课程：Health Informatics-Johns Hopkins University @ coursera
# Health Information Technology for Patients
In this video, we'll start off with talking about health information technology for patients and explore what's going on today and maybe what's going on in the future.
So, you've all been to the doctor, and you've all filled out pieces of paper and clipboards.
In fact, you've probably filled out 15 pieces of paper on clipboards and wondering why the heck is this not computerized the way everybody else's is.
事实上，你可能已经在笔记板上填了 15 张纸，并且想知道为什么这没有像别的地方一样计算机化。
The good news is that we do have these sorts of questionnaires now on tablets, and you can fill them out either in a doctor's office or at home.
So, what questions might come up if you're filling these questionnaires at home is like, what is the accuracy of this information, how should you use this information?
But wait, there's more, there are coming different types or new types of questionnaires.
Sometimes these are called patient reported outcome forms or patient questionnaires.
We're asking information that can come only from the patient, like, how do you feel, are you depressed, are you able to walk, are you able to do the things that you normally do, how do you sleep?
These are not things that we get typically from the clipboard type of questionnaire, we need to get this information.
The type of informatics question that comes out of this is, well, what do you do with this information? Is it true? Can you make clinical decisions based on this?
If somebody says they're suicidal on this form that's been filled out at home on a computer, what obligations do you have to intervene?
Making the questionnaire available may raise new questions and new problems about what to do with the information.
You may notice at the top of this, it's called a computer adaptive testing, and here it's the machine, rather the piece of paper the machine can kind of skip around and ask questions that are more relevant to you.
This can be done through skip logic like if you answer this then answer that, or it can be more sophisticated.
Well, if I've established that you're not suicidal, so I'm not going to pursue the suicidal questions, adding the questionnaire on a computer using more capability than you could have on a piece of paper.
I already mentioned that patients may fill things out at home, the main way that patients see their health data these days that's connected to the doctor or the hospital is through something called a patient portal.
You can see the types of information that patients can get at through the patient portal.
It can range anywhere from their appointments, through real patient data like lab testing, to secure messaging, to the entire patient record.
Well, how does medical care change where the patient can see everything?
Are the notes more honest?
We know that there are better because patients will correct errors so that's great, but do in fact the conditions change what they write because they don't want to write something about their mental capacity patients, mental capacity or capabilities.
No surprise that we have a digital medical devices.
You've all probably have had your blood pressure taken by a digital sphygmomanometer, a digital blood pressure cuff.
Increasingly, there are digital tools for the direct acquisition of medical data.
So, there are digital stethoscopes, and digital otoscopes, and digital ophthalmoscope.
The thing that's interesting when you have these digital formats is that you now can record what the doctor has seen, so that's interesting and that's great for record keeping. It's great for teaching.
You might even have decision support.
So imagine that you have a digital stethoscope, and the machine is listening in the same time that you are, and could point out by the way, did you hear the abnormal heart sounds that may indicate something bad?
Finally, we've all heard about wearables and devices or Internet of Things.
Increasingly, there's lot of devices around the patient.
Many of you probably use a fitness tracker, you may have a phone that tracks your heart-rate and such.
There are engineer's coming out with devices all the time.
A fun one is a contact lens that can measure the glucose level in the fluid on your eye so now a diabetic might not need to prick themselves to get blood to measure the glucose, the contact lens could do it for them, or there might be a chip that they can lick and that chip can now measure basic laboratory values.
I already mentioned digital stethoscopes to the heart, to the lung.
There are devices that can read brainwaves, and a whole number of other devices.
So again, we have informatics problems come out of these.
If you have continuous blood-pressure monitoring at home, well, that's a lot of data and number one where is it that it get stored, but even more importantly what does it mean?
A whole science and practice of blood pressure management has been based on blood pressures that were obtained infrequently at doctors' offices.
Well, how did those blood pressures compare with what you get at home?
How do you judge whether or not a blood pressure medication is working if you're getting all these blood pressure measurements all the time?
So, having a device and getting a lot of data is terrific, what the information we get out of that data is not clear and what knowledge we have to work with that information may not be clear as well.
So, that's it for our grand tour, a very quick tour of the new and upcoming IT for patients.