IPTV a viable health literacy channel

Australia is sitting on a diabetic time-bomb: every day, 280 Australians become diabetic, and the cost to our health system is at least $12.4 billion a year.

One of the ways to lower the rate of diabetes – and the cost of treating and managing it – is by increasing health literacy in the community.

A recent trial to improve health literacy using internet protocol television (IPTV) has given a glimpse of the possibilities from this novel approach.

However, while the method and technology works, the big question is whether government and business will provide the right climate for IPTV to become a commercially viable channel for health education.

The trial – a collaboration between the University of Melbourne’s Institute for a Broadband Enabled Society (IBES), Diabetes Australia - Vic, telecommunications giant Ericsson Australia and advanced social networking technology provider SeeCare – sought to improve access to high-quality, trusted information.

“You can Google anything and get any answer you like; particularly in times of crisis, such as when people are diagnosed with cancer or diabetes, the first thing people tend to do is reach for Google,” project manager Ken Clarke said.

“But it’s not that great an experience, and you just can’t trust what people are telling you.

“The health literacy project is all about delivering material to people so they can rely on it, but also in a way that’s good for people who typically don’t have access to a PC, or the skills to use one.”

Mr Clarke, a senior research fellow at IBES, said the TV becomes a user-friendly portal for those sectors of the community, such as seniors, Aborigines and Torres Strait Islanders, and migrants with English as a second language.

In the trial, 20 volunteers were assessed by four diabetes nurse educators. The nurses logged in to the system – which was an Ericsson customisation of SeeCare’s home care application – to allocate relevant content to the volunteers’ IPTV accounts, which was then available for them when they logged in at home.

“The ability to adapt and integrate different technologies and different care and support processes was key to the novelty of the approach,” SeeCare director Gil Tidhar said.

“The demand for relevant and reliable information is significant. Being able to provide such information remotely by educators who interact with people in need and their carers – and who are able to personalise the information and distribute it, especially to remote and regional areas – is a significant step forward.”

SeeCare is now planning to explore the incorporation of IPTV into its telecare offering.

“From SeeCare’s perspective, it’s clear that a quality health education system has to be a combination of technology and human support,” Dr Tidhar said. “You need both to provide appropriate care.”

At the trial’s public launch last week, Eric and Evelyn Weston were there to share their experiences with the audience, which included representatives from NBN Co.

Mrs Weston, 73, volunteered for the project because she wanted to help others, having seen the effects of the condition on her family. Mr Weston, 79, is pre-diabetic, and has been managing his condition for 11 years. Mrs Weston and her son have lived with diabetes for more than three decades.

Although Mrs Weston had a relatively high level of health literacy, she and Mr Weston were candidates for the pilot because of their unfamiliarity with computers.

“I don’t have one, and wouldn’t know how to use it if I did,” she said.

The value of the IPTV content is clear to Mrs Weston. “I’m pretty good at managing my diabetes, but I have a friend whose husband is diabetic and he doesn’t have a clue – and isn’t interested, either.

“There are a lot of people who have diabetes and think, ‘I’ll just take my medication and I’ll be right’ – and eat anything and everything. But you have to be very careful with your diet.”

Mr and Mrs Weston also provided feedback about the content. Mr Weston thought that there should have been information to show people with diabetes that they can lead a full and active life and still manage their condition, while Mrs Weston thought there should be material on complications from diabetes.

“We can target anything you care to mention,” IBES’s Mr Clarke said, “but content is king, and you’ve got to have a good bank of material to send out to people’s homes.”

IBES will now lobby the Victorian and federal governments for funding to bring the service out into the community, and to areas beyond diabetes education.

“Now we need that bigger dollop of cash,” Mr Clarke said. “We’ve done this on the smell of an oily rag.”

The diabetes education manager for Diabetes Australia – Vic, Carolyn Hines, said finding the money for content creation was a challenge, but that the technology was a cost-effective way to improve community health.

“It gives us the opportunity to fill a gap in terms of the resources that are out there, knowing that there is a means of delivering that information,” Ms Hines said.

“These things cost money, so it would be something that we would need to seek funding for, and as with every resource that we develop, we would need to go through a needs analysis with consumer involvement. But certainly the success of this pilot shows that there’s a great need for it.

“One of the good things about this is that you don’t have to purchase a DVD. From a health literacy point of view, we know that people have lower health literacy when they come from more disadvantaged areas of the community.”

Ericsson Australia strategic product manager Colin Goodwin said the use of IPTV for health education had been shown to work by the trial.

“With the roll-out of the NBN, the majority of Australians are likely to have IPTV, so what we’re looking at is a very common technology environment,” Mr Goodwin said.

“What was not clear before proof-of-concept was whether people would relate well to having healthcare education provided on a TV, rather than having to go to a computer or a tablet, for example.

“For many [clients], a computer is quite intimidating, whereas a TV is a lot more everyday. We saw with the people Diabetes Australia brought in – perhaps a little to our surprise – that they seemed to be very comfortable relating to it, even with things like authenticating themselves with user name and password with a keyboard and a TV didn’t really faze them.

“So even if people might prefer to interact with a TV, we should not assume that any sort of keyboard or device is necessarily an obstacle. That’s certainly something I learnt.”

The future of IPTV in health literacy will depend on policymakers creating the right environment for it to flourish, Mr Goodwin said.

“It’s an area which looks promising ... [but] these are not applications which easily pay for themselves. They need to be considered as one of hundreds of applications that could be available on your TV – and then the model will become possible to support them commercially.

“I don’t see it happening without government awareness and encouragement, just because you need to actually aggregate a reasonably large number of modest applications to make it an attractive proposition.

“Also, lots of people just don’t realise that for the NBN this is absolutely what it is intended for. It is for IPTV and many other purposes, not just internet access for PCs.”

Dr Tidhar agreed, and suggested that once the use of IPTV for health becomes understood in the community, the public will push demand.

“I believe that the seamless integration of different delivery platforms is where the world is moving,” Dr Tidhar said. “The demand from consumers to be able to view and access the information wherever they are, and on whatever platform, is definitely there.

“Technologically it’s possible. We need to change the way healthcare and support are provided to address that demand.”

Posted in Australian eHealth

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