Future access to poison information services:
The first poison center in the U.S. started in Chicago in 1953 with a lone pharmacist, Louis Gdalman, a stack of carefully crafted index cards and a rotary phone. Over the ensuing years, the index cards became microfiche; microfiche became floppy discs; floppy discs became CDs. The lone pharmacist became several pharmacists, and over time, developed into a multi-disciplinary team of physicians, pharmacists and nurses. The phone however, has remained a constant.
The delivery of healthcare and wellness at its core is the exchange of information from a trusted source (traditionally a physician, nurse, pharmacist or other healthcare professional) to an individual. The person can then take action that preserves or increases their wellness and health. This is classically defined as an in-person ‘face to face’ discussion.
Current information technology (e.g. computers, tablets, smartphones) has broadened and changed the definition of the delivery and access to healthcare information drastically. Individuals can now access health information through a variety of different methods and make good decisions and healthy lifestyle changes. The drivers of this technological change include: Immediate access to information for individuals (no waiting for appointments), available 24/7, convenience, and low to no cost for the individual.
Health care delivery (exchange of information with corresponding behavior change) is developing into three distinct platforms with differing labor and travel costs for each method:
- Technology mediated engagement
- Technology-assisted human engagement
- Face to face human engagement
Technology mediated engagement can include Apps, web sites, and/or medical devices that measure pulse, weight, blood pressure, glucose level; provide reminders on when to take or make adjustments to medications, as well as provide information and messages about health-related issues. The information provided can lead to behavior changes that maintain/increase wellness or prevent unnecessary utilization of health care resources. How many of you have searched for health related information before calling or going to a physician?
Technology-assisted human engagement includes the delivery of information through a remote or virtual communication connection with a health care provider. Poison centers have always operated in this realm with the use of the telephone.
In addition to poison centers, other organizations that provide such health care services include physician telemedicine consults and visits, nurse advice lines, health coaches, and other hospital and community resources. The phone however, is just one of several methods of technology assisted communication and engagement programs available. As adoption of new communications platforms are implemented, patients are starting to use text messages, web-chat, secure e-mail and video to obtain the health care access they need at the time they need it.
Using and integrating communication technologies in the delivery of health care information are a great alternative to classic face to face care. These approaches can deliver care at a fraction of the cost of a physician or ER visit. Certainly for many medical and surgical problems, in person evaluations and the ‘laying of the hands’ are irreplaceable in patient care, but for some topics, communication technology has a distinct and cost effective place.
This is change in how health care information is delivered is already having a profound impact on healthcare. A 2009 Price Waterhouse study showed the 50% of consumers were already accessing the internet for information and health care decisions. That number has certainly increased dramatically since this study was done.
So what is the future direction for the delivery of poison center services?
My Child Ate is an online resource developed by the IPC that has information on nine of our most common pediatric ingestions. It allows parents to quickly find trusted information and make decisions if further care or discussion is needed or not. In less than a year, it has attained an annual volume of 100,000 visits per year; that is a lot of parents looking for information! The Illinois Children’s Healthcare Foundation recently awarded a grant to the IPC to expand the content of this health information series.
A few poison centers (e.g. California, Texas) have developed apps for the iPhone and Android platforms; they are available on iTunes and Google Play. It will link individuals to their regional poison center in case of emergency as well as the useful information and prevention tips.
Technology Assisted Human Interaction and Engagement:
While the telephone continues to be the mainstay of poison center communication with the public, a few centers have developed other communication platforms such as web chat and text to meet the needs of their regions. Here in Illinois, we have developed initial plans to provide poison center services with web chat through a specialized phone/computer system; we have also had discussions with several health care texting firms on steps to create a texting option for Illinoisans.
Best wishes for a great holiday season. Until next time,