STAT6001: PUBLIC HEALTH INFORMATICS

SUMMARISING PUBLIC HEALTH INFORMATICS

1.0 Introduction: 

Telemedicine services has seen a huge surge in the recent times due to the emergence of high speed internet, newer technologies as well as government initiatives to provide health to all. Australia is also no difference in comparison to other developed countries as telemedicine services and its demand is increasing every day in Australia. The Australian government is also making use of social media platforms like Twitter to inform about the health care developments and new health information. Various departments including mental health Australia and Australian health department has taken such initiatives. This assignment therefore focuses on understanding the use of social media as a tool for public health informatics in the first part while the second part solely focused on the barriers to telemedicine and the ways to address the identified issues. 

2.0 Twitter review:

Twitter refers to American social networking and micro-blogging sites on which users interact and posts messages that are known as tweets. Twitter helps spread information among broad audiences who are ranging from trainees and physicians to patients. Sharing information on twitter has a higher level of potential in developing a collaborative and communicative atmosphere for the physicians, patients and researchers. Twitter helps share information about various health issues, the treatment associated with health issues and different epidemics. Additionally, twitter can also be used for monitoring disease and identifying lifestyle of society.

2.1 @ehealthpaho:

It has been observed from the @ehealthpaho that it is the twitter account WHO eHealth or PAHO (Twitter, 2020a). This organisation uses their twitter account to inform the public about various innovations in healthcare which can improve the healthcare facilities (Surian et al. 2016). Therefore, it can be aid that this twitter account is also helpful in informing people about different innovative solution of healthcare issues. The organisation has last tweeted on August 30, 2018. Therefore, it is seen that in the fourth week of August, the organisation has tweeted about the telemedicine in the postoperative care and how it can enhance the satisfaction among patient. PAHO has also offered information about the web-based decision quality outcome for the screening of prostate cancers (Twitter, 2020a). This week also offers information about electronic mental health and its impact. From this fact, it can be said that twitter micro-blogging is highly useful for different individuals that also includes the doctors, nurse and patients in understanding different innovation regarding the healthcare so that it can be used to take care of patients.

The third week of August has provided the fact that computer and internet have a higher level of knowledge regarding HIV (Twitter, 2020a). PAHO has also provided a brief overview of the utilisation of Smartwatch in managing health. It is seen from the utilisation of smartwatch that it helps track the heart rate and various activity of the body. From these facts, I have learned that twitter is one of the excellent tools that help share information and develop a connection with the physicians to the experts in the fields. This fact is helpful for the physicians in getting a brief knowledge about innovation so that they can increase the quality inpatient care (Nambisan et al. 2015). I have also learned from the above-mentioned facts that twitter posts are also helpful for the patients and individuals in having a brief knowledge about various health innovations that can help them in improving their lifestyle and securing good health. 

After the third week of August 2018, the organisation has tweeted in the last week of July. In this week, the organisation has posted about the efficiencies of cognitive behavioural therapy which is internet-mediated. They have also provided an overview of the real-time cartography about the epidemic disease in the rural villages and development of a mobile tool for the self-surveillance. They have a better focus on the research that can reduce the suicidal tendency among youths. In the third week of July, they have provided knowledge about the utilisation of electronic health and mobile health apps in healthcare. The second week of PAHO also offers sufficient information about the impact of mHealth (Twitter, 2020a). 

2.2 @telemedicine_Jn:

@telemedicine_Jn is the twitter account of the telemedicine journal that makes people aware of various innovative solutions in patient care and the management of records. In this present week that means in the third week of March, Telemedicine journal offers an overview of the impact of trust on the compliance of patient (Twitter, 2020b). They have also provided a brief overview of the importance of telehealth on the care of children who tend to commit suicide (Twitter, 2020b). They have published various research papers regarding automated text messaging systems for the facilitation of self-monitoring. From these tweets, I have learned that twitter publishes opinion of other people, the research articles and news to create awareness among people that can include doctors and nurses.  

In the second week of March, the journal also offers a better overview of the impact of telemedicine in a different field. Telemedicine is one of the new and advanced technologies that can facilitate several improvements in medical science (McClellan et al. 2017). Publishing tweets from this account aware patients and doctors about telemedicine. This journal also creates awareness among government about telemedicine technology so that they can install telemedicine in the rural areas for improving the healthcare facilities. The twitter account of the journal is also helpful in understanding the reaction of people about telemedicine. 

For making more number of people aware of this technology so that they can use it, utilisation of an appropriate social media is important (Yepes, MacKinlay & Han, 2015). The utilisation of social media can make more people aware of advanced technology as it is used by more people. In the second week of March, telemedicine journal has mentioned how telemedicine can be used in neonatal services (Twitter, 2020b). In the second week, the journal has also provided an overview of the consequences of coronavirus. Covid 19 has become a recent issue for the human because it has a higher infection rate. From this fact, it can be said that twitter can be used to inform people about pandemic diseases (Ji et al. 2015). Twitter not only offers information about the consequences of pandemic diseases but it also offers the impact of diseases, the treatment of diseases and the death rate of the diseases (Rocheleau et al. 2015). 

The journal has not published tweets in the last two weeks of February and the first week of March. From this information, it can be said that journal that telemedicine journal publishes information when they get any innovative information (Twitter, 2020b). In the second week of February, they have published the advertisements about the physical edition of their journal. In the first week of February, the twitter account of telemedicine journal has invited the public to join their 20^th anniversary. Therefore, Twitter is also useful in making people aware of another event. 

2.3 @TheMarmotReview

As the use of social media such as Facebook and Twitter have become an integral part of human lives, public health departments and other volunteer groups are now utilising these platforms to drive health consciousness by sharing health and well-being related information (Ye, Zhao, Nguyen & Wang, 2020). @TheMarmotReview is the Twitter account of The Institute of Health Equity and they periodically share public health and well-being related information. Review of this Twitter account suggests that their tweets put most emphasis on the improvements of life expectancy and also identifies how for some part of the society the quality of public health is decreasing. For example, in a tweet @TheMarmotReview is informing their followers about the impact of work-related stress on the workers' well-being. Furthermore, they also inform the masses about the disparity of the public health system as well as their tweets and share awareness messages with their followers about the importance of the improvement of health (Twitter, 2020c). 

This twitter handle is also driving health awareness as well as sharing public health-related policy changes news in order to inform the masses through their Tweets. Review of the tweets suggests that their main focus is on informing the public about the required changes in the public health systems, although some of their tweets also inform their followers about the practices that enhance public health and well-being. Some of their tweets explicitly focused on the health hazards involved in low paying jobs, where workers do not even have health insurance and discuss how employers are exploiting the cheap workforce for their benefits. Furthermore, their tweets also drive awareness among the masses about the adverse impact of equality issues, pay related issues and mental health issues. Overall, their tweets focus into the dissemination of public health policies, however, review of their tweets demonstrates focus into the dissemination of information about public well-being and health practices as well. The main aspect of this twitter handle is that they clearly present new developments in policy, framework and discussion in the healthy ministry regarding healthy health related issues. It helps in creating public awareness. 

3.0 Telemedicine in Australia: 

3.1 Barriers in Telemedicine in Australia: 

Technical issues: 

Computer or eHealth literacy: According to Scott Kruse et al., (2018), the lack of e-Health literacy is the main barrier of telemedicine. This is not only in the part of healthcare staffs, but also in the part of service users. Many staffs who are highly skilled in health delivery do not have much ICT skills which creates difficulties in providing proper telemedicine delivery to the patients. Therefore, it can be said that the lack of technical knowledge is one of the main barrier of e-health or telemedicine delivery. 

Internet bandwidth and interoperability: In addition to the lack of e-Health literacy,  internet bandwidth, overall interoperability and difficult application design of the e-Health services contribute to the barrier of telemedicine (Hassibian & Hassibian, 2016). This is true for rural areas which mainly requires telemedicine services as the patients from far rural areas cannot urgently come to urban areas for getting healthcare services (Zachrison et al. 2020). In such a scenario, due to low bandwidth and lack of interoperability from the patient and their relatives creates issues in telemedicine services. 

Management Issues: 

The managerial issues seems to present more barrier in implementing telemedicine than the technical issues.  

Privacy Issues: Patient personal health information breach can occur in telemedicine services. Personal can be circulated via third parties, stored in unsecure network and unencrypted hardware which can land in the hands of third parties and therefore can lead to privacy issues. According to Merchant, Ward & Mueller (2015), due to concern over privacy issues many patients and their relatives prefer face-to-face services rather than telemedicine. 

Resistance to change: One of the major reasons as identified by Caffery et al. (2017) is that telemedicine service providers are concerned over their investment on return. There is hardly any reimbursement for their investment for telemedicine. Moreover, for providing telemedicine, service providers needs to invest in training and workflows which creates difficulties in both effectiveness and efficiency of care in the care homes and hospitals as other staffs engage in either training or in telemedicine services. 

Lack of funding: One of the major reasons is the lack of funding from the government and concerned authorities for improving telemedicine services. This is mainly due to the lack of proper regulation and lack of federal government policies towards e-health services (Wilson & Maeder, 2015). In Australia, a National e-Health Strategy was commissioned in 2008 though the strategies outlined in this strategy is inadequate in addressing the e-Health challenges present in the country (Knight et al., 2014). It does not specifically focused on funding sources and government initiatives on periodical funding which has created a long term impact on the overall e-Health or Telemedicine services in Australia. 

Language barrier: One of the major barrier for Australia in implementing telemedicine is the language barrier in combination with the technical issues. The aboriginal and Torres Strait Islanders and the current inhabitants in the mainland Australia has language differences and therefore, during the e-Health service delivery, the lack of language and interpersonal skill training, providing telemedicine services become very difficult (Walsh et al., 2017).  

3.2 Recommendations: 

Therefore, for resolving the issues about the IT specialist’s doctors, the government of Australia must arrange proper training for the doctors so that they can have a greater knowledge about ICT to handle telemedicine.

The medical association of Australia has called an urgent government action for ensuring that Australians living in the regional, rural and remote areas can get access of reliable and affordable high-speed broadband system so that they can get telemedicine facilities. The government must ensure that every locality of Australia can get good network and electrical connectivity at the lowest possible costs so that they can access telemedicine facilities. The Australian government has announced a telecommunication fund of AU$22 million to improve the network infrastructure. It is necessary for the government in developing systematic planning of the telemedicine program. The government must take initiatives in developing collaboration among two different departments. Additionally, it is important to offer training to the employees of health and information technology in Australia so that they can work collaboratively with each other. Additionally, the higher-level staff must offer proper support to the lower level staff so that they can work collaboratively.

For resolving the reimbursement related issues, grants from different organisation and government are important so that it can help in implementing telemedicine. Moreover, other types of funding such as reimbursement from the private payers and the government must be increased. The Australian government can take help of some legislative action for resolving the reimbursement related issues.

For resolving the accreditation issues, the medical council of Australia and another health council must take the responsibilities for regulating the procedures and practices of the telemedicine. Along with the government of Australia must set proper policies as well as guidelines in using telemedicine in Australia. 

4.0 Conclusion: 

From the above analysis, it becomes clear that Australian Government has used social media as an effective tool for public health informatics by properly disbursing public health related issues, warnings and methods for dealing with health related issues. On the other hand, it is also identified that Australia in particular still lack behind in telemedicine as issues like ICT knowledge, internet bandwidth, resistance to change and issues like funding are creating barrier in implementing an effective telemedicine network in the country. For curbing the issues, some recommendations like policy changes and government initiatives are recommended.