Using video to elaborate test results to sufferers

Researchers at the institute of University of Illinois are in the initial stages of establishing a computer-generated physician or nurse that can elaborate test results to sufferers and next steps in treatment through patient portals available through an electronic health records (EHRs) system.

For now, the work is in the proof-of-concept stage, with researchers explaining the project in the March issue of the Journal of Biomedical Informatics. The work of showing test results to sufferers is being done at the institute of University of Illinois’ Beckman Institute for Advanced Science and Technology, and the Carle Foundation Hospital’s Research Institute.

While several sufferers today have access to their electronic health records (EHRs) when they log into their portal, they analyze a bunch of test results, often represented as numbers that can be complicated to understand, claims Dan Morrow, lead author and educational psychologist at the University of Illinois. “You see a table of numbers and scores but you do not get context on ranges and risks, and you don not know if a low score is normal or a high one is normal,” he explains. For now, the numbers are generally a basis for having a conversation with your doctor.

And for now, a computer-generated doctor has to wait as researchers take baby steps and develop up to that kind of technology. For starters, they are working on attempting to enhance the presentation of tests results whether get in the mail or through a portal, by color-coding scores. A low score for cholesterol, for example, would be green, a medium score would be yellow, and a high score would be red.

But work is underway to develop a more realistic patient-physician dialogue. A retired physician recorded scripts for the sufferer portal messages and other text required to develop the avatar clinician’s commentary. Multiple scripts have been established to emulate how various kinds of test results would be explained to sufferers.

Researchers also testing whether patients’ “gist memory,” which is fuzzy representations of an event, differs relying on whether the avatar speaks in a natural voice or a computer-generated voice.

As a 1st step, researchers brought older adults into the lab and had them go through various mock patient scenarios that affect the heart disease. Few of the adults, acting as patients and presented with mock test outcomes, would see a list of numbers or the similar numbers but color coded. Another group would see a video of a provider presenting results and told how they should think about the numbers, then assess how well the older adults understand and retain those outcomes.

The reality is that most individuals like information in a video but most physicians will not use video to explain results so the idea was to develop an avatar physician or nurse that appears in the video, in accordance to Morrow. “We need to emulate best practices in a real-life face-to-face atmosphere.”

The avatar clinician is programmed to display suitable facial expressions, gestures and other cues that promote patient understanding as if findings were being presented by a human.

Having got a grant to begin the project, the attempt recently got another grant to generate other clinician avatars, and now is seeking grants for pilot studies with patient portals next year.

If everything goes well, Morrow considers a first-generation product could be a reality in 2 or 3 years.

 

Health Informatics – What is it?

• Field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine. Medical Subject Heading (MeSH) — National Library of Medicine

• 'Health informatics is the logic of healthcare.' Prof. Enrico Coiera, Guide to Health Informatics , 2nd Edition

• "The role of the information sciences in medicine continues to grow, and the past few years have seen informatics begin to move into the mainstream of clinical practice. The scope of this field is, however, enormous. Informatics finds application in the design of decision support systems for practitioners, in the development of computer tools for research, and in the study of the very essence of medicine – its corpus of knowledge. The study of informatics in the next century will probably be as fundamental to the practice of medicine as the study of anatomy has been this century." (Source: Coiera E (1995) Medical Informatics , BMJ, 1995;310:1381-7)

• The terms 'medical informatics' and 'health informatics' have been variously defined, but can be best understood as meaning the understanding, skills and tools that enable the sharing and use of information to deliver healthcare and promote health. 'Health informatics' is now tending to replace the previously commoner term 'medical informatics', reflecting a widespread concern to define an information agenda for health services which recognises the role of citizens as agents in their own care, as well as the major information-handling roles of the non-medical healthcare professions… — British Medical Informatics Society

• Health Informatics is concerned with the study of the principles of information processing and with the provision of (general) solutions for information processing problems in the field of health care; uses appropriate (formal) methods and tools, especially from informatics, to model structure and mechanism information processing systems in the field of health care in order to describe or analyze these systems or in order to provide possibilities for their construction or for their evaluation. Haux — Universiteit Maastricht

• "…Informatics is an emerging discipline that has been defined as the study, invention, and implementation of structures and algorithms to improve communication, understanding and management of medical information. The end objective of biomedical informatics is the coalescing of data, knowledge, and the tools necessary to apply that data and knowledge in the decision-making process, at the time and place that a decision needs to be made. The focus on the structures and algorithms necessary to manipulate the information separates Biomedical Informatics from other medical disciplines where information content is the focus." (Source: Aamir M. Zakaria., MD "Medical Informatics Frequently Asked Questions", Duke University)

• Informatics: "The use of information systems, computer technology and telecommunications to improve patient care, research and education." (Source: Westmead Hospital, Westmead, N. S. W. Australia

• Health Informatics examines areas such as health concepts, ontologies, classifications, terminologies, (health) knowledge managment methodologies and algorithms, electronic health record storage and delivery structures, health messaging and communication systems (including visual and auditory), decision support systems, and much more. Related topics such as the human-computer interface, ethical and legal impacts, consumer access, security and privacy as well as many ethical issues are part of the health informatics domain. Evans, D. 2003.