Second Life and Healthcare

For this latest assignment, I was to create an avatar to explore the features of Second Life and think about how it could be used in doctor-patient relationships.

I have been a reluctant participant in virtual reality games, especially those online, because of my concerns of being in a world where everyone is not necessarily who they appear to be.  This coupled with my doubt as to what the true point of these types of games was I started this assignment with a skeptical and critical viewpoint.  I have read articles about our men and women in uniform coming back from war and utilizing virtual reality as a way to treat and deal with various medical conditions such as PTSD to restore them to a quality of life near or equal to a level prior to their experience in battle. With the research showing the potential success for these situations, I am all for its use.  But, I am skeptical about how viable and beneficial it will be in the more mundane healthcare situations, and I am having a hard time thinking outside the box about how I would use it in my own healthcare.

The field of psychiatry I believe is the one area that Second Life can most easily be integrated into patient care. It provides patients a safe and controlled environment to work through issues and situations that cannot necessarily be replicated in the real world. For everyday healthcare, I am unsure what benefits there could be in the virtual world.  There is a possibility this virtual world could be used for doctor visits instead of video teleconferencing. Even though webcams are fairly cheap these days, Second Life only requires a computer with software that anyone can access and an internet connection. To maintain privacy, a private forum would be needed which would be an additional expense.  Communicating via this online method may improve the amount and accuracy of the information the patient provides the doctor resulting in improved care the doctor can provide. The patient has the benefit of dedicated one-on-one time with the doctor, but may feel more comfortable sharing certain information when not "face-to-face."  However, this could also be a hindrance to the doctor-patient relationship because the doctor will not be able to pick up on certain visual and verbal (if voice chat is not utilized) cues that may help direct the doctor in his/her assessment. I think, overall, Second Life is more beneficial in providing education and support of patients in their own healthcare.

Palomar-Pomerado Hospital has a virtual hospital tour of the new facilities it will be unveiling in 2011.  This type of setup could benefit patients in that they could see what type of facilities they will receive treatment in as well as the process they will go through from admission to discharge.  Being a surgical nurse, I think this would be beneficial for surgical patients who experience quite a bit of anxiety when faced with a surgical procedure.  This would allow them to have some idea of where and what will be happening to them in a situation that can easily be perceived as out of their hands. The virtual world would also be able to put them in the perspective of what they would have in reality (i.e. transfer from pre-operative check-in on a gurney/bed to the operating room).

Second Life could also be a more interactive support forum utilized by patients who have the same conditions, whether acute or chronic. Also, this could be a forum for groups to provide information and support.  From the Wikipedia listing of Businesses and Organizations in Second Life,

Imperial College London (ICL) developed a virtual hospital and a series of documentary films (machinima) that describe what healthcare of the future could look like from the patient's perspective. The design of the virtual hospital campus, Second Health, is based on the principles and recommendations outlined in the recently published Healthcare for London: A Framework for Action. This work was initially managed by Dave Taylor at NPL who subsequently moved to ICL, where the Medical Media and Design Lab continue to undertake research to evaluate the effectiveness of this new medium for public engagement, collaboration, professional education and patient information and safety in the National Health Service.  (From http://en.wikipedia.org/wiki/Businesses_and_organizations_in_Second_Life, retrieved November 4, 2010).

There is a potential for helping the doctor-patient relationship in providing a place for information sharing and potentially conducting virtual visits. But, there will be some barriers to use.  There is the cost of maintaining a forum that will address the privacy concerns the patient may have. There is a learning curve in being able to effectively navigate the virtual world, which will require a certain time investment of both the doctor and the patient.  This could also require the doctor to become a technology resource to help guide the patient in how to operate in the virtual world to ensure the utilization of this method is effective for both of them. I’m still skeptical about the use of Second Life for other healthcare uses outside of psychiatric medicine.  But, I know there are many ways healthcare entities are utilizing Second Life that I am not aware of and look forward to discovering them.

Flu vaccination

An article from WebMD Health News dated October 14, 2010 highlighted results of a survey conducted by Consumer Reports regarding the flu vaccine for 2010. The survey found 28% of healthcare workers stated they would not get the flu vaccine this year.  A follow up article by Consumer Reports regarding this survey stated:

           “…  only 52 percent of health-care workers and those who work in residential nursing homes were immunized for seasonal flu last year and just 34 percent for H1N1."   (http://www.consumerreports.org/health/healthy-living/flu-vaccine/overview/index.htm)

The reasons for not being vaccinated were not provided in this article. Even though this was barely half of the health care workers, it was still a higher percentage than the 45% of adult Americans who were vaccinated last year for seasonal flu.

If health care facilities were required to publish the flu vaccination rates in conjunction with the rate of health care acquired flu infections like they do the core performance measures (e.g. treatment for heart attack, pneumonia, incidence of surgical site infections, etc.), would the health care consumer see this as a valuable performance indicator? Maybe in the future, but currently, I do not think health care consumers believe the vaccination is helpful as evidenced by the low vaccination rates over the years. 

 I think there is a potential for this statistic to be useful in providing education to the health care consumer. Showing a correlation between a high percentage of flu vaccinated health care staff with low incidences of health care acquired flu infections and incorporating this information in consumer education may reduce the “flu invincibility” thinking indicated by the survey and lead more people to vaccinate annually.  It may also be used to show the vaccination is not only a protection for the individual being vaccinated, but also protecting those the vaccinated individual is in contact with on a regular basis. Once the consumer sees the value in the vaccination, then they can provide pressure on the facilities to ensure the staff is vaccinated at a higher rate. 

Utilizing the CDC website, I tried to search for flu rates in health care facilities for patients who had an admission diagnosis other than the flu.  At this point in time, I have not been able to find such specific data.  I was only able to easily locate flu surveillance data for trends in the communities.  The data may be available, but it must be easily accessible in order to help change the minds of those who do not think it is worth getting the flu vaccine.  With the difficulty in finding such data, it does not surprise me there are those who continue to refuse the flu vaccine. If there is not readily available and extensive data to show how important it is to utilize the flu vaccine, then how can we expect people to change their actions?  Even with the extensive data showing simple hand washing is a major deterrent to infection transmission, there continues to be high rates of health care acquired infections associated with MRSA, VRE, and C-Diff et al. due to low compliance with hand washing.

This is an opportunity for health informatics to improve the collection, analysis, evaluation, and dissemination of the data regarding health care acquired flu infections. Making these improvements, especially with dissemination, health informatics can positively affect change in the prevention of flu.

The survey press release from Consumer Reports can be found at http://pressroom.consumerreports.org/pressroom/2010/10/my-entry-1.html. 

As an aside: during the course of my search for data regarding the flu and flu vaccinations, I found the ConsumerReportsHealth.org and Consumersunion.org as additional sources of health information.  I had known of the first website, but did not realize the publisher of Consumer Reports had a complementary website. My initial impression of these websites is they can be valuable adjuncts to other health information websites.

Beginnings

I'm a registered nurse working toward certification in Health Informatics. This blog is part of a course I am taking, The Internet and the Future of Patient Care, and is also the first blog I have created. I hope to develop a better understanding of this technology as well as share information with others. I look forward to also seeing how my ideas regarding blogging evolve throughout this course.