Category Archives: Information Technology

Patient Information Forum

Objectives

By the end of this session, participants will have a greater awareness of:

  • their own knowledge and interactions with health information
  • the importance of health literacy and accessible information
  • good quality health information resources
  • resources and techniques to help assess the quality health information
  • supporting material and organisations

What is the Patient Information Forum?

  • The Patient Information Forum (PIF) is the ‘go to’ UK membership organisation and network for people working in, and involved with, healthcare information and support. We are not-for-profit and independent.
  • We have a network of over 600+ members, representing every kind of information and support producer and provider, including the NHS, voluntary, commercial, academic and freelance sectors.
  • 89% of respondents in the 2017 PIF membership survey said they strongly agreed or agreed that they would recommend PIF membership to a friend.

What does PIF do?

  • We provide support to individuals and organisations to help them provide the best health information for patients.
  • We deliver practical resources to increase expertise for all those who share our vision, including delivering events, online discussion groups and a weekly e-newsletter.
  • We influence to ensure improving the quality of health information is high up on the agenda across the whole NHS and health sector
  • We work on projects, with patients and clinicians, to map their perfect patient information journey
  • We provide a best practice toolkit and updates to support the creation of high quality health information.
  • We highlight research and reports on key health information topics.

Producing Health Information for Children

The information PIF sends out is wonderful and it lets me know that I am not alone and I get fantastic insights on what others are doing in the same areas of communication and engagement. Then it’s a case of not re-inventing the wheel. If anyone’s looking for help and information and education, this is a great organisation.

Perfect Patient Information Journey

Why do we do it? 

  • We believe high quality health information is the cornerstone of achieving the best experience for patients, and putting them in control of their well-being, treatment and care.
  • We know that getting health information right is good for the patient and good for the NHS. It improves patients’ outcomes and saves the NHS money.

Our 2013 report, Making the case for information, outlined tangible benefits of investing in high quality patient information, including reduced GP demand.

Is knowledge power?

Patient views on the information they were given

  • 36% felt they were not given helpful information at first diagnosis
  • 32% find it difficult to access trustworthy information on their condition
  • 20% felt they did not have enough information to feel confident in discussing decisions about their treatment with their doctor

I wasn't a typical case

I wasnt given enough information to make a choice

I ask a lot of questions

Providers of online health information need to be aware of the searching behaviour of patients and their carers. Access, or lack of, to online health information and the literacy to be able to understand it, is causing a disparity in health outcomes.

  • Access to the Internet
    • UK has highest proportion of households with Internet access (82%)
  • Searching behaviour
    • More likely to search if they have chronic conditions
    • Disparity due to poverty and lack of Internet access
    • Knowledge of clinical terminology
  • Quality of online health information
    • Incorrect information leads to poor decisions
    • No requirement to adhere to quality standard
  • Shared decision-making
    • Involved patients are more likely to be compliant

Accessible Information Standard

  • From 1st August 2016, all organisations that provide NHS care and / or publicly-funded adult social care are legally required to follow the Accessible Information Standard.
  • The Standard sets out a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents with a disability, impairment or sensory loss.

Quality tools

The Information Standard Information Standard

Kitemark launched in 2009 – Now owned by NHS England

Six aspects of producing good quality information

  1. Information production process
  2. Evidence sources
  3. User understanding and involvement
  4. End product
  5. Feedback
  6. Review

discern online  – Assessing quality

  • Checklist of 16 questions
  • Authorship – Who wrote the content and what are their credentials? Are they qualified to provide this information?
  • Attribution – is it clear how the information was generated, e.g. is it referenced?
  • Disclosure – is the web-site sponsored by anyone who might have a commercial gain? When did they write it? Who did they write it for?
  • Currency – is there a date to indicate age of the content?

Consumer health information sources

PIF resources

PIF supports members with a range of events, a weekly e-newsletter which rounds up health information news, and resources including:

  • PIF website and Toolkit – which includes resources on communicating risk
  • Accessible Information Group – established to support people involved in implementing the new mandatory NHS England Accessible Information Standard (AIS)
  • Events – Shared Decision Making, Digital Health Information, Communicating Risk

Presented at our conference Empowering Patients with Information Technology

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NHS England are seeking views on the impact of data-sharing arrangements under the memorandum of understanding (MoU) on the health and healthcare-seeking behaviour of migrants.

This consultation closes at 5pm on 30 March 2018

Evidence can be:

peer-reviewed publications
narrative accounts
case studies
more formal analyses using qualitative, quantitative or mixed methods

https://www.gov.uk/government/consultations/data-sharing-mou-between-nhs-digital-and-home-office-call-for-evidence

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LIMS or Laboratory Information Management System is a program that helps labs to run more efficiently by integrating the various tasks relating to labs like inventory, quality control and testing into a centrally established database. Most of the labs have some type of LIMS systems customized to accomplish their individual tasks. The small and medium scale enterprises still have a dilemma in deciding whether it would be beneficial to implement such a system in their lab. For those in confusion, should know the various benefits and the possible drawbacks that such s system can provide to enable them in making a selection.

Though implementing and maintaining comprehensive LIMS software can be a largely time-consuming and expensive process, but once implemented it can save a substantial amount of time for the user as all the tasks are integrated into a central location. Before making an approach to various vendors for quotations the set of user requirements should be clearly defined. The user requirements can be estimated from the features available and while the most basic and inexpensive LIMS possess the basic features certain customization is necessary to fit the requirements of the laboratory.

The potential benefits

The benefits obtained from the use of LIMS are inclusive and not exhaustive depending on the laboratory requirements. The first and foremost benefits provided through this system is the electronic capturing and transmission of data which not only saves time and compliance related work but also eliminates the requirement of any storage space. Another benefit is the automatic calculation of data which is performed through this mechanically developed software. This reduces both time and possibility of error or crosscheck for the viability of data. Since the necessary are stored electronically analysis of information or preparation of necessary reports can be done with just the click of a few buttons.

Sample testing can also be efficiently scheduled through LIMS and minimizing the occurrence of errors, thereby showing the most appropriate results. The benefits of tracking the status of reagents and chemicals or linking an instrument to each test can be availed by incorporating such software in the laboratory. It can be configured to work with any kind of lab, be it medical, geological or fertility lab. Since the software is sold it modules the user needs to pay only for the services availed and not for the entire package as a whole.

Making the right selection

There are several versions of the software available in the market with each one quoting a different price. The cost of the LIMS software depends on the number of modules required in the lab and whether hosted web-based service if availed or self-installation is opted for. While the web-based service requires some high initial expenses in addition to a regular monthly fee, the self-installation options cost relatively cheaper. Before deciding on which software to choose it is advised to consult with the concerned IT department or similar section of the lab and choose any online service only after conducting proper research and analysis work.

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SHA deplores the weekend actions of computer hackers that caused the paralysis of large parts of the NHS in England and Scotland, placed patients at risk, and in some cases brought to a halt some ongoing operative and diagnostic procedures. SHA pays tribute to the NHS staff that coped so magnificently with such interference and those who toiled over the week end to restore services.

SHA notes that the Welsh NHS was not especially affected and believes that this is due in no small measure to the integrated way in which  primary and secondary care services are planned, delivered and supported in Wales which removed the internal market and its damaging effects over a decade ago. SHA also understands that the technical resilience of NHS Wales was in no small measure due to the priority given, over a number of years, to investment in NHS Wales IT systems and to the role of its central NHS IT support team.

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In 2015, the government made a pledge to assist UK patients to access more online pharmacy services to help the NHS save money. It also made attempts to examine the payments of the sector to ensure the presence of efficiency, innovation and healthy competition. Today, the pharmacy is a major foundational pillar of modern medicine.

In the UK especially, competition has grown with intensity, revenues are now capped, and many expect the pharmacies to begin managing chronic conditions. For a long time, independent pharmacies have been the backbone of the country’s community, but are at risk of being rendered obsolete as more major players surface and capture the market’s value.

Intention to Purchase Online Increases

The industry has continued to consolidate gradually with the rise of supermarkets and out-of-town shopping that present intense competition in the pharmacy landscape. The pharmacy models are also changing with community dispensing dominating in commodity generics. In the modern world, mail-order and internet services are strongly taking over the distribution of pharmaceuticals, and this has seen the growth of online pharmacies in the UK. With the rise of internet savvy consumers, brick and mortar pharmacies will no longer be the only option for consumers to receive their medication.

Today, consumers want it all, from personal care products to prescription services, with their only worry being convenience, expertise and accessibility. This leaves the community pharmacy in a tricky position. As dispensing continues to be a commodity, online pharmacies have developed a sustainable revenue stream that focuses on monetising their role in healthcare.

Online Pharmacies Save Time and Money

In England especially, online pharmacies play a great role in helping patients save both time and money on their prescriptions. An experienced pharmacist provides quality healthcare and uses their clinical expertise and practical knowledge to advise consumers on common problems such as aches, coughs, colds and healthy eating. They can also advise patients to visit a health professional when need be. For patients with a long-term condition under new prescription, online pharmacists are always ready to explain and advice on how the medicine should be taken and the side effects associated with it.

Patients tend to gather more confidence when dealing with online pharmacists, whom they have been noted to talk about very personal and sensitive symptoms and matters, unlike is the case with community services. Typically, it is safe to say that the rise of online pharmacies has changed the norm of medicine in the UK. With the rise of the online market, what should consumers know?

Online Pharmacies Facts

First, consumers need to steer clear of unregulated websites as these are common causes of fake medicine distribution that could potentially harm their health. In the UK, only selected few online pharmacies are regulated to offer online prescriptions. The regulation is designed to assure patients that the pharmacy meets certain standards in terms of who can legally dispense medication. The General Pharmaceutical Council has the responsibility of regulating online pharmacies to ensure that only generic medication is being delivered to consumers.

Normally, UK online pharmacies offer their medication at relatively low prices and in greater quantities. Patients also benefit from the anonymity, giving them the chance to describe embarrassing health conditions.

The other positive side of online pharmacies is that they have the capacity to provide rationed medicines that are not often provided in National Health Services such as facial hair reduction creams. Patients also prefer online services as they can obtain non-prescribed medicines. With the high rise of online pharmaceutical services, it is necessary to find out if the provider is regulated to avoid falling into the hands of a quack.

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It’s no secret that the general population is growing at a rate faster than ever before. As it stands, the UK has a population of 64.1 million – a number which is predicted to reach 70 million mid-2027, just 10 years from now.

The world’s population is expanding at a similar rate, with more than 7 billion people on the planet currently and urban populations rapidly developing and branching out.

The healthcare systems supporting these huge urban populations will find themselves under strain, as more and more health issues arise due to people living in such close proximity to each other and the pollutants existing in such cities.

Slums are being erected more and more in some of the world’s largest countries, such as India, Brazil, South Africa and Mexico – the number of people in the world living in slums reached 863 million in 2014 – and these have significant effects on the environment and the people who live in them. In turn, healthcare services for those who can afford it are being impacted and, due to poor sanitisation, such close confinements and the sheer number of people in one place, there are a number of cases of serious illnesses such as cholera and diarrhoea.

In China, the air pollution in the country’s large cities is causing serious respiratory issues as breathing the air in Beijing is likened to smoking 40 cigarettes a day. Therefore, healthcare services in the country are significantly under strain as the population suffers due to the radical urbanisation the country is undergoing.

Focusing on the UK alone, the strain such a huge population can have on a free health service is threatening to its ability offer the best care. The NHS currently deals with more than 1 million patients every 36 hours and is already under great strain. As the population grows, this issue will only increase along with it. Patient safety is currently the major issue, as under strain and overworked staff make decisions that could further jeopardise health because they are unable to think clearly.

The strain extends further than patient care too, supply and demand for items such as medical supplies and protective equipment will rise and there could also be a threat to the amount of available antibiotics and medicines to treat injuries and illnesses.

So what can we do?

It’s important we act now, to lower the potential strain on health services in the future, here are a few key ways to do this:

  • Encourage healthier living – obesity is rising in the world and this is one of the major contributing factors to the strain healthcare services are currently experiencing. Eating well and exercising more will improve general health across a population.
  • Businesses can implement healthcare plans in the workplace – many people get ill but their symptoms worsen because they do not want to pay for a check up at the dentist or antibiotics from the doctor. A healthcare service such as Bupa can cut costs and ensure people remain healthy.
  • More free phone services – People who simply want to talk about their symptoms should be able to call and speak to an advisor. The NHS 111 service took 1,351,761 calls in December 2016 alone, suggesting more support is required for this service.
  • Stronger support for mental health services and charities – Support for those suffering with mental health issues such as anxiety and depression can find that their symptoms worsen if they don’t seek help, but the current healthcare system isn’t prepared for this. Free advice services and support networks can lighten the load on healthcare providers such as the NHS, as well as offering people the help they need.

The growing population will continue to have a significant impact on the healthcare services around the world, with the above points implemented we can help reduce this strain.

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Healthcare technology continues to evolve and impress us every year. This year won’t be any exception. Innovations in patient monitoring devices hope to improve both care given to patients and the manner care is provided. It also aims to improve prognosis and quality of life. Here are the latest innovations in patient monitoring devices.

 

NHS England Explores More Patient Monitoring Solutions

Just November of last year, the UK National Health Service started working with Reliq Health, a company that creates telemedicine and mobile health products for community-based care. The goal is to explore different remote patient monitoring solutions and see how Reliq Health’s platform can help in improving health outcomes and reduce costs for individuals that have chronic conditions.

The platform makes use of a secure cloud-based software, sensors, and voice technology to support patients and their caregivers in proactively managing chronic conditions at home, thereby minimizing exacerbations and complications. It also decreases healthcare costs and improves patient satisfaction.

Reliq’s platform is currently enrolling patients from the Imperial College Hospital in London. The platform emulates a hospital to create a fully automated “virtual ward” in a patient’s home. It tracks vital signs and medication adherence. It also gives alerts for different tasks, from taking medications and vital signs to performing their prescribed exercises or activities. Educational materials are also provided so patients and family members can have a better understanding of the condition and manage it in a better manner.

The NHS Is Ready to Roll Out Two Apps for Better Care Management

The UK’s NHS is ready to roll out two applications that will allow the healthcare team to gather clinical data from patients at home. The program is currently being tested at four hospitals around Oxfordshire and could extend to four other NHS districts over the following year. This is the first time the NHS is testing a platform that gathers information directly from an mHealth device, instead of depending on the data sent by a patient to a provider.

The app is expected to provide medical-grade data that is crucial in providing proper care. Since the home is quickly becoming a primary care setting, more and more healthcare providers are utilizing connected care to minimise visits to the emergency department and reduce readmissions.

The apps have been developed over the last eight years and target chronic obstructive pulmonary disease (COPD) and gestational diabetes.

Close Monitoring of People Suffering from Alcoholism

Alcoholism is a hard habit to break. And those who are undergoing treatment for the addiction often experience relapse. Close monitoring allows for early intervention, which is why two companies are currently working on improving remote patient monitoring to improve care given to people who have alcohol use disorder.

Soberlink, creator of a remote breathalyzer approved by the FDA, will partner with MAP Health Management, provider of a remote platform. Together they will launch a pilot program this coming April. MAP’s platform focuses on improving financial and clinical results for chronic behavioral health disorders, such as substance use disorder. Those who will participate in the program will be provided with a Soberlink device which will be linked to their MAP profile.

The breathalyzer makes use of facial recognition technology to confirm the user’s identity. It will also send real-time information to MAP’s platform in case the user tests positive for alcohol, misses scheduled tests, or does a test with negative results.

The platform is capable of notifying the appropriate healthcare team members if it thinks that the patient is at risk for relapse. Team members will also be notified if the person is using alcohol.

MAP Health and Soberlink work with various treatment programs separately, but combining both technologies is a new innovation for the population. Although remote patient monitoring has become a norm for chronic conditions such as diabetes, it is something new to the substance disorder scene.

Improvement of Cardiac Monitoring System

patient monitoring

Endotronix, maker of cardiac monitoring systems, has added more money to fund the development of its remote cardiac monitoring system. The system known as Endotronix’s Cordella Heart Failure system is made of a wireless pulmonary artery sensor and a cloud-based patient management system. Endotronix is currently focusing on improving their clinical program so the product can soon be used commercially.

Monitoring any changes in a person’s heart rate is the best way to recognize a worsening heart failure. However, such observation was only available in clinical settings until recently. Endotronix’s system is different from other implantable devices as it allows patients and healthcare team members to see the data and come up with customized plans depending on the changes. The system is believed to play an important role in streamlining care and improving outcomes. It can also reduce healthcare costs.

Healthcare technology continues to play an important role in patient care, whether they are at home or in the hospital. And this year the world will see new technologies being tested and hopefully will create significant changes in the healthcare scene.

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With nearly all industries moving toward a more digital presence, it is no surprise that healthcare has taken a similar turn. Patients are demanding greater access to care in the UK, and online service providers are making an effort to meet this growing need. Just like brick-and-mortar health facilities, like dentists, hospitals, care homes, and specialists have an obligation to abide by standards set by the Care Quality Commission – the regulator of all health and social care services in England – online healthcare services must do the same. Unfortunately, a recent report published by the CQC highlights the perils some patients face when trusting the digital trend sweeping healthcare providers.

Dangers in Unsuitable Prescriptions

Errors in prescription medications take place in traditional pharmacy settings and doctor’s office around the world, but the anonymity of online pharmacies creates a higher probability of errors taking place. The most recent CQC report focused on digital healthcare service providers highlights some of the most glaring examples of substandard care in prescribing medications to patients. First, a widely known online pharmacy was found prescribing a large number of opioid-based medications without having a foundational system in place to confirm patients’ medical history or prescription track record. The CQC issued a restriction on the company, forcing it to limit its prescriptions until a sustainable system was established.

Another online pharmacy was cited for prescribing a high number of asthma inhalers, not in line with best practices of traditional providers. The company failed to implement a review system for new prescriptions, putting patients’ lives at risk. In this case, the CQC issued a warning to the online pharmacy to update its practices immediately. Other online providers were cited for not adequately reviewing patient medical histories prior to approving a requested prescription, and accurately identifying GP assessments before prescribing medicine to certain patients. Although the published reports from the CQC are helpful in bringing to light the risk patients face in using online healthcare services, there is only so much the organization can do to stave off potentially fatal issues that arise due to nonexistent safeguards among companies operating online.

How Patients can Help

The risks of using pharmacies and other healthcare services through a digital platform are growing as more individuals seek out immediate care for health-related issues. A representative from a team of medical negligence solicitors dealing with cases of prescription claims and those where harm is caused due to medication mistakes explains the most significant issue online providers present to the public. In essence, the same standard of care should extend beyond traditional settings in which doctors, nurses, specialists, and pharmacists are providing care face-to-face to those who offer medical guidance online. Patients deserve the highest quality care available, and online companies along with the people who work for them have an obligation to protect those who seek their services. That can be done by abiding by the best practices laid out by the CQC, including understanding the medical history of the patient, other medications the patient may be taking, and the recommendations of the patient’s GP.

Patients using online healthcare providers have a responsibility to do their due diligence when working with a primary care, pharmacy, or specialist company. The best step to take is to ensure that the organization is registered with the Medicines and Healthcare products Regulatory Agency, or MHRA by searching the company name, number, or website online. Additionally, any website that sells medicine to the public is required to show the EU common logo for potential patients to see. As the Care Quality Commission continues its objective to maintain a safe and high-quality healthcare environment for patients in England, individuals can do their part by being knowledgeable of the risks they face when conducting medical business online.

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Technology has long been a force for change in dentistry. Think back twenty, ten or even just five years ago, the industry looked drastically different and day-to-day work involved tasks that have since been replaced by processing power and some clicks. The dental industry is advancing rapidly. In this article, we will be discussing the advanced technology in dental industry and its effectiveness.

dental industry

Dentists working from a digital platform can instantly share patient information among staff members, transfer files to the lab, and help increase case acceptance by visually showing patients areas of diagnosis and proposed treatment. With these new capabilities, digital practices are experiencing greater productivity, better communications with patients and a more satisfied staff.

Smart Toothbrush

This technology is made to change tooth brushing habits of children and adults by motivating individuals to brush better through games (for kids) and coaching (for adults) that guide them toward improved dental hygiene. This product includes sensors that can identify the area of the mouth in which the user is brushing. This powerful technology also has the ability to store data, and create a personalized visual check-up to show where the user brushed and missed over a 7-day period.

3D Printing Makes the Digital Physical

A digital platform in dentistry means that all patient information, imaging systems, and CAD/CAM data work together in a connected pattern. Because of the real-time flow of information, the practice with a digital platform is capable of operating more efficiently with the quicker delivery of procedures and a higher level of productivity. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics, and surgery, the manufacturer of dental, craniomaxillofacial and orthopedic implants, and the fabrication of copings and frameworks for implant and dental restorations.

Lasers

Lasers in dentistry have seen a tremendous rise and fall in use and popularity. All lasers work by delivering energy in the form of light. When used for surgical and dental procedures, the laser acts as a cutting instrument or a vaporizer of tissue that it comes in contact with. When used for curing a filling, the laser helps to strengthen the bond between the filling and the tooth.

Some dentists are using lasers to treat:

  • Tooth decay.
  • Gum disease.
  • Biopsy or lesion removal.
  • Teeth whitening.

Intra-Oral Camera

The camera’s unique liquid lens technology works like the human eye to ensure effortless image capture to deliver clear, detailed images patients can really understand. This camera is having six long-lasting LEDs around the lens provide balanced. Your technology treatment plan will become clear and will be far more customized to your needs than a simple formula for equipment purchases.

Today’s patient is exposed to advanced technology every day and expects to find the same high-tech welcoming environment at the dental office. Advances in dental equipment are rapidly making this high-tech practice a reality, with innovative equipment increasing efficiencies and delivering better services to patients. Digital practices are experiencing greater productivity, better communications with patients, and a more satisfied staff.

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The transformative effects of the world-wide-web and the digital revolution are everywhere. Lives of citizens have been revolutionised as access to the web has completely altered how people connect and communicate with each other. The information technology revolution continues to challenge traditional ways in which human beings trade, communicate, organise, investigate, learn, and how they project themselves. The current political landscape is characterized by at least two interesting developments: political problems such as those surrounding the economy and environment are becoming more transnational, and citizens now have a capability to operate on their own terms rather than as members of traditional hierarchical interest and advocacy organizations.

digital revolution

Against this fast-moving and ever-changing background, in February 2016, the House of Lords agreed to continue the ancient practice of storing all British laws on vellum. Politics and politicians deserve what the digital revolution is doing to them: Western political systems have hardly changed in generations and are ripe for disruption. Cash for questions, expenses scandals, endemic corruption are all expected consequences of power: but enforced austerity by unelected technocrats, international migration crises, and lost opportunities for generations of young people demonstrate that political systems’ behaviours whose roots are nineteenth-century are incapable of identifying, let alone implementing solutions for our age. Narrow self-serving and self perpetuating elites who, in partnership with conventional media, have been peddling their self-interested version of reality now rage against the digital machine.

Some of this is easily explained. Whilst the pace of government is cumbersome and slow, technology is fast-moving and dynamic, making politics seem tired and dull. Political thinking is lame by comparison with the big ideas coming out of the information technology industry. Advances in software have thrown up fresh ways to think about what it means to own something, to share something, to be a citizen, to have a private life, and how to self-identify. These are among the most important questions of modern politics. However, they rarely get expressed by politicians or conventional political parties.

Whilst politicians wrestle with how to “manage” digitization, it continues to produce huge benefits in many parts of the world. In Nigeria phone-based banking for the first time permits money transfers without the physical exchange of cash, massively enhancing wealth-generating possibilities. In China, a billion phone users now pose an existential treat to the monolithic communist power structure. The Arab Spring, Tahir Square, and the Occupy movement: all were driven forward by a new generation of activists exploiting social media. Watch migrants unload in Lampedusa: a few possessions and a phone. Less propitiously, emergent terrorist organisations such as ISIS have understood from their outset that the power and influence of the web – the development of a digital caliphate – is key to dissemination of their violent message and the recruitment of adherents. In some cases, these changes are occurring either despite government opposition or because of bad government; more generally though governments seem not even relevant or incidental to these changes. They are simply encircled by them.

Governments have not though ignored the digital revolution. They have utilised the techniques of e-commerce and big business for their own narrow purposes, spending heavily on algorithm-based data mining to target election campaigning and political advertising with the aim of securing and retaining power. Ironically, of course, as the focus of politicians becomes ever more targeted on the key swing voters, districts, and constituencies, then the greater the distance between politicians and the people becomes, and the more people turn on to digital. Politicians have also been busy, as Snowden revealed, regularizing the mass surveillance of its citizens: listening-in but not listening to. And they have, thirdly, simply blamed and ridiculed digital communities, caricaturing them as short attention span clickbait zealots; populists who don’t understand the complexity of achieving change in a pluralistic system.

Conversely, the digital revolution in politics is another healthy sign that ordinary citizens haven’t given up on politics. In some respects, digital activity has been translated into a proliferation of political activity both within and beyond the traditional outlets. Particularly in countries with more plural systems, the internet has been influential in promoting emergent parties. The German Pirate party and Italy’s Five Star Party make good use of digital technology to manage their message (as ever, the medium is the message).

Nevertheless, it is certainly true that as the membership of mainstream political parties has fallen away and voter turnout has declined across the western world, irregular political campaigning has expanded. Concerned individuals often coalesce around issues that reflect their own interests. The new information technology has been an enormous help in this regard, enabling ad hoc pressure groups to form and allowing like-minded individuals to find each other and share their concerns. But this too creates an imbalance between the political class and the rest. Professional politics is becoming more concentrated – witness the emergence of the modern political dynasties – at the same time citizen politics is becoming more fragmented.

But it needn’t be like this. Democracy functions best when citizens get good information about what their government is doing. Widespread transparency makes citizens better and more active participants and makes politicians more accountable. Democracy, at least in its ideal form, promotes equality of power. Democracy promotes debate. Democracy can bring together individuals with high diverse viewpoints. Debate and deliberation forces people to improve and strengthen their arguments. It is axiomatic to me that many of the major problems facing governments today are complex and multi-faceted, requiring negotiation, compromise, but also clarity about goals. Bringing people together is what the internet does: democracy is the function of harmonising discrepancy, of managing disagreement, and of legitimising leadership and authorising progress. Here are four proposals to unlock the full potential of democracy as a collective decision-making institution in the age of the Internet.

Firstly, the role of technology companies can and should change, but this requires leadership from within. Facebook’s community is larger than many countries, and the magnates running such companies have the power to change them for the better. Do they have the will though? Mark Zuckerberg’s new year message hinted at insight into his personal disconnect from reality. He should take responsibility for the content of what Facebook circulates, and see himself as a leader not a tech geek. Most important, Facebook should not allow such stories to be presented as news, much less spread. If they take advertising revenue for promoting political misinformation, they should face the same regulatory punishments that a broadcaster would face for doing such a public disservice.

Secondly, there is a role every user of digital technology can play. The internet has made us less trusting of our own judgements (and those of experts) and more deferential to the wisdom of crowds. A rebalancing is needed in the way we calibrate our understanding: sure experts get it wrong; but so do mass hysteria crowds. The solipsistic echo chamber that is Twitter and Facebook thrives on selective affinity: “I like you because you agree with me”. Perhaps an individual, helpful response is to be more Socratean, welcoming what we do not know or understand, happy to acknowledge our limitations, but eager to learn.

Thirdly, collectively, we need to recognise that social media is here to stay but that it can also be a huge positive. Social media can shine the light of transparency on the workings of a Trump. Was Hillary Clinton really replaced by an alien in the final weeks of the 2016 campaign? We all need to be able to see who wrote this story, whether it is true, and how it was spread. Rather than seeing social media solely as the means by which Trump ensnared his presidential goal, we should appreciate how they can provide a wealth of valuable data to understand the anger and despair that the polls missed, and to analyse political behaviour in the times ahead. Valuable democratic opportunities are created on social media when people use them to talk to politicians and civil servants, and to each other. Social media radically reduce the cost and difficulty of people organising themselves, forming ‘communities of interest’ united by a shared concern, whether a common complaint about a local NHS service, opposition to a local planning application, or a suggestion for a traffic calming measure.

Finally, and lastly, there is the issue of what government can do. There are emerging expectations for MPs to listen to and engage with people on these channels. Politicians need to use social media to learn more about the needs and views of their constituents, and as a gateway to more sustained contact with their constituents.

Like all successful politics it starts at the local level: social media users are more likely to contact their local politicians – a local councillor or constituency MP – than national politicians. The public debate is on social media and Parliament should catch up. Listening to these gives an opportunity to bridge national institutions with street-level social reality, fashioning new instruments in gathering and understanding social attitudes on politics and policy. Therefore, every parliamentary debate should have a social media element to allow the public to offer their views and opinions for the benefit of the participants. Numerous social media platforms support the streaming of live video, allowing viewers to tune in and comment on debates in real time.

Government can also help prepare the digital users of tomorrow for a world in which facts are contested more than ever. As Peter Hyman wrote recently: “In a world of “alternative facts”, how can we give young people the skills to shine a spotlight on the truth?” We need education to promote questioning, critical thinking and critical analysis of evidence and the news as a defence against the worst excesses of the internet.

In conclusion, a health warning about our fascination with digital: we’ve been here before. The death of democracy was widely predicted with the advent of mass-circulation newspapers and then again with the broadcasting of Parliament. And, of course, not everyone shares that fascination with digital. The explosion of new digital practices has occurred within a social context where many are excluded or unwilling to participate in such practices. Not everyone uses social media – including some of the poorest and most vulnerable in society. Political change is a hard grind, requiring face-to-face contact, and development of political and community relationships over years, not seconds. Technology is not a panacea for the problems democracy faces.

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There are many of us who might suffer from some sort of mental health issues to a varying degree and there are still plenty of aspects we don’t really understand, although we are now in a climate of improved awareness.

This means that there are more self-help options available now than ever before, including some mobile methods that can soothe you wherever and whenever you need it.

Here is a look at some useful apps, including one that taps into the benefits of CBT and a childhood activity that is proving popular with stressed-out adults. There is also an overview of an app that works on improving your sleep patterns plus details of an anxiety management option to download on your smartphone.

Accessible therapy

Some mental health issues are more complex than others and might require some professional intervention as part of your healing process, but there are some apps that can help you to cope with things like depression, anxiety disorders and other issues that you might be trying to contend with.

A method of treatment that has come to the forefront in recent years is cognitive behavioral therapy (CBT) and there are some apps like MoodKit which aim to cover most of the bases surrounding the general concepts of CBT.

You can use the app in conjunction with working alongside a therapist and it teaches you self-monitoring and encourages you to engage in mood-enhancing activities.

Coloring can make you happy

There has also been a real surge in popularity for adult coloring books and it is perfectly understandable when you start to list some of the health and psychological benefits attached to this activity.

If you think back to your childhood you will most likely have some happy thoughts of time spent drawing and coloring your favorite characters and pictures, and you can tap into these positive emotions by returning to this popular pastime.

You can even get a coloring book app on Google Play so that you can improve your mood with an activity that has been used to help with anxiety and other stress-related disorders.

A good sleep is always important

You can’t really expect to function at 100% when you are not enjoying a regular and restful sleep pattern.

To combat this problem there is an app called Sleep that aims to help you improve your sleeping patterns. It uses a combination of CBT methods together with some other customizable programs and even has a virtual sleep expert to consult when you need some pointers on how to get the sleep you need each night.

SAM can help with anxiety management

SAM is the acronym for self-help anxiety management and this is an app that is designed to help anyone suffering from anxiety.

You can self-evaluate your current mood and level of anxiety using this app, and SAM is an app aimed at trying to help you look at things more calmly and patiently, working through any issues in baby steps rather than giant leaps. You should also see progress being made as it records where you are at on the road to recovery.

If you want to improve your mental health issues and work your way through some specifics, there is bound to be an app that can help you with that.

Harvey Woods is a therapist who writes about self-care and managing our feelings and thoughts in today’s fast-paced world where stress is the norm.

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Information technology is increasing the opportunity and roles for citizen and patients within their own health. Electronic health records are becoming available to all citizens and patients. The knowledge and skills necessary for citizens and patients to benefit from access and contribution to their records is emerging rapidly and guidance is appearing. (RCGP guidance and DH work stream) The patient provider relationship is evolving to reflect this within the United Kingdom and in countries in Europe. Information, personal data, knowledge and understanding are becoming ubiquitous. (Bill Gates New Year) Primary education has become a universal experience. Mobile and information technology is becoming easily available to citizens who are empowered to take actions that impact positively on their own and their family’s lives. These actions are at times in opposition to the messages of commercial advertising that citizens receive through the media.  The twentieth century has been described as the century of the self. It was brought in with the early engagement with psychology, global markets, telephony and the motor car. It went out with a sense of uncertainty “all watched over by machines of amazing grace”. (Adam Curtiss – BBC2) 
 
Just as for the extension of human rights and animal rights, the progression of expert autonomous patients has been a long and hard one with obstacles along the way – not least obstacles created by patients themselves. Ivan Illich suggested that doctors had misappropriated patients’ health. To some extent this is true just as Victorian engineers appropriated the right to design and build tunnels, bridges, factories, drains, reservoirs, dams and other engineering projects in the nineteenth century. But it is also true that citizens and patients are happy to accept a passive and fatalistic role in their own and public health leaving what is without doubt their responsibilities to the media, the market and to their highly paid professionals. Professionals will in fact do no more or no less than they are paid for whereas patients and their families and friends are able to do more for themselves than ever before.
 
Public and environmental health is a consequence of behaviour, nature, markets, culture and technology. The developed World is at the end of one stage of its economic growth and is facing recession, mass migrations, global warming, increasing food costs and population growth worldwide. Markets will be required to adapt as the world’s human population increases by two and a half billion people in the next forty years whilst advertising and the markets encourages all people to expect the levels of lifestyle of the developed world. The planet unfortunately cannot support such lifestyles for all.
 
Modern lifestyles are producing new problems to deal with. An older population has more illnesses and incapacity to be helped with. There are less young people to help older people. Urban life is causing more mental health problems. Physical inactivity, over consumption, drug and alcohol abuse, obesity, diabetes and related pathologies are market, culture and lifestyle induced. These problems are to some extent the result of the perfect safe, comfortable life that is afforded by cheap and safe transport, central heating, telecommunications and leisure. It seems that all play and no work makes Jack a sick boy. Bodies have evolved to cope with work and stress and require some regular use to remain in shape.
 
High profit shareholder companies and costly technological medicine are progressing at a time that the WHO (reference) advises responsible authorities to invest in lower cost primary care, health promotion, prevention and public health. 
 
Health management is a biological imperative for all species and for every individual. Each “family’s” day to day life – eating, sleeping, socialising exercising – is driven by biological and cultural behaviour. Lives incorporate healthy and unhealthy behaviours and choices. Secondary health activities occur alongside citizens’ daily health behaviour in modern societies. These include the management of urgent problems, continuing care, preventative care and the promotion of good health and health seeking behaviour. This latter is to reduce the negative effects that environment and lifestyles can have on patients’ lives.
 
One strand of improved efficiency in service provision worldwide may be the introduction of electronic health records allied to the education of billions of confident, enquiring skilled, patients and carers. Citizens will learn to manage and improve their own health data and to work as partners with health commissioners and providers. They will also become experts in their own and their environment’s health and not leave the environment to the newspapers and businesses but become involved and knowledgeable about their own environment and about local business and development. ( Maslow’s hierarchy of needs)
 
Health is not just the absence of disease but it is also the fullest expression of each genome within a healthy environment and on a sustainable planet. Passive consumerism is not the fullest expression of the full potential of the genome active participation represents a fitter expression.
 
The use of the world “global” reflects the similarity of humans worldwide despite differences in languages and creeds. Uniform systems of numeracy, scientific measurement, botany, geography, accountancy and other abstract disciplines have offered solutions to global problems aided by their description, analysis, study and reproducibility.  Electronic health records describe, analyse, study and reproduce too especially as their architecture and coding become consistent, universal and ubiquitous.
 
It seems sensible to address electronic health records issues globally as well as the levels of the 195 separate states since there are such rapid and so many global technological advances that are changing the health IT landscape. There will be national solutions as well as international ones and there are reasons to press forward with both together.
 
Culture changes invoke resistance, mistakes, misfortunes and opportunities. SMS messaging started 20 years ago and has spread around the world. Mobile phones are doing the same. ITC, shared care pathways and shared electronic records have the potential to integrate self and professional care whilst augmenting traditional medicine. Communication technologies allow the care pathways and care records to be shared between patients, families and lay carers.
 
At a time when some old people are living longer than they want to, some younger children have no access to health care. There are an additional two billion people to share the planet in the next forty years.
 
What are changing or need to be changed and where do medical records, intelligence, information, data and data processing fit in with these changes? 
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