Using internet and web technology for clinical purposes: what has been tried and evaluated; what works and what needs more work; words of caution; coming shortly - but not yet fully evaluated for clinical applications.
• Patient/clinician education and information
• Remote monitoring of chronic conditions
• Patient and family/care-giver support
• Post-discharge psychosocial support
• The Electronic Health Record
• Online collaboration
• Guides to everything
BMC Res Notes. 2012; 5: 548.
Published online 2012
Design and process
evaluation of an informative
website tailored to breast
cancer survivors’ and
intimate partners’ post-
treatment care needs
Evelyn Pauwels,1 Elke Van Hoof,2,3
Caroline Charlier,1,4 Lilian Lechner,4 and
Ilse De Bourdeaudhuij
BMC Dermatol. 2011 May 18;11:10. doi: 10.1186BMC Dermatol. 2011 May 18;11:10.
Mapping randomized controlled trials of treatments for eczema--the GREAT
database (the Global Resource of EczemA Trials: a collection of key data on
randomized controlled trials of treatments for eczema from 2000 to 2010).
Nankervis H, Maplethorpe A, Williams HC.
“An international, publically available and comprehensive
resource which brings together all randomized controlled trials
on eczema treatment using a highly sensitive search has the
potential to release more filtered knowledge about patient
care to those who need it most and to significantly shorten the
duration and costs of many clinical eczema research and
The database can be accessed free of charge at
• Demographics – potential user profiles
• Information in context
• Ability to interpret information
• Ability to appraise information
• “incomplete and impersonal”
Need for selection and direction
Roughly 13% of your screen will display actual results; the rest will be
taken over by ads and other unsolicited activity.
Untangling the Web — Patients, Doctors, and the Internet
Pamela Hartzband, M.D., and Jerome Groopman, M.D.
N Engl J Med 2010; 362:1063-1066
March 25, 2010DOI: 10.1056/NEJMp0911938
“The benefits, though, must be weighed
against the potential negative effects of
receiving clinical data without context. Patients
and families may be confused by results and
worried that minor abnormalities might
portend serious consequences.”
Conclusion: The study demonstrates that online counseling
via e-mail reaches patients with unmet therapeutic
needs, but also indicated its limitations, suggesting that the
online setting may be most useful for prompting and
supporting a transition to conventional counseling
January 1 2011 | Volume 8 | ppg Doc05
Online counseling via e-mail for breast cancer patients on the German
internet: preliminary results of a psychoeducational intervention.
David N, Schlenker P, Prudlo U, Larbig W
The Western Journal of Emergency Medicine
November 1 2011 | Volume 12 | Issue 4 | ppg 442-7
Can emergency medicine residents reliably use the internet to answer clinical questions?
Krause R, Moscati R, Halpern S, Schwartz DG, Abbas J
SVHG Clinical Information Portal
A single entry point for communication and
access to all clinical information required for
patient care in SVHG.
Current discussions with Pharmacy and ICT.
CONCLUSIONS: While the smartphone's role in medicine
and education appears promising and exciting, more
high-quality studies are needed to better understand the
role it will have in this field. We recommend popular
smartphone applications for physicians that are lacking in
evidence and discuss future studies to support their use.
Journal of Medical Internet Research
January 1 2012 | Volume 14 | Issue 5 | ppg e128
The smartphone in medicine: a review of current and potential use among
physicians and students.
Ozdalga E, Ozdalga A, Ahuja N
“… application would allow workers to log into a
Web-based service which hosts all the programs
the user would need for his or her job. Remote
machines owned by another company would
run everything from e-mail to word processing
to complex data analysis programs.”
You may not have asked to be
added to Google maps, but
it’s up to you to try to correct
it. And this isn’t easy.
Harnessing the cloud of patient experience: using social media to detect poor quality
Felix Greaves, Daniel Ramirez-Cano, Christopher Millett, Ara Darzi, Liam Donaldson
BMJ Qual Saf 2013;22:3 251-255 Published Online First: 24 January 2013
BMJ Qual Saf doi:10.1136/bmjqs-2012-001744
Editorial: Patient-centred healthcare, social media and the internet: the perfect storm?
Ronen Rozenblum, David W Bates
“In the past, healthcare was managed mainly via interpersonal communication between
the caregiver and the patient, while today, social media offers different modes of
interaction. For example, Facebook has become a significant source of healthcare
information, such as specific data about health conditions and healthcare facilities,15
and blogs have become a powerful communication tool to disseminate health
information and engage patients with their care. Researchers have found that, based on
the data posted on Twitter, they can detect an array of types of activity, most notably
disease outbreaks such as cholera and influenza,16 ,17 but more recently, data about
issues like headache appearance.18”
• Earlier this year a Harvard professor was able to re-identify
individuals in a genetics database by cross referencing with public
records, with an accuracy rate of 42% if only three types of
information - zip code, date of birth and gender - were
present, rising to 97% when first name or nickname - information
that could easily be extracted from many email addresses - was
Data security and privacy: can we have both? Companies store copies
of information in multiple locations to minimise the risk of data
loss, but does our right to privacy suffer as a result?
Email : John Burn-Murdoch; theguardian.com, Wednesday 31 July
2013 07.30 BST
References & bibliography1: Ryhänen AM, Rankinen S, Tulus K, Korvenranta H, Leino-Kilpi H. Internet based
patient pathway as an educational tool for breast cancer patients. Int J Med
Inform. 2012 Apr;81(4):270-8. doi: 10.1016/j.ijmedinf.2012.01.010. Epub 2012 Feb
22. PubMed PMID: 22361159.
2: Kaufman N. Internet and information technology use in treatment of diabetes.
Int J Clin Pract Suppl. 2010 Feb;(166):41-6. doi:
10.1111/j.1742-1241.2009.02277.x. Review. PubMed PMID: 20377663.
3: Hill-Kayser CE, Vachani C, Hampshire MK, Metz JM. High level use and
satisfaction with internet-based breast cancer survivorship care plans. Breast J.
2012 Jan-Feb;18(1):97-9. doi: 10.1111/j.1524-4741.2011.01195.x. Epub 2011 Nov 20.
PubMed PMID: 22098063.
4: Pauwels E, Van Hoof E, Charlier C, Lechner L, De Bourdeaudhuij I. Design and
process evaluation of an informative website tailored to breast cancer survivors'
and intimate partners' post-treatment care needs. BMC Res Notes. 2012 Oct
3;5:548. doi: 10.1186/1756-0500-5-548. PubMed PMID: 23034161; PubMed Central
5: Wakefield DS, Kruse RL, Wakefield BJ, Koopman RJ, Keplinger LE, Canfield SM,
Mehr DR. Consistency of patient preferences about a secure internet-based patient
communications portal: contemplating, enrolling, and using. Am J Med Qual. 2012
Nov-Dec;27(6):494-502. doi: 10.1177/1062860611436246. Epub 2012 Apr 18. PubMed
6: Krause R, Moscati R, Halpern S, Schwartz DG, Abbas J. Can emergency medicine
residents reliably use the internet to answer clinical questions? West J Emerg
Med. 2011 Nov;12(4):442-7. doi: 10.5811/westjem.2010.9.1895. PubMed PMID:
22224135;PubMed Central PMCID: PMC3236170.
7: Miller DM, Moore SM, Fox RJ, Atreja A, Fu AZ, Lee JC, Saupe W, Stadtler M,
Chakraborty S, Harris CM, Rudick RA. Web-based self-management for patients with
multiple sclerosis: a practical, randomized trial. Telemed J E Health. 2011
Jan-Feb;17(1):5-13. doi: 10.1089/tmj.2010.0133. Epub 2011 Jan 9. PubMed PMID:
21214498;PubMed Central PMCID: PMC3064874.
8: Miller DM, Fox R, Atreja A, Moore S, Lee JC, Fu AZ, Jain A, Saupe W,
Chakraborty S, Stadtler M, Rudick RA. Using an automated recruitment process to
generate an unbiased study sample of multiple sclerosis patients. Telemed J E
Health. 2010 Jan-Feb;16(1):63-8. doi: 10.1089/tmj.2009.0078. PubMed PMID:
20064056;PubMed Central PMCID: PMC2998972.
9: Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current
and potential use among physicians and students. J Med Internet Res. 2012 Sep
27;14(5):e128. Review. PubMed PMID: 23017375; PubMed Central PMCID: PMC3510747.
10: Mosa AS, Yoo I, Sheets L. A systematic review of healthcare applications for
smartphones. BMC Med Inform Decis Mak. 2012 Jul 10;12:67. doi:
10.1186/1472-6947-12-67. Review. PubMed PMID: 22781312; PubMed Central PMCID:
11: Timm J, Renly S, Farkash A. Large scale healthcare data integration and
analysis using the semantic web. Stud Health Technol Inform. 2011;169:729-33.
PubMed PMID: 21893843.
12: Park JB, Choi HJ, Lee JH, Kang BS. An Assessment of the iPad 2 as a CT
Teleradiology Tool Using Brain CT with Subtle Intracranial Hemorrhage Under
Conventional Illumination. J Digit Imaging. 2013 Aug;26(4):683-90. doi:
10.1007/s10278-013-9580-0. PubMed PMID: 23404630; PubMed Central PMCID:
13: Bradley WG Jr. Teleradiology. Neuroimaging Clin N Am. 2012 Aug;22(3):511-7.
doi: 10.1016/j.nic.2012.05.001. Epub 2012 Jun 24. Review. PubMed PMID: 22902118.
14: Maclean DL, Heer J. Identifying medical terms in patient-authored text: a
crowdsourcing-based approach. J Am Med Inform Assoc. 2013 May 5. [Epub ahead of
print] PubMed PMID: 23645553.
15: Cueva M, Kuhnley R, Slatton J, Dignan M, Underwood E, Landis K. Telenovela:
an innovative colorectal cancer screening health messaging tool. Int J
Circumpolar Health. 2013 Aug 5;72. doi: 10.3402/ijch.v72i0.21301. Print 2013.
PubMed PMID: 23930245; PubMed Central PMCID: PMC3736451.
16: Hartzband P, Groopman J. Untangling the Web--patients, doctors, and the
Internet. N Engl J Med. 2010 Mar 25;362(12):1063-6. doi: 10.1056/NEJMp0911938.
PubMed PMID: 20335581.