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The Internet and Health:
 Controversies and Opportunities




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The Internet and Health:
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The Internet And Health : Controversies and opportunities

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Topics around patients use of Health Information in Internet

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The Internet And Health : Controversies and opportunities

  1. 1. The Internet and Health: Controversies and Opportunities The Internet and Health: Controversies and Opportunities Ignacio Basagoiti Director de Campusalud www.campusalud.com Proyecto Webs Médicas de Calidad www.pwmc.org
  2. 2. 2 The Internet and Health: Controversies and Opportunities Objetives Internet Quality g limit the importance of topic Experience g incite questions Proposals g promote considerations g suggest, propose solutions I am going to exclusively speak of the health information, leaving aspects like the electronic mail, the communication between health profesionals and patients, the forums and spaces of interaction and other important emergent elements like health blogs, drugs commerce and the children in the Internet
  3. 3. 3 The Internet and Health: Controversies and Opportunities Objetives An educated health care consumer is likely to get Internet better care. A “citizen-centered health system” that promotes Quality health, requires informed patients capables to take Experience their own decisions about your health. Proposals tree of Knowledge The Internet as theTree of Knowledge
  4. 4. 4 The Internet and Health: Controversies and Opportunities Objetives Connected users Internet Quality Experience Reino Unido Nov 2002 Suecia Proposals Finlandia Portugal Austria Holanda Luxemburgo Italia Irlanda Francia España 31 Grecia Alemania Dinamarca Nº de individuos Belgica Fuente:EGM, 2003 UE 43 0 20 40 60 80
  5. 5. 5 The Internet and Health: Controversies and Opportunities Objetives Algunos datos ciudadanos conectados Internet (América Latina) Quality Argentina Bolivia Experience Brasil 14,3 Chile Proposals Colombia Cuba Rep Dominicana Ecuador El Salvador Guatemala Honduras Nicaragua Mexico Panama Paraguay Peru Puerto Rico 22,8 Uruguay Venezuela Total 0 1 2 3 4 5 Octubre 2003 http://global-reach.biz/globstats/refs.php3
  6. 6. 6 The Internet and Health: Controversies and Opportunities Objetives Algunos datos Citizen conected Internet Quality Experience 20,7 17 Proposals 44,1 millones (39,8 spanish speakers) 74,8 millones (60,5 spanish speakers) 22,8 + 14,3 =37,1 Nov 03
  7. 7. 7 The Internet and Health: Controversies and Opportunities Objetives Internet Who, What and Why access to medical information? Quality Experience Proposals “Health seekers” — Internet users who search online for information on health topics, whether they are acting as consumers, caregivers, or e-patients
  8. 8. 8 The Internet and Health: Controversies and Opportunities Objetives Internet Who? Who, What and Why access to medical information? Quality Experience Use of Internet to look Proposals for health information Eurobarometro 2003 (58.0) 50 45 40 35 30 25 20 15 10 5 0 UE B DK D GR E FR IR IT LX NL A P FIN S UK
  9. 9. 9 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Spanish Health-Seekers os all those online, years 2003-2005. Experience Proposals 2005 28% 2004 23% 2003 18% 0% 5% 10% 15% 20% 25% 30% Source: SIBIS 2004, INE 2003 & 2005
  10. 10. 10 The Internet and Health: Controversies and Opportunities Objetives Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience Proposals
  11. 11. 11 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Global use of the Internet vs search health information, last tree months, by age. Experience Millares 16000 Proposals 14000 12000 10000 8000 6000 4000 2000 0 Total 15-24 25-34 35-44 45-54 55-64 65-74 >74 Total 15-24 25-34 35-44 45-54 55-64 65-74 >74 Total 15.131.420 4.207.916 4.799.150 3.382.589 1.791.724 780.737 144.617 24.685 Salud 4.255.720 867.193 1.467.377 1.161.245 516841 202288 35286 5489 Source: INE 2005
  12. 12. 12 The Internet and Health: Controversies and Opportunities Objetives Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience g Main number of the Internet users and health- seekers Proposals are between 25 and 34 years.
  13. 13. 13 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Percentage of the Internet users that search health information last tree month of whole poblation and online poblation, by gender. Experience 30,9 Proposals 35 28,13 25,84 30 25 20 15 10 5 0 Total Hombres Mujeres % de poblacion total 4,87 9,85 9,45 % de usuarios de Internet 28,13 25,84 30,9
  14. 14. 14 The Internet and Health: Controversies and Opportunities Objetives Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience g Main number of the Internet users and health- seekers Proposals are between 25 and 34 years. gWomen online search health information more than men (30,9 vs 25,8)
  15. 15. 15 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Percentage users who search health information last tree years of whole population and online population by age groups. Experience 35 Proposals 30 25 20 15 10 5 0 Total 15-24 25-34 35-44 45-54 55-64 65-74 >74 % de poblacion total 4,87 16,15 19,07 16,3 9,15 4,36 0,92 0,16 % de usuarios de Internet 28,13 20,61 30,58 34,33 28,85 25,91 24,4 22,24
  16. 16. 16 The Internet and Health: Controversies and Opportunities Objetives Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience g Main number of the Internet users and health- seekers Proposals are between 25 and 34 years. gWomen online search health information more than men (30,9 vs 25,8) g 34% of online users betwwen 35-44 years, searched the web for health information in last tree months.
  17. 17. 17 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Percentage of use the Internet for search health information last tree Experience month of all online users, by educational level. 40 Proposals 35 30 25 20 35,18 15 28,13 26,47 27,2 22,47 10 16,65 5 0 0 E.Secundaria E.Secundaria Todas Analfabetos E.Primaria FP Superior E.Superior 1ª 2ª % salud 28,13 0 16,65 22,47 26,47 27,2 35,18
  18. 18. 18 The Internet and Health: Controversies and Opportunities Objetives Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience g Main number of the Internet users and health- seekers Proposals are between 25 and 34 years. gWomen online search health information more than men (30,9 vs 25,8) g34% of online users betwwen 35-44 years, search the web for health information in last tree months. g A higher educational level correlates a higher search for health information
  19. 19. 19 The Internet and Health: Controversies and Opportunities Objetives Internet Spain Who? Who, What and Why access to medical information? Quality Percentage of use the Internet for search health information last Experience tree month of all online users, by work situation. 40 Proposals 35 30 25 20 34,19 35,23 35,22 15 29,3 28,13 26,3 10 21,8 5 0 Activos Activos Labores Todas Estudiantes Pensionistas Otras ocupados parados hogar % salud 28,13 29,3 26,3 21,8 34,19 35,23 35,22
  20. 20. 20 The Internet and Health: Controversies and Opportunities Objetives Spain Who? Who, What and Why access to medical information? Internet g Number of spanish health-seekers has a continuous Quality increase. 28% of citizens online search the internet for health information. Experience g Main number of the Internet users and health- seekers Proposals are between 25 and 34 years. gWomen online search health information more than men (30,9 vs 25,8) g34% of online users betwwen 35-44 years, search the web for health information in last tree months. g A higher educational level correlates a higher search for health information g Housewife and pensioners online are the two groups with highest percentages of health-seekers
  21. 21. 21 The Internet and Health: Controversies and Opportunities Objetives Internet What? Who, What and Why access to medical information? Quality Experience Proposals
  22. 22. 22 The Internet and Health: Controversies and Opportunities Objetives Internet USA What? Who, What and Why access to medical information? Quality Health topics searched for by internet users Topics % of online men % of online women Experience Specific disease or medical problem 60 71* Proposals Certain medical treatment or procedure 46 57* Diet, nutrition, vitamins, nutritional supplement 43 59* Exercise or fitness 40 45 Prescription drugs or over-the-counter drugs 36 43 Health insurance 30 31 Alternative treatments or medicines 27 33 A particular doctor or hospital 27 30 Depression, anxiety, stress, mental health issues 19 26* Experimental treatments or medicines 21 24 Environmental health hazards 18 18 Immunizations or vaccinations 15 17 Sexual health information 11 11 Medicare or Medicaid 9 13 Problems with alcohol or drugs 7 9 How to quit smoking 5 10* Source: Pew Internet & American Life Project November 2004
  23. 23. The Internet and Health: Controversies and Opportunities Objetives Internet USA What? Who, What and Why access to medical information? Quality Experience Proposals
  24. 24. 24 The Internet and Health: Controversies and Opportunities Objetives Internet USA What? Who, What and Why access to medical information? Quality Experience 44% of Internet users have searched online for information about diet, nutrition, vitamins, or nutritional supplements Proposals 36% have searched online for information about exercise or fitness. Internet users between the ages of 18 and 29 are the most likely to have searched for this type of information – 51%, compared to 35% of 30-49 year-olds, 28% of 50-64 year-olds, and just 13% of Internet users age 65 or older. 34% users have ever searched online for information about prescription or over-the-counter drugs 25% have searched online for information related to health insurance.
  25. 25. 25 The Internet and Health: Controversies and Opportunities Objetives Internet USA What? Who, What and Why access to medical information? Quality Experience 80% internet users have looked online for Proposals information on at least one of 16 health topics, with increased interest since 2002 in diet, fitness, drugs, health insurance, experimental treatments, and particular doctors and hospitals. Some demographic groups showed notable interest in specific topics – 59% of online women have read up on nutrition information online, for example, compared with 43% of online men. Thirty-eight percent of online parents have checked online for health insurance information, compared with 26% of internet users who do not have children living at home. Pew Internet & American Life Project May 2005.
  26. 26. 26 The Internet and Health: Controversies and Opportunities Objetives Internet USA Why? Who, What and Why access to medical information? Quality Among other things, Internet users: Experience Research a diagnosis or prescription. Prepare for surgery or find out how best to recover Proposals from one. Get tips from other caregivers and e-patients about dealing with a particular symptom. Give and receive emotional support. Keep family and friends informed of a loved one’s condition. Find humor and even joy in a bad situation More than half of those who recently conducted searches did so on behalf of someone else — a spouse, child, friend, or other loved one — not for themselves.
  27. 27. 27 The Internet and Health: Controversies and Opportunities Objetives Internet USA Why? Who, What and Why access to medical information? Quality 57% of those who recently conducted searches did so on behalf Experience of someone else — a spouse, child, friend, or other loved one — not for themselves. Proposals parents, women, healthy people, and the middle aged between 30 and 49 years old. small group of Internet users who are living with a disability, handicap, or chronic disease. who take care of someone living in their household
  28. 28. 28 The Internet and Health: Controversies and Opportunities Objetives Internet USA Why? Who, What and Why access to medical information? Quality Experience 38% of online parents have checked online for health insurance Proposals information, compared with 26% of internet users who do not have children living at home. Caregivers who live with someone who is chronically ill or disabled, a group of searchers who make through and frequent use the Internet for health issues, are particularly likely to have searched for information about a specific treatment – 62% have done so 44% of Internet users have searched online for information about diet, nutrition, vitamins, or nutritional supplements. Some of these searches are certainly for weight management
  29. 29. 29 The Internet and Health: Controversies and Opportunities Objetives Internet Advantages Health Care Information Quality Accesibility to information: one of the most Experience important aspects of online health advice is the fact that it Proposals is available at any hour of the day or night, from wherever users are able to log on. Instantaneous Comfortable Conectivity (interaction space) Personalization: allows consumers to customize the portal interface and information preferences Anonimity: is important that Internet users can get health information anonymously
  30. 30. 30 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Accesibility oConection Experience oSpecial needs Proposals All we can = noise Not only can nearly everyone use the information, but publishing your own Web site is just as easy. This has resulted in an unprecedent proliferation of information sources on a global scale A new religion Absolutely trues, solution for whole problems, virtual sustitute...User must accept the considerable discrepancy (‘asymmetry’) in knowledge between themselves and health professionals. Credibility Information sources, scientific references Information excess–Organization chaos Where is Wally? “Plain language” Information must be comprehensible Cybercondriacs
  31. 31. 31 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Accesibility oConection Experience More than 70% world population have no access to a telephone line. Proposals Home Internet conection in Spain by kind and year Millares 5000 4000 3000 2000 1000 0 Whole homes online Phone line traditional Broadband 2003 3.599.054 2.683.193 1.275.790 2004 4.544.751 2.405.420 2.029.652 2005 4.982.199 2.124.647 2.956.752
  32. 32. 32 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Accesibility Experience Special needs oPhísicals Proposals oCognitives oEducacionals Technical adaptation to ageing changes is necessary for better usability. Additionally, cognitive, psychological and social factors are just as important for optimizing access and usage of computers by the elderly population. Low health literacy limits many users’ ability to understand what is available online
  33. 33. 33 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Experience Proposals Health .................... 4.220.000.000 Salud ....................... 136.000.000 Medicine................. 1.170.000.000 30 march 2006 Searching for information has become more difficult, and the quality of search results is often disappointing
  34. 34. 34 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Plain language” Information must be Experience comprehensible. Proposals Consumer health information should be written at a comprehensible reading level; often patients want pragmatic information sauch as how long their illsness will prevent them from working, before scientific details
  35. 35. 35 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Cyberchondriacs Quality FREQUENCY OF ACCESSING HEALTH INFORMATION ONLINE: 1998-2005 "How often do you look for information online about health topics – often, sometimes, hardly ever or never?" Base: Have access to Internet Experience 1998 1999 2001 2002 2003 2004 2005 Proposals % % % % % % % Often 12 13 16 18 17 19 25 Sometimes 30 30 30 35 37 31 33 Hardly ever 29 31 30 27 23 24 14 Never 29 26 25 20 22 26 29 Total who have looked for health or medical 42 43 46 53 54 50 58 informati on sometimes or often Total who have ever looked for 71 74 75 80 78 74 72 health or medical information
  36. 36. 35 The Internet and Health: Controversies and Opportunities Objetives Internet Problems Health Care Information Quality Cyberchondriacs Experience Adults who now look for medical data Proposals or on sanitary cares assiduously do it more than in previous years. •Although the total number of adults who have looked Health information online there are decreased, the frequency with which the North American users consult the pages Web that offer health contents increases. •Thus, 58% of the interviewed people whom they have access to Internet recognize that it looks for this class of information "some times" or "often", 50% as opposed to that it consulted these news year the past.
  37. 37. 36 The Internet and Health: Controversies and Opportunities Objetives Internet Solutions Health Care Information Quality Experience accesibility Proposals □The European Commission has been active in establishing quality criteria for Health related websites and accessibility of web sites. Patients who seek online health information may have a variety of physical impairments, and its important to develop resources that are usable by individuals with disabilities. □The Web Accesible initiative (WAI) and the spanish UNE 139803, provides guidelines for assuring broad accesibility to Internet Based Information.
  38. 38. 37 The Internet and Health: Controversies and Opportunities Objetives Internet Solutions Health Care Information Quality Experience credibility Proposals Self- regulaing policies They are the rules and guiding principles a health site follows with respect to privacy, security, editorial, and advertising. Their main problema are that often are posted as footnotes –so consumers may be unaware of their existence- , are self-proclaimed, and are not standardized. Source disclosure. By using high-quality sources, a health site can demonstrate it has the ability to gather, organize, and present quality health information and add value for consumers. If consumers trust most of the sources used by a health portal, they are likely to transfer that trust to the portal itself.
  39. 39. 38 The Internet and Health: Controversies and Opportunities Objetives Internet Solutions Health Care Information Quality Experience Acredited Search Engines Proposals The search engines, on the heels of the Web, realized that they have a real stake in making sure the results of their searches are relevant, reliable and trustworthy. Rather search engines (not specialized) promoting trustworthy health and medical sites such as Kosmix.com, mamashealth.com, Webmd.com and Healthline.com whith “touts sites that have been accredited by online Web ethics committees like the Health on the Net Foundation.”
  40. 40. 39 The Internet and Health: Controversies and Opportunities Objetives Internet g Authority, Transparency and Honesty Quality Experience g Contents: gtrustworthy, Proposals gupdated, glegible, iniciativas gadapted to the receiver • eHealth g Orientación: • Hon Code g receiver information, • Discern g segmentation (patients vs profesionals) • IHC g disclaimers, g contact facilities, • pWMC g usability • WMA
  41. 41. 40 The Internet and Health: Controversies and Opportunities Objetives iniciatives Internet HON PRINCIPLES (*) Quality 1 2 3 4 5 6 7 8 Experience WMA Proposals PWMC HON: Authority / Complementarity / Confidentiality / Attribution / Justifiability / Authorship / Sponsorship / Editorial policy . eEUROPE 2002 QUALITY CRITERIA (*) 1 2 3 4 5 6 WMA PWMC eEurope: Transparency and Honesty / Authority / Privacy / Updating / Accountability / Accesibility
  42. 42. 41 The Internet and Health: Controversies and Opportunities Objetives una duda ... Internet Quality Who must assume responsability offer health Experience information online to citizen? Proposals g goverment institutions g medical societies and organizations g patient associations(asoc. enfermos, autoayuda...) g profesional staff
  43. 43. 42 The Internet and Health: Controversies and Opportunities Objetives una duda ... Internet ...What sources of information trust european citizens? Quality Experiences 0 20 40 60 80 100 Proposals Medical societies 84,4 Org consumidores 67,2 Universities 65,5 Mass Media 39,3 Goverment 23,4 Org religious 22,9 Political org 10,7 Eurobarometro 2003 (58.0)
  44. 44. 43 The Internet and Health: Controversies and Opportunities Objetives Internet Quality En la mejora de calidad ... Experience Proposals proyect Webs Médicas de Calidad (pWMC)
  45. 45. 44 The Internet and Health: Controversies and Opportunities Objetives proyecto Webs Médicas de Calidad (pWMC) Internet Is .... Quality Experience An inter-institutional iniciative with an important Presence of scientific organizations (TSB, AEP...) Proposals Look for ... An rigurous acreditation of the Internet resources, since ethic and usability perspective Seal
  46. 46. 45 The Internet and Health: Controversies and Opportunities Objetives Internet Internet presence Quality E-journal ? Educaensalud ? Campusalud vs Experience TSBsalud Proposals web TSB Accesibility plans Online education? Experts group NTS pWMC Campusalud Prof
  47. 47. 46 The Internet and Health: Controversies and Opportunities Objetives Internet Quality A Patients Virtual Library Experience Proposals Access to credible and comprehensible health information Evidence based information Documents offers by prestige organizations User friendly and accesible tools Free log in Pattern standard defined by BIREME-PAHO/WHO A reference site where obtain trustworthy health information for citizens who consume that like for professionals who must provide it
  48. 48. 47 The Internet and Health: Controversies and Opportunities Objetives Internet Finding relevant information and ascertaining its Quality trustworthiness are two Experience inseparable concepts necessary for the web to flourish as an Proposals unpredecedent source of knowledge and continue in Conclusion helping ill patient or citizen to stay healthy
  49. 49. The Internet and Health: Controversies and Opportunities Thank you!!

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