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E-Health, Telemedicine Pose Challenges, Offer Benefits for Patients with Arthritis

Michelle Burda, MLS, & Terence Starz, MD  |  Issue: August 2016  |  August 11, 2016

In the field of arthritis, there has been limited evidence-based research on the use of e-health activities for patients in the management of rheumatic diseases. Diseases including rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, juvenile idiopathic arthritis, psoriasis and regional musculoskeletal disorders have been studied with the focus being on quality and content of information on the Internet. There has been more work on integrating e-health into care management activities in other disciplines, especially oncology.

E-health has opened wonderful opportunities to patients and clinicians, yet provides major challenges in some ways analogous to drinking water from a fire hose. However, by understanding the mechanics and opportunities of e-health, providers can help determine how—with its effective use—the promises of greater patient engagement, satisfaction and management outcomes of overall improvement and cost efficient delivery of care can be realized.

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Michelle Burda, MLS, is the education and health literacy coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region, and Health Sciences Library System at the University of Pittsburgh. Her role is to support the efforts of the National Library of Medicine to provide all U.S. health professionals with equal access to biomedical information and improve the public’s access to information so they can make informed decisions about their health. She is responsible for training, outreach and development of classes on NLM resources and health literacy training in New York, New Jersey, Delaware and Pennsylvania.

Terence Starz, MD, is a clinical professor of medicine in the Division of Rheumatology at the University of Pittsburgh School of Medicine and is in practice at Arthritis and Internal Medicine Associates–UPMC in the Western Pennsylvania area. In addition, he is involved in clinical research projects, including rheumatoid arthritis outcome studies, and has participated in classification and intervention studies in fibromyalgia and healthcare utilization in low back pain. He serves on the Board of Directors of the Great Lakes Region of the Arthritis Foundation and the Pennsylvania Rheumatology Society.

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FYI …

Review the WHO’s National eHealth Strategy Toolkit.

Resources & Recommended Reading

  1. Alcorn N, Madhok R. Health information on the Internet. J Rheumatol. 2012 May;39(5):883–884. doi:10.3899/jrheum.120136.
  2. Ansani NT, Vogt M, Henderson BAF, et al. Quality of arthritis information on the Internet. Am J Health Syst Pharm. 2005 Jun 1;62(11):1184–1189.
  3. Berkman ND, Sheridan SL, Donahue KE, et al. Health literacy interventions and outcomes: An updated systematic review. Evid Rep Technol Assess (Full Rep). 2011;(199):1–941.
  4. Citrome L, Burda ML. A clinician’s best friend: The US National Library of Medicine’s patient resources. Int J Clin Pract. 2012 Nov;66(11):1018–1019. doi:10.1111/ijcp.12010.
  5. Ferwerda M, van Beugen S, van Burik A, et al. What patients think about E-health: Patients’ perspective on Internet-based cognitive behavioral treatment for patients with rheumatoid arthritis and psoriasis. Clin Rheumatol. 2013 Jun;32(6):869–873. doi:10.1007/s10067-013-2175-9.
  6. Grajales FJ, Sheps S, Ho K, et al. Social media: A review and tutorial of applications in medicine and health care. J Med Internet Res. 2014 Feb 11;16(2):e13. doi:10.2196/jmir.2912.
  7. Maloney S, Ilic D, Green S. Accessibility, nature and quality of health information on the Internet: A survey on osteoarthritis. Rheumatology (Oxford). 2005 Mar;44(3):382–385. doi:10.1093/rheumatology/keh498.
  8. Rains SA, Karmikel CD. Health information-seeking and perceptions of website credibility: Examining Web-use orientation, message characteristics, and structural features of websites. Comput Human Behav. 2009 Mar;25(2):544–553. doi:10.1016/j.chb.2008.11.005.
  9. Rhee RL, Von Feldt JM, Schumacher HR, et al. Readability and suitability assessment of patient education materials in rheumatic diseases. Arthritis Care Res (Hoboken). 2013;65(10):1702–1706. doi:10.1002/acr.22046.
  10. Richter JG, Becker A, Koch T, et al. Internet use in rheumatology outpatients in 2006: gender less important. Clin Exp Rheumatol. 27(1):15–21.
  11. Sadasivam RS, Kinney RL, Lemon SC, et al. Internet health information seeking is a team sport: Analysis of the Pew Internet Survey. Int J Med Inform. 2013;82(3):193–200. doi:10.1016/j.ijmedinf.2012.09.008.
  12. Singh AG, Singh S, Singh PP. YouTube for information on rheumatoid arthritis—A wakeup call? J Rheumatol. 2012;39(5):899–903. doi:10.3899/jrheum.111114.
  13. Stinson JN, Tucker L, Huber A, et al. Surfing for juvenile idiopathic arthritis: Perspectives on quality and content of information on the Internet. J Rheumatol. 2009;36(8):1755–1762. doi:10.3899/jrheum.081010.
  14. Thompson AE, Graydon SL. Patient-oriented methotrexate information sites on the Internet: A review of completeness, accuracy, format, reliability, credibility, and readability. J Rheumatol. 2009;36(1):41–49. doi:10.3899/jrheum.080430.
  15. van der Vaart R, Drossaert CHC, de Heus M, et al. Measuring actual eHealth literacy among patients with rheumatic diseases: A qualitative analysis of problems encountered using Health 1.0 and Health 2.0 applications. J Med Internet Res. 2013;15(2):e27. doi:10.2196/jmir.2428.
  16. Weiss BD. How to bridge the health literacy gap. Fam Pract Manag. 21(1):14–18.
  17. Internet skill-related problems in accessing online health information.
  18. Berland GK, Elliott MN, Morales LS, et al. Health information on the Internet: Accessibility, quality, and readability in English and Spanish. JAMA. 285(20):2612–2621.
  19. Fischer SH, David D, Crotty BH, et al. Acceptance and use of health information technology by community-dwelling elders. Int J Med Inform. 2014;83(9):624–635. doi:10.1016/j.ijmedinf.2014.06.005.
  20. McCarthy DM, Waite KR, Curtis LM, et al. What did the doctor say? Health literacy and recall of medical instructions. Med Care. 2012;50(4):277–282. doi:10.1097/MLR.0b013e318241e8e1.
  21. Schonlau M, Martin L, Haas A, et al. Patients’ literacy skills: More than just reading ability. J Health Commun. 2011;16(10):1046–1054. doi:10.1080/10810730.2011.571345.
  22. van Deursen AJAM. Internet skill-related problems in accessing online health information. Int J Med Inform. 2012;81(1):61–72. doi:10.1016/j.ijmedinf.2011.10.005.
  23. Pew Research Center Health and Technology in the US. 2013 Dec 4. Accessed May 1, 2016.
  24. Comstock J. Rock Health: 80 percent of Internet-connected adults use digital health tools. 2015 Oct 19. Accessed May 1, 2016.
  25. CDC Centers for Disease Control and Prevention Health Literacy Understanding Health Literacy. Accessed May 1, 2016.
  26. National Institute of Health.
  27. NLM in Focus. What is health literacy? 2016 Apr 13.
  28. Berkman N, Sheridan S, Donahue K, et al. Low health literacy and health outcomes: An updated systematic review. Ann Intern Med. 2011 Jul 19;155(2):97–107. doi: 10.7326/0003-4819-155-2-201107190-00005.
  29. Kutner M, Greenberg E, Jin Y, et al. The health literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006–483). U.S. Department of Education. Washington, D.C.: National Center for Education Statistics. 2006 Sep.

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