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STAT6001 Twitter for Public Health Data: Public health Informatics and Telemedicine Assessment Answer


ASSESSMENT BRIEF
Subject Code and TitleSTAT6001: Public Health Informatics
AssessmentAssessment 1: Report – Summarising Public Health Informatics (including evaluation)
Individual/GroupIndividual
Length2,500 words
Learning OutcomesThis assessment addresses the following learning outcomes:

  • Synthesise knowledge of public health informatics
  • Analyse the role of ICT in public health management and healthcare access and service delivery
  • Examine global and national legislation and strategies for ICT applications in health
  • Apply critical reasoning skills to assess and report onthe effectiveness of an ICT project
  • Evaluate the innovative use of ICT, including mHealth, eHealth and social media strategies for health promotion, disease outbreak and risk communication, emergencies and disaster response
  • Evaluate the ways that systems, infrastructure and resources can constrain the effective applications of ICT

*Please Note: This time is Sydney time (AEST or AEDT). Please convert to your own time zone (eg. Adelaide = 11:25pm).

Instructions:

In this assessment, you will follow two parts:

Twitter Review:

Follow three public health-related Twitter accounts and summarise what you have learned from following these feeds for 5 weeks (from Week 1 to week 5 of the trimester). Critique on how Twitter as a social media tool, can be utilised for informed public health informatics field. Note that you will need to create a Twitter account. You may pick up accounts from the following list (1500 words)

  • @Croakeyblog
  • @ehealthpaho
  • @equitylist
  • @TheMarmotReview
  • @RuralMental_Hth
  • @DigitalHealth
  • @eHealthAus
  • @JMedInternetRes
  • @Healthypolicies
  • @AUMentalHealth
  • @telemedicine_Jn

Telemedicine in Australia (1000 words

Summarise the barriers to the uptake of telemedicine in Australia based on articles provided in the learning resources and wider literature (last 5 years). Classify them into ICT issues and management issues and evaluate current methods.

Answer

Public health Informatics and Telemedicine


Introduction

The report introduces Social media sites like Twitter as a better indicator for providing real-time public health data which can be mined and analysed accurately to track and predict disease outbreak such as H1N1 and the recent cases of Ebola. The report also discusses Telemedicine technology as electronic means for the health care professionals to be at the services of the patient without the requirement to visit them in person.

Part 1: Twitter as public health informatics

Description

The systematic application of Information and communications technology to the practices in public health, research as well as learning is referred to as public health informatics. It is the use of computers, communication, information systems and clinical guidelines in application to the public health of the vast majority (Wang et al., 2017). The public health informatics relates to professions such as nursing, public health care facilities including hospitals as well as researches in medical fields. 

The system provides insights as well as opportunities to improve the elements of the public health surveillance system. The elements are planning and system design, Data collection and management, Analysis of the data, Interpretation, Dissemination, and application to the public health programs. 

Social media sites like twitter among others are perceived to be better indicators for providing real-time public health data and can be mined and analysed accurately to track and predict disease outbreak such as H1N1 and the recent cases of Ebola in the African countries.

Findings from twitter accounts

NAMEDESCRIPTION
@Croakeyblog
The twitter account is handled by Melissa Sweet, who is an independent journalist and shares news regarding public health and health policies among others.
Since joining Twitter in October 2009, she has tweeted estimated 258,000 tweets until 5th April 2019 
Her latest tweet includes the 2019 Australian budget analysis focusing on the health policies, where she tweeted, "The people in most need receive the least" reference to her blog croakey.org  Melissa Sweet (@croakeyblog).
The content in the tweets, however, needs a specific intellectual ability, but the description of the policies are illustrative and detailed
@TheMarmotReview
The twitter is handled by the Institute of Health Equity team which was previously the Marmot Review team and focuses on reducing health inequities by tackling the social determinants of health.
The team has posted 1,678 tweets till the current date since its inception in July 2011.
The tweets mainly reference to various blogs, and the latest one includes, "‘THE BROKEN PLATE – Ten vital signs revealing the health of our food system, its impact on our lives and the remedies we must pursue' — a report with commentary by @MichaelMarmot" IHE (Marmot Review) (@TheMarmotReview).
The contents of the tweets are usually easy to understand and uses descriptive take on health issues.
@telemedicine_Jn
The twitter is handled by the Telemedicine Journal which provides innovative solutions in patient care and records management. 
The twitter account was opened in September 2009 and has since posted 881 tweets.
The latest tweet includes, “The impact of Telemedicine on teamwork and workload in paediatric Resuscitation: A simulation-based, randomised controlled study” referring to the content in the journal with the same name Telemedicine Journal (@Telemedicine_Jn).
The content of the website and the tweets are comprehensive and provides the right amount of knowledge to individuals interested in the concerned telemedicine field.


Application of twitter in public health

The use of social media sites like Twitter is increasingly adopted in the sector of public health, due to the barriers in financial support and decreased resources. Many public health professionals are now using Twitter to facilitate development in their profession (Dixon et al., 2015). To bypass the hurdles in funding and resources, public health professionals have turned to Twitter and other social media websites for professional development. Twitter with more than 500 million active users has the unique function of communicating with peers and other like-minded individuals in fewer characters and hashtags, which allows the public health professionals to communicate and connect efficiently and quickly actively.

Using Twitter’s functionality of using keywords and search specific phrases like ‘public health information’ or simply ‘public health’ can provide the user with all the news regarding the recent developments in the field of public health to other incidents and events. The twitter feeds are optimised on a real-time basis and provide with dynamic ranges of information like an outbreak of a particular disease or development of a new vaccine or medicine (Sinnenberg et al., 2017). The technology also enables the individuals to report on various medical events or new policies regarding public health in the form of tweets.

Strengths of using Twitter in public health

Twitter as a platform for public health raises awareness among individuals and also helps to counter misinformation. Twitter is the key to get the trusted information on immunisation, virus, therapy, Ebola among others to the public (Berry, 2017). Most people nowadays get their news from Twitter rather than the newspapers. This makes Twitter an excellent platform to share new and critical information during a health crisis. During September 2018 as Typhoon Mangkhut approached the Philippines, the World Health Organisation turned to twitter posting infographics about how to stay safe during and after the natural calamity. 

Posting everything about everything online including people's health, with hashtags like #flu can reveal the diseases being discovered in new locations. This can help the public health institution to get the perspective of the severity of the disease symptoms without being present physically.  Other advantages that Twitter offers over traditional data includes real-time tracking of the data, ease of accessibility as well as reduced cost of operations. Official health care twitter channels can provide the required health information in real-time. The news coming through twitter channels are also cost-effective and can be accessed free of cost. The only requirement being the knowledge in the public health services and connectivity to the internet which doubles the efficiency of the platform.

Critique of twitter regarding public health

The primary factor which makes twitter inefficient in regards to public health is the reliability of the sources of information. Sometimes the sources of information are not reliable, and that stirs up significant problems especially in the field of public health. The spreading of wrong information is the primary cause that people are not particularly fond of the information presented by the platform. In recent times Twitter has deleted many accounts that are responsible for spreading misinformation among the public (Eckert et al., 2018). The pages were allegedly dedicated to fringe medicine in an apparent crackdown by the Twitter team. The accounts were mainly focused on health and natural remedies to treat cancer and other untreatable diseases such as AIDS.

This is causing the authentic people to lose their livelihoods as well as their passion and purpose of propagating health information among the population. The part of the society which is trying hard to keep the people well informed about the public health are losing their credibility due to some miscreants and people are losing their faith on the twitter's public health community overall.

Challenges, barriers, and limitations 

The problems and limitations of Twitter are related to the collapse of the context. This refers to the state where professional and personal boundaries can undesirably overlap. The subsequent tension inhibits extensive use of Twitter in the public health sectors due to the openness of the internet upholding health privacy as well as confidentiality policies. However, the two main limitations are the inconclusiveness of the evidence and reflections on the public health methodology.

Some public health information is often based on incomplete research, or the informatio0n is posted before the completion of the study which leads to incorrect information or inconclusive information. The research paper often clarifies the evidence later after conducting all the necessary researches on the information, and since the matter was already in the public forum, the data could not be redacted but only admitted to being wrong affecting the reputation of the organisation.

The methodological flaws in the research posted on Twitter do not pool their findings by period or study type. This poses a severe threat to the credibility of the information. Either the results confuse the public in regards to the public health terminologies or the research becomes redundant by the time it is posted on Twitter.

Future of Twitter in public health 

One of the primary attributes of the platform is its real-time nature which will help the public health professionals to use it as traditional research data. The conventional methods involve studies, panels as well as survey data which can take months to gather whereas twitter as a platform can provide all the necessary studies and surveys in a quick and efficient form. The data is comparable in the global scale that is surfacing instantly and is readily available. Twitter's data source is easily accessible to the researchers within limited human resources as well as financing (Frieden, 2015). The platform also provides the researchers with the current clinical data as opposed to the clinical data through traditional methods which can be lagging behind the actual occurrence of the illness or the disease.

Another attribute of twitter which makes it future in public health is the openness in the discussion of the users about their health issues. People do not hesitate to post about embarrassing illness such as diarrhoea among others. This openness in discussing health problems can provide Twitter with the means to sympathise with others and share personal experiences to increase the knowledge of the people in a general point of view.

Part 2: Telemedicine – its barriers and potential infrastructure

Description 

Telemedicine is used for allowing the health care professionals to diagnose, evaluate as well as treat patients at a significant distance using the technology of telecommunications. The approach has been through a prominent advancement in the last decade, and it is gradually becoming a more critical part of the Australian healthcare infrastructure (Flodgren et al., 2015). In the early days, the technology was only used by the doctors to connect with their patients in one location with specialists at another place. The technology is of great benefit especially to the rural people of the population or people from remote areas where the availability of specialists was limited. 

Telemedicine involves the use of electronic means to communicate and provide the software necessary to the health care professionals to be at the services of the patient without the requirement to visit them in person. The technology is regularly used by the doctors to perform follow-up visits, management of medication and chronic conditions, consultation with a specialist and other clinical services which can be provided remotely via secure video as well as audio connections. 

The benefits of telemedicine technology are:

  • Patients need not to have to take time from work to visit doctors physically
  • Patients do not have to bear travel expenses and other expenses
  • Patients enjoy less interference with the child as well as responsibilities regarding elder care.
  • Patients also enjoy privacy with their doctors.
  • There is no threat to potentially expose to contagious patients in the vicinity (Driessen, Castle & Handler, 2018)
  • Professional health care providers enjoy increased revenue.
  • The efficiency of the office structure to the health care professionals is provided.
  • The providers perform better follow through with the patients.
  • There is the least chance of missing appointments and less chance of cancellations.

Barriers to uptake telemedicine 

In a theoretical view, the convenience of telemedicine, as well as its effectiveness, should be enough reasons to implement the system on a global level. However, there are few barriers which need to be addressed before the proper implementation of the telemedicine system. Some of the obstacles and their solutions are mentioned below:

Licensing of the physicians – telemedicine through its concept would allow cross country consultations that would allow specialists from another city in the country to help more patients. Since the regulations of physicians vary state to state and country to country;, therefore, practitioners may need full medical licensing in the places, the one where they live and the one where they need to practice. In addition to obtaining necessary clearances to practice medicine in different areas, physicians may also be asked to adhere to the state medical rules which are diverse and sometimes confusing (Bele et al., 2019). The potential solution that could help solve the problem is to create a national telemedicine license in Australia. 

Credentialing – physician specialists are required to have telemedicine credentials in all hospitals that work from a hub. Not only the entire volume of the paperwork is time-consuming, but the costs of administrative processes are significantly high. The time as well the financing required to provide credentials for telemedicine could be better used to train the hospital staff and also the patients within the hospitals (Campling et al., 2017). The possible solution for the problem is to streamline the credentialing process with common requirements that would allow the physician to apply for many hospitals at the same time.

Compensations – insufficient fund expenditure, as well as the lack of compensation, are the monetary severe issue in the telemedicine field. Similar to licensing laws, the compensation structures vary across Australia. For the practitioner to receive specific compensation criteria according to the national policies, have to be met. When the compensation is limited, patients are underserved in the affected regions. According to many cases, the cost of telemedicine is too high of a cost burden for the hospitals to bear. One of the many solutions id grants forms organisations as well as government entities such as the Australian Medical Association (AMA) to help implement telemedicine.

Potential infrastructure support

Better technological equipments – since the inception of telemedicine the only purpose of it was to connect patients with health care professionals in populated urban centres, but with the evolution of technology, the use of telemedicine has become simpler and eliminates the need for costly equipments. Most medical practices have electronic health records for managing health records of patients (Moloczij et al., 2015). It is essential for the telemedicine technology to integrate seamlessly with the core solutions.

Better internet access – many of the countries including some underdeveloped and developing countries cannot use telemedicine technology because most of the population do not have access to high-speed internet needed for face to face teleconferencing. There is even no internet connection altogether in the remote areas of these countries; therefore it is required for the prerequisite of the technology which is, internet to be integrated within these places for the commencement of telemedicine technology. 

Public space kiosks – installing public kiosks in private compartments near the healthcare facility is also a potential infrastructure solution for the patients to connect with the required health care professionals in the remote areas. The patients will be provided with health care cards to communicate with their doctors. The card will be swiped into the kiosks just like ATMs and will contain all the necessary health information of the patient (Dzau & Ginsburg, 2016)

Conclusion 

The report concludes that Twitter is an excellent means of public health informatics which helps to inform the population about required healthcare information like diseases outbreaks, the invention of vaccines and cure for diseases. In the future, the website can help to provide valuable research data to the healthcare professionals and the researchers in the medical field quickly and effectively. The report also states the importance of telemedicine in the area of medical technology which provides convenience to the patients to connect with their doctors through the medium of the internet. The telemedicine technology helps to save time for the patients and health care professionals to serve more people in a short time.

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