Including everyone in electronic health information services

Hinder, S; Nelson, P; Kershaw, H

Abstract

In this study we investigated what people with long-term health conditions feel about using NHS websites and what support they might need to use them. We studied people with diabetes and chronic obstructive pulmonary disease (COPD) because of the high cost to the NHS of treating these conditions. We were asked to focus on older people, people on low incomes and people with a learning disability. These are social groups that may be excluded from electronic health information services.
Most interviews were carried out on a one-to-one basis. We also carried out a focus group with people with a learning disability. In interviews we showed people a demonstration of NHS websites tailored to their conditions and then asked what they thought of them and what support and training they might need if they chose to use them. We carried out the study in Bolton, Salford, Bury and Manchester.
One of the most important findings of this study was that people had not heard of NHS Choices, HealthSpace and Easyhealth. This was even the case for people who had searched online for health information previously. Most people had a very positive attitude to these websites when we demonstrated them. In order to increase use of these websites there is need to be publicising them more extensively so that knowledge of them spreads throughout the population.
Another important finding of the study is that people who cannot use a computer generally had family members who they can ask to get information from NHS websites if needed. They can also ask the family member to teach them to use a computer if they want to. By promoting NHS websites to all computer users, we can also indirectly improve access to electronic health information for those people who do not use a computer.
We were also aware that some people cannot use a computer due to their physical illness, such as finding it difficult to sit in one position for any length of time or having memory problems resulting from a stroke.
There is a high degree of trust in information from NHS websites and this attribute could usefully be used to promote the websites.

Those people who said they would consider learning how to use a computer wanted this as close to home as possible or at a venue they were familiar with, such as a community group they attended, their GP surgery or a hospital clinic. People who could not use a computer expressed a preference for basic computer training rather than training in using NHS websites. Some people who can use a computer thought they may need some training on registering for HealthSpace in order to view the Summary Care Record or the Salford Diabetes Record.
We found that there were few computers in the supported living accommodation for people with a Learning Disability and the support workers we interviewed did not use a computer. There were no computer training courses available for staff. Promotion of the NHS websites by the learning disability services to those who can use a computer, as in the case of families, would indirectly improve the access to health information for people with a learning disability.
We held a focus group with students with a learning disability in their IT class at a community college. Neither the students nor the tutor had heard of Easyhealth, NHS Choices or HealthSpace. We were informed that, with appropriate funding, the curriculum for IT at Entry Level 2 could be developed to include the use of NHS websites, and that tuition could be personalised and localised around the needs of individual students.
We found that some people did not believe that there would be any benefit in getting more information on their health condition or in seeing their health records. This means any promotion of NHS websites would need to clearly explain the benefits of being able to access health information. Many people, including those who want to use the websites, are concerned about data security issues, both in terms of data hacking and in terms of who has access to their records. Any promotion of HealthSpace needs to include strong assurances on data security.

Citation

Hinder, S., Nelson, P., & Kershaw, H. Including everyone in electronic health information services

• Report Type: Project Report
• Deposit Date: Feb 3, 2011
• Publisher URL: http://www.connectingforhealth.nhs.uk/engagement/public/projects/everyone
• Additional Information: Additional Information : Report produced for NHS Connecting for Health by RaFT Research and Consulting Limited www.raftresearch.co.uk