Mowafa S. Househ

Empowering patients through social media: The benefits and challenges:

This article explores the range of social media platforms used by patients and examines the benefits and challenges of using these tools from a patient perspective. A literature review was performed to investigate the use of social media technology by patients. The MEDLINE database was searched using the terms “social media” and “patient.” The search was conducted in September 2012 and yielded 765 abstracts. Initially, 63 abstracts were selected. All articles dating from 2004 through 2012 were included. Only 12 articles were found to be relevant for the purposes of the review. The results of this research found that there appears to be an increase in the use of social media by patients across the healthcare spectrum. The research indicates a promising future for the use of social media by patients; however, evidence related to the efficacy and effectiveness of social media is currently limited. Various challenges have also been identified relating to privacy and security concerns, usability, the manipulation of identity, and misinformation. The use of social media technology is an emerging trend for patients who are seeking health information. Conclusions are that such technology holds promise for improving patient engagement and empowerment and community building. Social media has a future in healthcare, especially with regard to patient engagement and empowerment; however, there are several challenges to overcome before the technology can achieve its potential.

National efforts to improve health information system safety in Canada, the United States of America and England

OBJECTIVE In this paper we review progress as well as challenges encountered in Canada, the United States and England with regard to ensuring safety of health information technology. METHOD A review of major programs and initiatives for ensuring safety of health information technology in the three countries was conducted. Published literature and Web resources from national programs were reviewed for relevant information. RESULTS It was found that in all three countries the issue of technology-induced error has been recognized as being of critical importance. The three countries have developed approaches for dealing with the issue that have some commonalities; however, they are at varying different stages of maturity, with England having the longest standing and most well developed safety programs, while Canada and the United States are at earlier stages. The types of approaches employed have included work on developing standards related to usability and interface design, certifications, directives from regulatory bodies, educational initiatives in health information technology (HIT) safety as well as research into safer HIT design and implementation methods. CONCLUSIONS HIT promises to lead to improved patient safety. However, it has become recognized that if not designed and deployed appropriately, such systems can lead to new types of errors. Based on this recognition, a variety of initiatives are being undertaken in Canada, the United States and England to promote the safe design, procurement and deployment of HIT. It is concluded that improved approaches to system design, testing, regulation, error reporting, safety education and cross-country collaboration will be needed to further promote safer HIT.

Ethical Issues of Social Media Usage in Healthcare

OBJECTIVE Social media, web and mobile technologies are increasingly used in healthcare and directly support patientcentered care. Patients benefit from disease self-management tools, contact to others, and closer monitoring. Researchers study drug efficiency, or recruit patients for clinical studies via these technologies. However, low communication barriers in socialmedia, limited privacy and security issues lead to problems from an ethical perspective. This paper summarizes the ethical issues to be considered when social media is exploited in healthcare contexts. METHODS Starting from our experiences in social-media research, we collected ethical issues for selected social-media use cases in the context of patient-centered care. Results were enriched by collecting and analyzing relevant literature and were discussed and interpreted by members of the IMIA Social Media Working Group. RESULTS Most relevant issues in social-media applications are confidence and privacy that need to be carefully preserved. The patient-physician relationship can suffer from the new information gain on both sides since private information of both healthcare provider and consumer may be accessible through the Internet. Physicians need to ensure they keep the borders between private and professional intact. Beyond, preserving patient anonymity when citing Internet content is crucial for research studies. CONCLUSION Exploiting medical social-media in healthcare applications requires a careful reflection of roles and responsibilities. Availability of data and information can be useful in many settings, but the abuse of data needs to be prevented. Preserving privacy and confidentiality of online users is a main issue, as well as providing means for patients or Internet users to express concerns on data usage.

Association of Online Health Information–Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

Background Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information–seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. Objective The aim of this study was to determine the online health-related information–seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information–seeking behavior on their self-care activities. Methods A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Results Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease, unemployment, and not seeking diabetes education were the most common barriers for online health-related information–seeking behavior. Younger age, female, marital status, higher education, higher income, and longer duration of Internet usage were associated with more online health-related information–seeking behaviors. Most (89/96, 93%) online health-related information seekers reported positive change in their behaviors after seeking online health information. Overall odds ratio (OR 1.56, 95% CI 0.63-3.28) for all self-care responses demonstrated that there was no statistically significant difference between those seeking health-related information online and non–health-related information seekers. However, health-related information seekers were better in testing their blood glucose regularly, taking proper action for hyperglycemia, and adopting nonpharmacological management. Conclusions Physicians and television are still the primary sources of health-related information for adult diabetic patients in Saudi Arabia whether they seek health-related information online or not. This study demonstrates that participants seeking online health-related information are more conscious about their diabetes self-care compared to non–health-related information seekers in some aspects more than the others.

Communicating Ebola through social media and electronic news media outlets: A cross-sectional study:

Social media and electronic news media activity are an important source of information for the general public. Yet, there is a dearth of research exploring the use of Twitter and electronic news outlets during significant worldly events such as the recent Ebola Virus scare. The purpose of this article is to investigate the use of Twitter and electronic news media outlets in communicating Ebola Virus information. A cross-sectional survey of Twitter data and Google News Trend data from 30 September till 29 October, 2014 was conducted. Between 30 September and 29 October, there were approximately 26 million tweets (25,925,152) that contained the word Ebola. The highest number of correlated activity for Twitter and electronic news outlets occurred on 16 October 2014. Other important peaks in Twitter data occurred on 1 October, 6 October, 8 October, and 12 October, 2014. The main influencers of the Twitter feeds were news media outlets. The study reveals a relationship between electronic news media publishing and Twitter activity around significant events such as Ebola. Healthcare organizations should take advantage of the relationship between electronic news media and trending events on social media sites such as Twitter and should work on developing social media campaigns in co-operation with leading electronic news media outlets (e.g. CNN, Yahoo, Reuters) that can have an influence on social media activity.

The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review

Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes.

The epidemiology of Dengue fever in Saudi Arabia: A systematic review

Dengue fever (DF) is the most serious mosquito-borne viral disease worldwide. DF is an acute febrile illness caused by Aedes aegypti and Aedes albopictus, which are endemic in certain cities of Saudi Arabia, such as Jeddah and Makkah (Mecca). An online literature search was conducted using relevant keywords to retrieve DF studies conducted in Saudi Arabia. Forty-five articles were identified initially. After screening for exclusion and retrieving full texts, a total of 10 articles were used for this review. Four studies were cross-sectional, and three observed a seroprevalence ranging from 31.7% to 56.9%, either among clinically suspected cases or among patients visiting the hospital for other reasons. Evidence extracted from risk factors and distribution studies indicated that young males are commonly affected. Fever, vomiting, thrombocytopenia and leukopoenia were the common features of the three studies related to clinical presentation of DF. One cross-sectional study concerning an educational program for DF demonstrated that a positive family history of DF, literate mothers, and age over 17 years were the predictors of a high DF knowledge score. However, the paucity of large epidemiological studies limits the generalizability of such evidence. Future studies in Saudi Arabia should focus upon the expansion of DF to other cities in the Kingdom. Larger epidemiological studies are needed for estimating the true burden and incidence of DF in the Saudi population, as they are limited to seroprevalence among clinically suspected cases and hospital-based patients.

The Association between Computer Literacy and Training on Clinical Productivity and User Satisfaction in Using the Electronic Medical Record in Saudi Arabia

The association of computer literacy, training on clinical productivity and satisfaction of a recently implemented Electronic Medical Record (EMR) system in Prince Sultan Medical Military City ((PSMMC)) was investigated. The scope of this study was to explore the association between age, occupation and computer literacy and clinical productivity and users’ satisfaction of the newly implemented EMR at PSMMC as well as the association of user satisfaction with age and position. A self-administrated questionnaire was distributed to all doctors and nurses working in Alwazarat Family and Community Center (a Health center in PSMMC). A convenience sample size of 112 healthcare providers (65 Nurses and 47 physicians) completed the questionnaire. A combination of correlation, One Way ANOVA and t-tests were used to answer the research questions. Participants had high levels of self-reported literacy on computers and satisfaction of the system. Both levels were higher among physicians than among nurses. A moderate but significant (at p < 0.01 level) correlation was found between computer literacy and users’ satisfaction towards the system (R = 0.343). Age was weakly, but significantly (at p < 0.05), positively correlated with satisfaction with the system (R = 0.29). Self-reported system productivity and satisfaction was statistically correlated at p < 0.01 (R = 0.509). High level of satisfaction with training on using the system was not positively correlated with overall satisfaction of using the system. This study demonstrated that EMR users with high computer literacy skills were more satisfied with using the EMR than users with low computer literacy skills.

Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries

Objective: To assess the epidemiology of attention deficit hyperactivity disorder (ADHD) in Arab countries, and identify gaps for future research. Methods: We searched PubMed from July 1978 to July 2014 and reviewed local journals with cross-referencing. The keywords we used were ADHD, diagnosis, prevalence, incidence, factor, diagnosis, rate, risk, and each of the names of the 22 Arab countries (Jordan, Egypt, Lebanon, Saudi Arabia, and so on). Studies were eligible for inclusion if they investigated the epidemiology of ADHD in any Arab country, and were published in English. The search was conducted from 2nd to 5th August 2014 in King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Results: A total of 22 articles were included in the review. Twenty studies were cross-sectional and found the prevalence of ADHD ranged between 1.3-16%, prevalence of hyperactive type ADHD between 1.4-7.8%, and the prevalence of inattention type between 2.1-2.7%. Only 2 case-control studies investigated potential risk factors. Evidence extracted from these studies shows a significant association between ADHD and male gender, previous psychiatric illness in the family, vitamin D deficiency, poor school performance, sleep problems, and nocturnal enuresis. Conclusion: The prevalence of ADHD in Arab countries is comparable to reports in North America, Africa, and other countries of the Middle East. Longitudinal studies are needed to investigate the prognosis and determinants of this condition in the Arab world.

The Potential of Social Media and Internet-Based Data in Preventing and Fighting Infectious Diseases: From Internet to Twitter

Health threats due to infectious diseases used to be a major public health concerns around the globe till mid of twentieth century when effective public health interventions helped in eradicating a number of infectious diseases around the world. Over the past 15 years, there has been a rise in the number of emerging and reemerging infectious diseases being reported such as the Acute Respiratory Syndrome (SARS) in 2002, HINI in 2009, Middle East Respiratory Syndrome (MERS) in 2012, Ebola in 2014, and Zika in 2016. These emerging viral infectious diseases have led to serious public health concerns leading to death and causing fear and anxiety among the public. More importantly, at the moment, the prevention and control of viral infectious diseases is difficult due to a lack of effective vaccines. Thus having real-time reporting tools are paramount to alert relevant public health surveillance systems and authorities about taking the right and necessary actions to control and minimize the potential harmful effects of viral infectious diseases. Social media and Internet-based data can play a major role in real-time reporting to empower active public health surveillance systems for controlling and fighting infectious diseases.