at the horizon? Int J Healthcare Technology and Management 2003;5 ( 3/4/5 ): 194-212.

Powell J, McCarthy N, Eysenbach G . Online but untreated: Depression in users of Internet communities. BMC Psychiatry 2003; 3:19 .

Eysenbach G. The impact of the Internet on cancer outcomes. CA Cancer J Clin Nov/Dec 2003; 53(6): 356-371.

Eysenbach G , Powell J, Kuss O, Sa ER. Empirical studies assessing the quality of health information for consumers on the World Wide Web: A systematic review. JAMA 2002; 287: 2691-2700.

Eysenbach G , Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 2002; 324: 573-577.

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