Reaching the Masses and Sceptics: Role of Smart Health Information Portals in Holistic Medicine

1. Reaching the Masses and Sceptics: Role of Smart Health InformationPortals in Holistic Medicine Daswin De Silva Centre for Organisational and Social Informatics Faculty of IT, Monash University, Australia daswin.desilva@monash.edu

2. Overview Introducing Holistic Medicine (HM) Online Health Information Delivery Smart Health Information Portals SHIP Content Management Personalisation and Quality Heart Health Online Integrating Holistic Medicine Information Conclusion

3. Introducing Holistic Medicine What’s in a name.. Holistic medicine (HM) or complementary and alternative medicine (CAM) “All forms of medicine and treatment that focus on the person and their interactions with the environment as a whole instead of a specific illness or a certain part of the body” – AHMA 2012 Xue et al (2007) outline 17 forms of HM while Ernst and White (2000) mention 24 forms. Acceptance, awareness and use of holistic medicine is increasing worldwide. Used more often by those with higher socio-economic status. HM is heavily reliant on traditional mediums of information propagation.

4. Online Health Information Delivery Advancements in Internet technology has gradually evolved ‘informed patients’ who are up-to-date on medical condition, treatment options and even rate of survival. Allopathy health care lifecycle is information-intensive with virtually free access to all phases and all formats of information (text, images, and video) via the Internet. Health information access has become an integral part of the health strategy in most countries. Australia: www.healthinsite.gov.au, UK: www.nhs.uk, USA: www.healthfinder.gov

5. Smart Health Information Portals Health information: one size does not fit all. Individual and circumstantial variations: gender, age, marital status, ethnic background, occupation, stage of illness etc. A smart health information portal (SHIP) addresses this concern with a substantial level of personalised access to quality assessed health information and advice. Formal definition: the provision of smart technology and techniques to enhance the core capabilities of health content management, health content delivery and collaboration.

6. Smart Health Information Portals A constrained vocabulary (taxonomy/ontology) is at the core of a SHIP. Developed and maintained by a domain expert, this contains key terms, medical and general, relevant to the domain of health. Computational intelligence features are utilised to accumulate health information, assess quality and enable personalised delivery. SHIP content management is cyclic.

7. SHIP Content Management Lifecycle

8. SHIP Content Management Lifecycle Locate - The initiating phase of the lifecycle. Relevant terms, phrases and any other resource identifiers are used to search and acquire appropriate content Personalise - Refinement of the acquired content. Application of domain expertise - meta-tags, summaries and quality metrics. Store - Structured storage of acquired content, personalisation attributes and user feedback. Revise - Update content to reflect developments in health research. Provide search criteria and sample content to the Locate phase.

9. Personalisationand Quality Personalisation translates the structure imposed on content to provide an intuitive and user-friendly interface for querying. Use of novel technology such as intelligent filtering, mobile interfaces, interactive sessions. Quality assessment is essential for health information delivery. Usually determined by four factors - relevance, usefulness, reliability and timeliness.

10. Heart Health Online http://hearthealthonline.monash.edu.au/ A publicly available SHIP, conceptualised, designed and developed at Monash. Address health and mental health information needs of individuals with cardiovascular disease. Originated from a study outlining the need for health information resources relating to heart disease, psycho-education and psychological symptoms (e.g. depression, anxiety and stress) often associated with coronary diseases. High level of emphasis on quality and personalisation.

11. Heart Health Online The vocabulary consists of 300 terms; a histogram of number of resources by term for the top 20 terms Also gives insight to the quality of content in the portal as the focus is not on actual CVD illnesses but mainly on mental conditions.

12. Heart Health Online The portal implemented three methods of search; Personalised search (user selects from a series of categories to generate information tailored to needs), topic search (a list of topics to search from) simple search .

13. Integrating Holistic Medicine The Heart Health portal is well positioned for HM integration as a growing body of literature notes the success of HM in treating mental health issues. The process has to initiate by defining the scope for HM within the context of mental health and related heart conditions (out of 17–24 forms of HM). Lack of information on HM or the lack of access to quality HM information? A simple Google search for ‘holistic medicine for mental health’, returns more than four million hits. Importance of measures of quality

14. Integrating Holistic Medicine Three pathways to integration: content management, as part of content delivery and by using recommender techniques. Content management Expand the existing vocabulary to include HM terms and classifications. new terms need to be linked to existing terms and subject categories. identify the characteristics of available information.

15. Integrating Holistic Medicine Content delivery main focus is on personalisation. Introduce a new category, Holistic medicine, to the type of information required. Also expand into sub-groups of different forms of HM with multiple options for search. Topic search can be used to expose linked terms in the constrained vocabulary

16. Integrating Holistic Medicine Recommender techniques Techniques to estimate the quality (mainly in terms of relevance) of information resources that have not been seen by the user. Linked topics in the constrained vocabulary can be used to promote and improve access and visibility of HM resources For instance, if a user is browsing through content related to stress management, then recommender techniques can be used to estimate the ratings of all HM resources and list out the top ranked resources.

17. Conclusion Exponential growth of health information resources on the Internet. Citizens of the information age are quick to update themselves on medical conditions, illnesses etc. It is crucial for Holistic medicine to adopt the SHIP approach to reach out to information seeking masses. Also a medium to dispel myths and criticism surrounding HM techniques. Three pathways of integrating HM resources to an existing SHIP - with examples from Heart Health Online.