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  • Subject Name : Public health

Part 1 - Twitter Review

Introduction to Twitter Review

Public health informatics is the methodical use of expertise, information, and IT in the areas of public health. Health endorsement, surveillance, awareness, and scrutiny are all the applications of public health informatics. The promotion of wellbeing of all individuals will ultimately lead to the promotion of the whole population's health. Disease and injury prevention are the changing circumstances that add to the risk of the population. Public health informatics is considered as the most practical system in addressing illness epidemics, outbreaks, natural disasters, and epidemics. The use of statistics compilation systems and global surveillance such as health information exchange and health information organizations help in population-level monitoring. Various databases are used to collect, monitor, and review the data to make inferences. Similarly, Twitter is one of the social media platforms that allow users to send and receive 140 character messages to one another (Certified Health Informatician Australia, n.d.).

Public health researchers are now using twitter to analyze the contents of tweets with interactive features for interventions and recruitments. Health care researchers have leveraged on the application to collect large database information for analysis. From different researches, it has been found that social media platforms like Facebook, Twitter, and Instagram are widely used to get data on population-level health and behavior. Twitter is mostly followed by a social media platform because it is a exclusive big data source followed by public health researchers because of the real-time nature of the substance (Wu et al., 2020). This provides easiness in assessing and penetrating publically accessible stuff. Twitter-based health research is growing at a fast pace due to its increase in the number of publications. The breadth and diversity of financial support opportunities suggest the worth of presenting a broad attention in Twitter-based health research. Here, three platforms like @equitylist, @TheMarmotReview, and @AUMentalHealth will be discussed with the help of news feed presented in the period of semester-1 to semester-5.

@equitylist is the platform that shares information on public physical condition, evenhandedness, and human growth. The social determinants of health are specially taken care of under the information on the page. Equity is the absence of remedial or avoidable differences among different groups whether they are economically, socially, geographically, or demographically different. Health determinants are more respected to improve and maintain the health outcomes of individuals. Health is the basic right and needs realization to eliminate inequalities that result in the unstable health status of individuals to pursue and enjoy one’s life (NBN guide to health in the home, 2019).

The news feed of the page has included the topics such as implications for infection prevention precautions in COVID-19 times, Airborne Coronavirus: Things to know, Risk factors for Coronavirus deaths, WHO Coronavirus disease dashboard, Coronavirus: treating symptoms and pandemics, independent evaluation of global COVID-19 response, and the discussions by WHO on the current pandemic situation (Certified Health Informatician Australia, n.d.). In the report published by NASEM Health, the data of feeding infants and children from birth to 24 months have been described with a summary of complications in care due to COVID-19 (Phelan, Katz & Gostin, 2020). All the latest updates have been shared on the page delivering the information on lockdown rules and exceptions for essential workers. Equity and Health retweeted The Economist Intelligence Unit on the report they published on lung cancer must be a high priority in Europe. 41% of the countries were studied under this report to give the updation on National Cancer Control Plans in the past five years (Smith et al., 2020). The recent report shared by World Economic Forum retweeted by Equity and Health presents the data that the study of COVID-19 shows 40% of cases in Italian towns had no symptoms. Similarly, the reports were presented, discussions were done, and tweeting and retweeting the content is available. The major topic of discussion was found as COVID-19 and its impact on society in all respects (Certified Health Informatician Australia, n.d.).

@TheMarmotReview is the news feed platform that shares the data on reducing health inequities by tackling the social determinants of health. Health equity is the most essential aspect of the healthcare service delivery system as said by international organizations. Health equity is followed to Universal Health Coverage means the services should be accessible to everyone irrespective of caste, creed, sex, religion, and economic status (Ohannessian, Duong & Odone, 2020). The topics of discussion in the news feed were Health equity in England, public health expenditure since 2010 to 2020, the importance of communities who have engaged in hard times to engage population, discussion of the conference on "The Ethical Principle of Equity in the Response to the Pandemic and Beyond, priorities for a wellbeing-centered recovery”, COVID legacy bill, interviews of healthcare providers about inequalities laid open to COVID-19, and a hot discussion on tackling health inequalities in light of the marmot review and COVID1-19 (Ohannessian, 2015).

All topics discussed bounced the light on the advancement of health equity and justice in post-pandemic times. The webinars, seminars, tweets, retweets, statistical information, conferences, have been shared to provide equal opportunity whether the person is rich or poor. The social inequalities have been observed at the times of COVID-19, so it is the reflection of high mortality in some areas. This point had a major discussion by the World Federation of Public Health Associations with the launch program organized by Global Sustainable Health Equity Moment (Wu et al.,2020).

@AUMentalHealth is the platform that is followed to review the national peak of psychological wellbeing in Australia. Mental health is the concept of emotional and social well being of an individual and communities. The news feed presented on the page relates to all the concepts of enjoyment of life, being stable to set and fulfill goals, capable to build and maintain relationships, and the ability to ‘bounce back’ from sadness and stress. The researches have also presented the social and emotional wellbeing of Aboriginal and Torres Strait Islanders to reflect a holistic view of health. The posts shared on Twitter by @AUMentalHealth delivers the data on Australia’s increased focus on mental health and wellbeing of all the people to do something for Victorians. Sustainable mental health is the major discussion on the page to share ways to improve mental health (Liang, Wang, Murphy & Hui, 2020). The research was present on mental health concerns that were faced by a large number of ethnic communities and groups in assessing and receiving culturally and linguistically appropriate information and treatment for mental health concerns (Hinde 2020).

Other hot topics for discussion on the platform were mental health effect because of COVID-19, mental health challenges, need of leadership to galvanize support for consumer and career development, opportunities to fast track mental healthcare reformation with the evidence-based practice at federal and state levels, impacts of racism on mental health, entertaining chat options for maintaining mental health during COVID-19, ways to boost resilience in the workplace and identity to support, multicultural mental health, and many more. A wide variety of organizations such as the Food and Drug Administration, National Science Foundation, National Institutes of Health, universities, and foundations are using Twitter to present their data (Certified Health Informatician Australia, n.d.). At present, Coronavirus is a widespread disease that needs some innovative developments to measure the impacts of efforts done by assistance committees (Wu et al.,2020). The reports published have been presented along with the statistics to guide civil society and non-governmental organizations so that they can think of providing support for medically and socially vulnerable populations in European countries. COVID-19 is the pandemics that have caused worry, stress, and fears to the uncertainties. The movement of people is restricted to areas to slow down the multiplication of the deadly virus. This has allowed the individuals to face new realities of work from home, home-schooling children, temporary employment, and lack of physical contact with family, friends, and colleagues (Liang, Wang, Murphy & Hui, 2020).

Conclusion on Twitter Review

Hence, Twitter is the platform that shares valuable information that healthcare researchers have posted in the form of the news feed. Individuals who are interested in capturing data on health topics analyze the information to do further researches. Twitter is becoming more popular for healthcare research information because it presents evidence-based data on the platform each day. Six different ways have been identified in the Taxonomy of Twitter to use healthcare data. Data on the platform is provided in the form of a user's profile and especially with tagging feature to present demographics of literature. New opportunities are provided to characterize the data for user data analysis in studies. In the future, the information would be presented in a standardized reporting format under the guidelines of healthcare researchers who use this application with policies and address all the privacy and confidentiality related concerns.

Part 2. Telemedicine in Australia

Introduction to Telemedicine in Australia

Australia has a remote and rural population that lives too far from accessing healthcare services made available by the government. Telemedicine and telehealth is the concept that has emerged its importance by providing a promising solution to narrow the gap. The healthcare services are provided in the country to improve the level of healthcare services in the rural and remote Australian population. Along with the benefits of telemedicine, some challenges are also faced by the people in delivering as well as in availing of the services. The notifiable point is that technological advancements are there that have great potential in overcoming the barriers. In this essay, barriers that are faced by Australian healthcare providers and receivers are going to be discussed that have created challenges in issues management of applications (Liang, Wang, Murphy & Hui, 2020).

Public and private sector partnership, quality infrastructure, and financial support models are there that have accounted for various modalities in the system. Healthcare workers, technology entrepreneurs, and public sector officials in Australia are facing complications in the victorious execution and acceptance of telehealth-enabled services. According to Dr. James Freeman, father of telehealth startup named HCF-backed said that models of care are facing discrepancies in the distribution of patients and allocation of doctors transversely in Australia. The physician-patient ratio is very disproportionate as there is one General Practitioner per 3000 patients (Liang, Wang, Murphy & Hui, 2020). If the consultant is a specialist than the number gets more increased. The services, as well as specialists, are both very less in number due to which the problem arises in healthcare delivery systems. There is a high rate of inequity in the country as seen in Indigenous and non-Indigenous populations in the country. This matter has a concern about the convenience of wellbeing services using wheels, wings, and feet as the video conferencing or transport mechanism (Martin J. S., 2014). According to the Australian Institute of Health and Welfare report, the total expenditure on health has been calculated and it was found that each year the expenditure on health systems has been increased from AU$95 billion in 2003-04 to an estimated AU$155 billion in 2013-14 (Liang, Wang, Murphy & Hui, 2020).

There is a perfect storm of an aging population that is seen in Australia ready to avail healthcare services. These are those people who are suffering from chronic health conditions and increased expectations of both healthcare professionals and consumers in the system. Significant pressure is there in monetary terms that are alleviating Australia in improved health outcomes, improved patient care, and long-term commitment. The government of Australia is seen with putting no efforts in infrastructure improvement, fund allocation, and physician motivation. This is the reason the country is facing barriers in the healthcare delivery system. The reports have been published that presents that the needs of government, healthcare providers, and clinical partners should be on creating sustainable and profitable business models as seen "the biggest challenge" in telehealth in COVID-19 times. Financial disincentives have created the environment of discouraging healthcare practitioners from using telehealth services to provide benefits to patients as well as practitioners. NSW is the regulatory body of Australia that is working on assessing the uncertainty reports that provide hospitals and institutions the real data of negative behavior.

The telemedicine services are not provided in the remote and rural areas of Australia, they have to come at least 15 kilometers nearest to the place. This challenge is found due to the non-availability of internet services in the areas. Allied health professionals, healthcare providers, and general practitioners cannot charge the patient for the services delivered through Medicare. Here, this situation presents that 140 million general practitioner services are delivered each year, no one among them is telehealth entitled. Out of 160 million therapeutic consultation conducted every year, only 6 million among them are telehealth entitled (Klonoff, 2020). Almost all the models of healthcare in the country are government-funded. Telehealth is the under-financed field concerning funding allocation. It has been noted that only 4 percent of the total therapeutic care services conducted can be funded by Medicare.

Another barrier stated regarding telehealth in Australia is “a lack of coherent vision” and “mismanagement”. The thought that is got here regarding this barrier is of financial support models that have been put into practice to hold up telehealth has been disastrous. As an example presented in the news feed from twitter is that Skin cancer is a very common disease in Australians. One in every two Australians is diagnosed with skin cancer. In the implementation of telehealth, it is very simple to get, store, and forward the X-Ray images through the implementation of the system (Klonoff, 2020). General practitioners take a dermoscopic image of skin cancer and send it to a specialist for judgment and details back. This is a long bandwidth and not a real-time investment. Forwarding and storing reports well really need infrastructure but there is no funding from the government to upscale this project.. The current methods were used in addressing patients needs but were not found to be very effective. So, the barriers faced in healthcare delivery system through telemedicine should be looked after to provide best care to patients.

Recommendations on Telemedicine in Australia

The redeployment of time and money is needed to have a better return on the efforts of doctors as well as care seekers. Videoconferencing is the means to connect with government jurisdictions that involve family, education, and society services to get people jointly right away and rapidly (Liang, Wang, Murphy & Hui, 2020). The speculation in telehealth proposal on a nationwide scale would be in the order of five to one by plummeting requirement on hospital admissions and outpatient services, decrease in hospital visit, abridged society concern nursing professionals, and decrease on-demand more and more limited clinical possessions (Klonoff, 2020). The whole healthcare government system is set up around acute care, while there are natives with chronic illnesses who have to be taken care of. They need lots of face-time communication with the patient, also needs monitoring, adherence, privacy, and engagement with the doctors (Certified Health Informatician Australia, n.d.).

Conclusion on Telemedicine in Australia

However, many challenges are faced by the healthcare providers as well as seekers to receive medical care, the shift in Medicare can make facilitation in telehealth and sort of convenience-based services. Currently, the NSW government agency is also working with multidisciplinary teams to deliver the services related to chronic illness through telemedicine. Telehealth can support expert development, education, and improved network among doctors.

References for Public Health Informatics

Certified Health Informatician Australia (n.d.). Health Informatics Certification: https://www.healthinformaticscertification.com/

Hinde N. (2020). Hopelessness is a heavy feeling. Huffpost, U.K Edition. 

Klonoff, D. C. (2020). The Coronavirus 2019 Pandemic and Diabetes: An International Perspective.

Liang, Z. C., Wang, W., Murphy, D., & Hui, J. H. P. (2020). Novel coronavirus and orthopedic surgery: early experiences from Singapore. The Journal of bone and joint surgery. American volume.

Merclean, R. (2015.) Electronic health records (EHR) competency model http://www.healthpronet.org/docs/2011-04_Merclean-JBS.pdf

NBN guide to health in the home (2019) https://www.nbnco.com.au/content/dam/nbnco2/documents/nbns-guide-to-health-in-the-home.pdf

Ohannessian, R. (2015). Telemedicine: potential applications in epidemic situations. European Research in Telemedicine/La Recherche Européenne en Télémédecine4(3), 95-98.

Ohannessian, R., Duong, T. A., & Odone, A. (2020). Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: a call to action. JMIR public health and surveillance6(2), e18810.

Phelan, A. L., Katz, R., & Gostin, L. O. (2020). The novel coronavirus originating in Wuhan, China: challenges for global health governance. Jama323(8), 709-710.

Smith, A. C., Thomas, E., Snoswell, C. L., Haydon, H., Mehrotra, A., Clemensen, J., & Caffery, L. J. (2020). Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). Journal of telemedicine and telecare, 1357633X20916567.

Wu, C., Chen, X., Cai, Y., Zhou, X., Xu, S., Huang, H., & Song, J. (2020). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA internal medicine.

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