Sunday, January 11, 2009

A Whole-Person Approach to Diabetes Health Education Part 4 of 4

In my last post, I discussed the effect of mental stress and personality characteristics on a diabetic people's ability to control their blood glucose levels. In this post I focus on the role of health information technology in support of health education programs.

The Role of Health Information Technology

What do people with diabetes (and other chronic conditions) need in order to overcome their psychological obstacles and promote healthy living? As previously discussed in this paper, they must have adequate knowledge and understanding, positive emotions, rational attitudes and beliefs, effective coping skills, and motivation. That means they not only have to be aware of their physical health problems and ways to manage them, but they must also be aware of how their mental health (attitudes, emotions and mental stress) affects their blood glucose and how to control it. Achieving this daunting goal requires health coaching and counseling, of course.

The coaching and counseling services can be enhanced through interactions with other people and use of health information technologies. These people may be healthcare professionals, family and friends, and even "virtual acquaintances" through Internet-based social networking (e.g., peer-support groups). The health information technologies include web sites, educational software, psychologically-based self-help software tools, and personal health records (PHRs).[1] Unfortunately, we are in the "Stone Age" when it comes to most health information technology. Current day PHRs are not very useful to the typical consumer/patient, and could be much more useful to professionals.[2]

What is needed is an easy, low-cost way for comprehensive physiological and psychological data to be transformed into useful personalized information. This information should increase people's awareness of their current health status and risks, as well as provide information that increases their ability to manage their diabetes. Today's PHRs are very immature regarding these types of capabilities.

By way of full disclosure, I've been developing such a health information software program for over two decades, called the Personal Health Profiler™ (PHPro™). The PHPro is a major departure from the kinds of PHRs in use today. It promotes more rapid and complete understanding of a person's physiological, psychological and mind-body functioning and risks; it provides ongoing feedback and instruction; and it helps a person developing effective coping strategies. The information presented by the PHPro comes from analysis of detailed data about the relationships between a person's:

  • Internal dynamics—including coping skills, problematic physical signs and symptoms, co-existing illnesses, emotions, mental stress, and cognitions (attitudes, beliefs, expectations, etc.).
  • Behaviors—including diet, exercise, alcohol and substance use, sleep, etc.
  • External influences/causes—including stressful interpersonal relationships, stressful and unhealthy physical (e.g., work, living) environments, economic pressures, etc., as well as supportive conditions that promote good health.
  • Medications—including possible side-effects, drug-drug interactions, and precautions.
  • Demographics—including gender, age, ethnicity, socioeconomic status, etc.

In addition, the PHPro provides these essential functions:

  • "Pushes" targeted information to consumers and professionals to fill knowledge gaps and increase understanding, instead of requiring that the information be "pulled" by them. This means exceptional "findability;" that is, navigating to and accessing relevant information is a breeze compared to the complex and often convoluted process required to obtain and filter desired information from typical web portals and search engines.
  • Identifies key life stressors and health risks, as well as a person's underlying attitudes, beliefs and emotions, which help focus coaching and counseling efforts, and improve self-management.
  • Delivers warnings, alerts and other essential feedback, so necessary adjustments can be made to plans of care in a timely manner.
  • Uses a structured, personalized coping strategy methodology that helps a person attain more adaptive coping skills.
  • Identifies potential medication side-effects, drug-drug interaction, and precautions to minimize prescription errors and manage problematic medication issues.
  • Supports well-care/sick-care integration.[3]
  • Continually evolves using flexible software modules, data sets and algorithms that are all transparent and easily modifiable.
  • Accommodates any current and future data and technology standards.[4]
  • Continually feeds a knowledge base with de-identified personal health information to support research efforts for continually improving care effectiveness.

These capabilities make the PHPro a useful tool supporting a whole-person approach to diabetes health education.

International Diabetes Health Education Program

I am honored to be part of an international, interdisciplinary group that has been collaborating for about eight months on developing integrating whole person health information technology, social support, and health coaching and education. Our efforts aim at enabling and motivating diabetic people to manage their condition effectively by developing healthy attitudes and beliefs, emotions, coping strategies, psychosocial relationships, and life satisfaction, as well as gaining essential awareness, knowledge and skills.

I will discuss more about this exciting collaboration in future blog posts.

Conclusion

Effective self-management of diabetes (and other chronic illnesses) is difficult for many individuals because it involves a complex interaction between both psychological and physiological (mind and body) factors. A whole-person approach to diabetes health education is therefore important. It combines self-care instruction, coaching and counseling, and innovative health information technology tools to build knowledge and competence, establish effective coping skills, and motivate diabetic people's motivation by helping overcome psychological obstacles.

References:

[1] National Guideline Clearinghouse. 2006 May. Available at this link

[2] Beller, SE. Health Information Technology: Past Predictions, Current Reality, and Future Potential - Part 1. 2008 Nov. Available at this link

[3] Beller, SE. Well-Care Sick-Care Integration. Available at this link

[4] Beller, SE. Art of Health Knowledge Creation and Use. Available at this link

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