eHealthcare: The Self-Serve world of Health 2.0
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Discussion: Call for new research – the emergence of ehealth & a health 2.0...

Discussion: Call for new research – the emergence of ehealth & a health 2.0

This is an increasingly innovative area for research, design, commerciality and ‘everyday’ interaction. The area leads on from other discussions about ‘eCitizens’, website analysis related to ehealth (e.g. Clinical Websites that are ‘dangerous to health’ Roberts JM, Copeland, KL Int. Jnl. Medical Informatics 62 (2001) 181-187), or as a ‘Health 2.0’. To date, my own work reviews various online health portals as patients seek information about health and wellbeing as part of elective surgeries overseas (see Lunt et al. 2009). Part of the aim (and responsibility) of current research is to set up important questions and directions for possible future investigations.

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  • 1. 
 Summary
Paper
 eHEALTHCARE
–
The
self‐serve
world
of
Health
2.0
 
 November,
2009
 
 Author:
Dr
Mariann
Hardey
 Subject
matter:
Social
media,
web
platforms,
patients,
health
professionals,
web
 information,
user‐generated
content,
user‐reviews,
consumer,
e‐healthcare,
self‐ service,
medical,
wellbeing,
online
portals,
pro‐active
patient,
medical
informatics
 
 Type
of
paper:
Discussion
Topic
 Specification:
The
patient
as
consumer;
‘self
service
model’
of
health
care;
medical
&
 wellbeing
online
portals
 
 Relevance:
This
is
an
increasingly
innovative
area
for
research,
design,
 commerciality
and
‘everyday’
interaction.


The
area
leads
on
from
other
 discussions
about
‘eCitizens’,
website
analysis
related
to
ehealth
(e.g.
Clinical
 Websites
that
are
‘dangerous
to
health’
Roberts
JM,
Copeland,
KL
Int.
Jnl.
 Medical
Informatics
62
(2001)
181‐187),
or
as
a
‘Health
2.0’.
To
date,
my
own
 work
reviews
various
online
health
portals
as
patients
seek
information
about
 health
and
wellbeing
as
part
of
elective
surgeries
overseas
(see
Lunt
et
al.
 2009).

Part
of
the
aim
(and
responsibility)
of
current
research
is
to
set
up
 important
questions
and
directions
for
possible
future
investigations.

 
 Discussion:
Call
for
new
research
–
the
emergence
of
ehealth
&
a
health
2.0
 
 Social
media,
and
in
particular
the
social
platforms
that
we
label
as
a
‘Web
2.0’
e.g.
 Social
Network
Sites
(SNSs),
blogs,
forums,
user‐review
sites
etc.
have
opened
up
 new
mediations
(Hardey,
2007;
2009b)
between
people
as
‘patients’
and
‘health
 professionals’.

In
addition
these
provide
new
forms
of
access
to
health
related
 resources
as
well
as
forums
for
community
based
discussions
and
reviews
of
 services.

Recently,
the
social
commentator
Andrew
Keen
(2005)
has
cautioned
users
 of
the
web
about
the
loss
of
expert
and
specialist
guidance
amid
such
a
diversity
of
 information.

This
discussion
seeks
to
describe
the
types
of
resources
that
non‐ medical,
or
‘lay’
users
access
for
health
information.

By
doing
so,
I
also
seek
to
 identify
the
need
for
more
research
into
this
area,
as
well
as
dialogue
with
health
 professionals
and
the
commercial
sector.
 


 The
web
provides
a
range
of
access
points
(via
mobile
phones,
PCs
etc.)
and
options
 for
health
and
medical
information.

By
‘surfing
the
web’
patients
have
become
 
 1

  • 2. ‘consumers’
of
health
information,
as
they
seek
to
access
data,
purchase
health
 products,
post
to
discussion
forums,
share
experiences,
join
member
only
pages,
 read
advertisements
and
so
forth
(c.f.
Lunt
et
al.
2009).

The
preference
for
elective
 procedures
represent
one
means
by
which
consumer
patterns
have
changed
in
 terms
of
health
care
information
and
provision.
Increasingly,
individuals
are
 influenced
by
the
number
of
reviews
of
a
product,
the
trust
invested
in
other
users
 and
marketing
strategies
e.g.
‘personalised
suggestions’
from
websites
such
as
 Amazon.com
(e.g.
Hardey,
2009;
Hardey
&
Hardey
2009).

To
Google
‘surgery
 abroad’,
or
‘cosmetic
enhancement’,
or
a
particular
elective
procedure
such
as
 ‘breast
augmentation’
opens
the
consumer
to
an
array
of
social
media
options
and
 increasingly
participatory
platforms
where
they
can
interact
with
other
‘patients’
 and
medical
‘experts’.


There
is
often
little
guidance
about
the
validity
of
such
 information
either
in
the
management
of
content,
or
how
both
patients
and
medical
 professionals
should
treat
such
mediations
(see
also
Lunt
el
al.
2009).

Where
once
 the
web
was
as
seen
as
a
static
series
of
pages
with
the
user
‘detached’
from
the
 main
resources,
today
Web
2.0
encourages
users
to
share
information
and
to
affect
 their
own
decisions,
consumer
practices
etc.
with
access
to
a
particular
service,
 resource
or
information
(c.f.
Leadbeater,
2007;
2008).



 
 The
conditions
that
have
involved
the
emergence
of
Web
2.0
and
medical
 information
involve,
commercially
led
organisations,
the
media
as
well
as
more
 official
Government
agencies
including
national
health
services.

What
is
important
 to
note
is
that
there
is
no
standard
or
official
representation
to
adhere
to
for
either
 patients
or
health
professionals.
Indeed,
some
sites
have
‘dead’
links,
making
them
 hard
to
navigate
and
provide
confusing
and/or
poor
quality
information
(e.g.
 Hernández‐Borges
and
Macías‐Cervi
(1999),
and
where
much
of
the
emphasis
is
 given
over
to
the
promotion
of
advertising
space.
In
contrast
other
sites
may
provide
 content
based
on
evidence‐based
medicine
but
require
a
good
English
reading
ability
 on
the
part
of
users.

The
digitisation
of
medical
records
that
are
made
available
to
 practitioners
within
healthcare
organisations
has
been
accompanied
by
initiatives
 such
a
Goole’s
health
records,
which
can
be
created
by
individual
users.


Such
 resources
highlight
the
potential
for
increasing
social
and
health
inequalities
as
more
 health
information
and
services
move
onto
the
web.



 
 Generally
websites
visited
are
viewed
by
consumers
who
search
for
information
with
 ‘something’
to
do
with
‘health’,
‘medicine’,
‘treatment’,
‘surgery’
‘wellbeing’
and
so
 forth,
and
which
relate
to
broad
and
open
definitions.

Such
tags
are
underwritten
 through
the
software
code
that
strives
to
deliver
information
that
a
know
user
may
 require
(Hardey
and
Hardey,
2009).


In
addition
sites
that
provide
patient
reviews
of
 health
resources
and
individual
practitioners
are
continuing
to
grow,
such
the
site,
 ratemds.com
that
allows
patients
to
rate
and
read
about
professional
health
 practitioners.
Therefore,
the
consumer,
or
‘pro‐active
patient’
is
expected
to
be
 responsible
for
his/her
health
and
to
have
sought
the
‘right’
information
to
inform
 lifestyle
choices
(Entwistle
et
al,
1998;
Giddens,
1990).

In
other
words,
these
 patients
face
the
possible
risk
of
making
‘wrong’
as
well
a
‘right’
choices
on
the
basis
 of
information
that
may
be
largely
gathered
from
the
web.
The
pro‐active
patient
 
 2

  • 3. may,
for
example,
feel
that
they
‘know’
a
doctor
and/or
service
on
the
basis
of
other
 patients’
experiences
before
they
have
visited
a
specific
clinic.
Particularly
if
the
 services
offered
are
for
elective
procedures
overseas.
In
addition,
in
the
light
of
the
 proliferation
of
information
from
other
pro‐active
patients,
the
marketing
and
 pharmaceutical
industries
as
well
as
medical
practitioners
there
greater
need
for
 people
to
be
not
only
web
literate,
but
also
have
confidence
in
the
health
 information
that
they
access.

Such
literacy
may
now
include
the
need
to
be
aware
of
 how
code
may
shape
the
information
that
they
access
(Lash,
2002).
 
 In
sum,
there
is
a
range
in
the
quality
and
usability
of
the
web‐based
resources
 available
to
visitors
of
medical,
health
and
wellbeing
websites
and
services.

The
 consultation
of
one
source
is
unlikely
provide
the
reliable
health
information
(see
 also
Kim
et
al.
1999).


As
a
result,
the
role
of
the
consumer
as
a
pro‐active
patient
 has
become
one
of
a
participator
based
on
his/her
inter/active
engagement.
Here
 the
selection,
assessment
and
contribution
of
information
is
important
(c.f.
Lash,
 2002).

Moreover,
how
such
resources
may
provide
an
effective
and
efficient
way
of
 providing
knowledge
and
services,
must
be
carefully
observed
and
analysed.


 
 References:
 Boyer,
C,
Selby,
M.,
Scherrer,
J.R.,
Appel,
A.D.
(1998)
The
health
on
the
net
code
of
 conduct
for
medical
and
health
websites
‐
Computers
in
biology
and
medicine
–
 Elsevier.
 Chen,
J.S.,
Prebensen,
N.,
Huan,
T.C.

(2008)
Determining
the
motivation
of
wellness
 travellers,
Anatolia
19
(1),
pp.
103‐115.


 
 Connell
J.
(2006)
Medical
tourism:
Sea,
sun,
sand
and
...
surgery,
Tourism
 Management,
27
(6),
pp.
1093‐1100.

 Duan,
W.
Gu,
B.,
Whinston,
A.B.
(2008)
‘Do
online
reviews
matter?—An
empirical
 investigation
of
panel
data’

‐
Decision
Support
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 Entwistle,
V.
A.,
Sheldon,
T.
A.,
Sowden,
A,
and
Watt,
I.
S.
(1998)
“Evidence‐
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 patient
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Care,
 14(2)
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 Eysenbach,
G.,
Diepgen,
T.L.
Gray,
G.A.,
Bonati,
M.
(1998)
‘Towards
quality
 management
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medical
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on
the
internet:
evaluation,
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 Medical
Journal,
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‐
bmj.com.
 Giddens,
A.
(1990)
The
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 Hardey,
M.

(March
2007)
‘Going
Live:
Converging
Mobile
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 Sociability
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Media/Culture
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http://journal.media‐ culture.org.au
 Hardey,
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‘Technology,
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in
 S.J.N.
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 Boston:
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  • 4. Hardey,
M.
(2008)
‘The
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no.
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 4