Public Health Informatics

Assessment 1: Report–Summarising Public Health Informatics (including evaluation)

Introduction

According to data published in 2018, Australia has one of the highest internet penetration rates as 88% of the Australian has access to the internet. As social media usage is one of the primary activities on the internet, in 2019 around 63.61% of Australians were active social media users. Moreover, around 19% of internet users in Australia actively uses social media platform such as Twitter. Hence, almost one-fifth of the 'netizens' can be reached through Twitter in Australia. This is why various public health organisations utilise this Twitter platform to share healthcare and well-being information around the world and Australia is no different in such as well. In order to understand and assess the usefulness of Twitter-based healthcare awareness programmes, these following three twitter handles or twitter accounts will be reviewed by the author and they are @Croakeyblog, @telemedicine_Jn and @AUMentalHealth.

Part 1: Twitter review

Review of the twitter account

@AUMentalHealth

According to Twitter profile statistics, @RuralMental_Hth is active on Twitter since 2010 and since then they have tweeted around 12,500 tweets. This twitter handle belongs to a healthcare organisation named Mental Health Australia and as a result, this twitter account is dedicated to the mental health and mental health practices in Australia. On a regular basis, this twitter handle publishes various mental health and well-being related information which focuses on the enhancements of awareness about mental well-being as much as physical well-being. For example, the most recent tweet from this twitter handle posted about mental health impact due to the COVID-19 restriction on public activities(AUMentalHealth, 2020). This tweet shared a link which features expert opinions and discussion about the mental hardship on the young demographics of people.

Fig 1: Generating Awareness about Mental Health Impact from Racism

(Source: AU Mental Health on Twitter, 2020)

 In another tweet from the month of June, shared information about how racism has an adverse mental impact on the victims of racism. This tweet not only focused to generate awareness about the psychological impact of racist comments or behaviours but also provided expert opinions about how victims can cope with racism and remain psychologically healthy. 

@telemedicine_Jn

Second Twitter account or handle reviewed was @telemedicine_Jn and this handle belongs to the Telemedicine Journal. Telemedicine journal is a publisher for peer-reviewed healthcare-related journals. This twitter handle is active on Twitter for almost 11 years and since then they have shared 959 tweets. This twitter account shares awareness about various healthcare issues such as mental health, obesity, diabetes and so on. However, due to the currently ongoing pandemic, the majority of the recent tweets are related to COVID-19 awareness(Telemedicine_Jn, 2020). Furthermore, they also share information about public webinars where anyone can participate as an audience in order to gain information about the current healthcare industry and public well-being. In another recently published tweet, they have also shared peer-reviewed journal which discusses how COVID-19 pandemic can have a psychological effect on the society and how this impact can be minimised.

Fig 2: Asking people to support the continuous growth and development of research during COVID-19 pandemic 

(Source: Telemedicine Journal on Twitter, 2020)

The tweet is about the rapid and continuous growth of research and development for the COVID-19 pandemic throughout the world. The Telemedicine journal has tweeted the information about the way @LiebertPub has collected and unlocked access to its pertinent resources containing a wide number of articles of @Telemedicine_Jn. The articles provide a wide range of information on the process of dealing with the corona virus. For example, of the articles provides information on tissue engineering, which has a unique group of technologies and tools for developing diagnostics, preventive measures and treatments playing a crucial role during the rapid COVID-19 crisis and the future outbreaks of the virus. 

Fig 3: Sharing News about COVID-19 measurement in Australia

(Source: Croakey News on Twitter, 2020)

In another tweet, they have shared information about the psychological health of the aboriginal communities in the Torres Strait Island and stresses that healthcare departments need to take immediate actions in order to avert any mental health crisis. This tweet focused on the garnering of public and authority’s awareness about the mental health of the aboriginal people. Therefore, this twitter handle covers various social healthcare problems and helps with the development of public awareness as well as ensures public healthcare has a voice.

Fig 4: Mental Health Awareness among Aboriginal People

(Source: Croakey News on Twitter, 2020)

Critique of Twitter as a Public Health Information Sharing Channel

The previous discussion has already suggested that 63.61% of the Australians are active on social media platforms and among them, 19% are active on Twitter. This, as a result, demonstrates Twitter as an important social media platform in Australia. This is why various public healthcare and well-being organisations have chosen this platform as a digital channel to reach the masses with public well-being and awareness related information. Now, review of the previous 3 twitter handles or twitter accounts suggested that various organisations regularly share healthcare-related information through twitter as the use of hash-tags (#) helps these posts reach a broader audience. social media-based healthcare information sharing is a proactive measurement which ensures the development of public awareness about the healthcare practices, the importance of well-being and healthcare policies. This argument, as a result, indicates this digital medium as an important channel which helps with the dissemination of healthcare information and awareness(YouTube,2020b).

In the words of Godfrey (2020), social media is one of the greatest ways of sharing any kid of information and news at present time. This is specifically important when it comes to sending alert to people about something serious in the quickest manner. Thus, the news on COVID-19 pandemic whether it is disseminated individually or nationally, social media spreads the message where it is required to reach. Among various other social media platforms, Twitter is one of the mostly used social media networks used for spreading health information. For example, everything can be seen on Twitter and other social networking sites regarding corona virus, number of people affected or recovered specific to regions. Thus, the information has helped people becoming aware of the COVID-19 situation as well as educating people pertaining to the symports of the virus and thus, saving lives.

The social media, as a result, allowed NGOs to actively share information about the public healthcare system as well as the policies and which as a result the authorities to ensure the robustness of the healthcare infrastructure. Social media platforms such as Twitter have enabled the healthcare professionals and healthcare organisations to drive public awareness and keep them informed about the developments in the healthcare industry (YouTub, 2020a). As stated by Sokolov (2020), before corona virus, other global pandemics also occurred within the past 10 years such as Ebola, swine flu and Zika, which are also documented and influenced through social media conversations. Just before 10 years, the NGOs were not well-equipped to spread risk information through social media. People used social media platforms for directives, but unofficial or untrustworthy sources had the flashiest voices. By 2014, the health organisation become efficiently equipped and prepared for launching their campaign using social media. Today, social media have become ripened by means of their functionality. Large organisations have progressed in communicating online and identifying the misinformation that mislead people and spread unnecessary anxiety and trauma among people. Now the social networks are fighting actively against fearmongering and misinformation. 

However, despite the benefits of social media or Twitter-based healthcare information sharing, there are issues related to privacy and confidentiality. Social media-based healthcare-related posts cannot be relied upon because anybody can share information from unreliable sources. Therefore, it is up to the users to ensure the validity and reliability by ensuring they are following information from reputable sources. have also stressed on the privacy issue as they stated that engagement of individuals to tweets are publicly available and engagement with tweets related to specific health issues can allow others to perceive the health issue of the other person. As healthcare information is private, such a flaw adversely affects traditional doctor-patient privacy or confidentiality (YouTube, 2020a). 

Therefore, based on this discussion it can be seen that social media platforms such as Twitter-based healthcare information and awareness sharing are beneficial because of the effectiveness. However, there are privacy, confidentiality and reliability issue are the biggest drawback for this channel.

Conclusion

In conclusion, this section of this report has reviewed three twitter handles which regularly involves in public health dissemination. The review suggested that this twitter handles focuses on various public health areas from healthcare-related activities to healthcare-related practices and policies. Furthermore, in order to assess the importance and effectiveness of such public health awareness and surveillance practice various scholarly journals were accessed as well. Knowledge gathered from these journals suggests that social media platform such as Twitter has become one of the leading media for the contemporary healthcare industry because of the effectiveness to reach the masses. However, findings also suggest that not every Twitter accounts cannot be relied on because the genuineness of the information is in question, moreover, there are privacy issues related as well. 

Part 2: Telemedicine in Australia

Introduction

The implementation of telemedicine systems within Australia is more feasible than ever because of the massive developments in the ICT or Information and Communications Technology in Australia. Telemedicine allows doctors or other healthcare professionals and patients to communicate remotely and provide remote diagnostic as well as access to diagnostic reports remotely. However, despite the benefits, there are significant privacy and legal issues associated with telemedicine. Therefore, before the broad implementation of telemedicine, it is important to ensure the minimisation of barriers related to healthcare data privacy and legal issues. This section of this report will discuss the barriers and how they can be averted.

Barriers to the Uptake of Telemedicine in Australia

Following are some of the critical barriers for largescale telemedicine implementation in Australia:

Disadvantages compared to face-to-face interactions: one of the biggest disadvantages to the telemedicine is that there are disadvantages when compared to the traditional face-to-face doctor-patient interactions. Doctors or healthcare professionals are unable to perform various tests such as checking blood pressure, breathing consistency, temperatures and so on. However, such barrier can be averted if the patient has a smartwatch or smart band which provides such information as they can be communicated to the doctor or healthcare professional. However, there is the quality of care questions among the masses about such telemedicine service. Though such availability is not prevalent yet in Australia and as a result primary diagnosis through health vitals are one of the biggest barriers for telemedicine. During the Covid19 outbreak, virtual hospital has been developed in the Australia so that face-to-face communication can be reduced with efficiencies (Sweet, 2020a). In this present era, telehealth services help the patients in receiving healthcare service from the GP. However, some GP do not think that it is a standard process to treat the patient because it does not increase the rate of fitness.

Privacy and Confidentiality Issues: Another critical barrier in telemedicine is the privacy issue. As telemedicine depends on the internet connectivity and any patient-related information are also stored on network-connected computer systems they need to be encrypted with credentials. This, as a result, ensures protection against unauthorised access to such private patient information. However, any computer security is vulnerable and any individual with proper knowledge and mal-intention can access them and which as a result will cause a breach of doctor-patient confidentiality. Hence, this is a critical barrier to the implementation of telemedicine from the legal point of view. For reducing the confidentiality as well as privacy related issues, the government of Australia has developed COVIDSafe app. This app can decrease the privacy related issues (Sweet, 2020b). Recently government has developed a campaign in promoting the MyHealthRecord as the single source of record that increases the effectiveness to record data.

Technical Knowledge Restriction: In order to provide or receive telemedicine services it is important to know and be equipped with the technological infrastructure. For patients, they are more simplified as they only require a network-connected communication device and internet connection. However, for healthcare providers this is a complex process to implement as they need to ensure secure communication, secure and proper storage of patient information, managing schedules electronically. Therefore, technical knowledge is a necessity and which can be a major barrier for the widespread implementation of telemedicine in Australia.  Before Covid19, there were limited situation where telehealth were applied. After the pandemic telehealth are using delivering the healthcare services in the Australia (Dlapiper, 2020). Medicare registering providers of healthcare providers offers services from a location to offer a better service so that the social distancing can be maintained. This fact increase technical issues among healthcare providers.

Digital Patient Data Management: As patient data are stored in computers in telemedicine services, it is important to ensure that the service providers are well-equipped with infrastructure, both hardware and software. Proper digital data management will allow the healthcare professionals to access correct patient information whenever required, hence proper indexing needs to be there (Sweet, 2020a). On the other hand, data management also needs to ensure that the stored data are secure and there is no security flaw which can result in a breach of confidentiality 

Issues with Private Insurers and Insurance Plans: Another crucial issue with the largescale implementation of telehealth is that majority of the insurance plans do not cover telemedicine services and even if they cover there are a list of healthcare providers who are eligible and patients are required to only avail services from them. Hence, this is a critical issue as well.

Current Trends

The temporary MBS phone consultation as well as telehealth system was introduced to the citizen of Australia in the year of 13^th March to save the citizen from Covid19 outbreak. This item involves the doctors in the phone and videoconferencing to offer healthcare services to the customers (Health, 2015b).  The international organisation for standardisation has defined telehealth as the utilisation of the technique of telecommunication for offering telemedicine, health education and medical education over the distance. Mainly ICT are used through telehealth services in order to deliver the health services. Videoconferencing is the main way with the help of which telehealth can improve the access to the service of healthcare for the patients who lives in the remote or rural areas (Ama, 2020). After the COVID19 outbreak, the critical changes have been performed in the telehealth services with the help of key stakeholders that includes Australian college of remote and rural medicine, royal Australian college of physicians and many more. Government has developed telehealth a new key to fight against the COVID19. With the help of the telehealth services, government has expanded the consultation service to the patient with the help of telehealth (Health, 2020a). The primary health workers fight the battle against COVID19. Therefore, for reducing the unnecessary exposure of them from the COVID19 patient, telehealth services is highly important. Telehealth services involve the doctors in delivering healthcare services with the help of videoconferencing or phone. This fact reduces the pressure on the emergency department or the hospitals. Telehealth services allow the people in accessing the essential healthcare services in home as well as supporting the quarantine policies in order to reduce the spread of COVID 19 and risk regarding exposure to the COVID19 patient.

Recommendations

In order to avert the barriers, the following recommendations are being made:

• For the wider adoption of telemedicine, rural areas need to implement this service. Implementation in rural areas will demonstrate the benefits to the masses and which attract wider adoption of telemedicine in Australia. 
• Marketing or advertisement for telemedicine among patients needs to be done in order to show the effectiveness of remote diagnosis in order to gain the confidence of the patients.

Conclusion

In conclusion, telemedicine is beneficial for effortless and real-time treatment and diagnosis. However, there are privacy, legal and infrastructural implementation barriers in Australia. Based on the understanding the author has also provided recommendations to avert these barriers as well.