Web 2.0 and Health by Michael Hardey

Health and Web 2.0 Programa de la Sessió Tècnica Salut i Web 2.0 Michael Hardey Hull/York Medical School [email_address]

What is Web 2.0 ? It is a term that is used to signify an underlying shift in the basis of the Web: From a situation where users are predominantly consumers or readers of content to one in which they increasingly generate content We are all consumers and producers on Web 2.0

eHealth web 2.0: Evolution and change eHealth 1.0 (1992-2004/5) Data between experts and agencies, information designed for patients eHealth 2.0 (2004/5- beyond) ‘ Read’ Mode ‘ Write’ & Contribute Information delivery, telemedicine Quality of information… Primary focus Main issue Information consumption Surveillance, quality, data access… ‘ Static’ State ‘ Dynamic’ Web browser Viewed through… Browsers, RSS Readers, anything Organisations, State agencies Content Created by… Anyone – user generation ‘ Experts’ Domain of… ‘ Everyone’

Web 2.0 is about The Social Web

Lets look at some examples Social Networking Podcats Wikis Blogs Second Life All the data and applications are located remotely – not on the user’s PC

Social Network Sites - SNSs Groups can be formed in SNSs that users may join All can contribute in content Demographic of general SNSs under 30 years Some SNSs aimed at older people, professional groups etc

Podcasts Portable, cheap to produce for the public Can easily deliver current awareness information to busy health professionals Easy to find and use -listen on the go and on demand Good for those with reading or sight difficulties

Wiki An online resource which allows users to add and edit content collectively Usually free and easy-to-learn and use Can have misleading information – but can be moderated

Blogs No need to know html coding No need to find server space Usually free Allow interactivity and sharing Easy to read and write

Second Life A virtual world – users make an avatar and can build houses, interact with others… A discussion about sexuality held at a the University of Plymouth’s ‘health info island’. The centre has books, films and other media that can be viewed by visitors 27.5 percent of active Second Life users 18-25 years

Some themes User-generated data Central to many of these resources – SNSs are only useful because of the data that people contribute Users are at the centre of web 2.0 resources Can be accessed through mobile devices e.g. mobile phones

The new cartography Maps – previously need costly equipment and expertise Maps ‘make sense’ of complex data through visualisation Since 2005 detailed global maps that include satellite and conventional geopolitical projections have freely been available through – YahooMaps Microsoft’s Virtual Earth and GoogleMaps Mashups - the result of using an application that combines content from more than one data source into an integrated, representation - a ‘Do-It-Yourself’ geographic information system (GIS).

Is crime a health issue? Daily crime reports (public in some Sates in USA, Poland…) geolocated on a map. You can search fro your street View details of a crime… Not available in UK – as public have no access to such detailed and current data.

User generated crime data This is a user generated crime map from Brazil where there is not access to official crime data Like ‘whoissick’ users put information on the site and locate it by means of a postal code

Pollutant monitors Real time data can be delivered that is layered onto maps. Can shape individuals choices about where to live…

Location matters Accessed through mobile device These locate the user via GPS or phone network Location aware resources Can inform, for example, a person with chronic asthma that they are about to entre street with poor air quality

User review sites Users write about their experiences of e.g. a hotel User can rate it on a scale We can all read the reviews and decide where we would like to stay We like these sites - over 7 million visits a month from USA alone

Health service rating sites ‘ Patient opnion.org’ Funded from subscriptions from NHS providers UK based Users can write comments on services but no individual is identified

Doctor rating sites Based in USA Under USA law site owners are not responsible for the information put there by users Data taken from the Web about individual doctors Users can write comments Users can use a five point scale to rate a doctor

User reviews We know health is a commodity… In a market based health system health products and services are directly marketed at consumers If we make choices based on review sites we may have more trust in the service we receive But ‘popular’ doctors/services may not be able to manage the demand What is the impact on the doctor-patient/consumer relationship? Are we sure the reviews are true? How would you feel to find yourself on such a site?

Part of empowerment? ‘ As Member States try to contain healthcare cost and the paternalist model of "doctor-knows-best" is eroded, patients want to learn about their condition, its treatments, and preventative measures…. The underlying philosophy of e-health is to empower the individual to look after his/her own health most effectively’ (UK Parliamentary Select Committee on European Union 2000) Will consumer/patients want to make choices based on user review information?

More themes Software and other material are located remotely – no applications reside on the user’s computer It is global – so, for example, ‘RateMD’ is based in California and not subject to the legal or professional systems of Canada, UK … It is mobile – can be accessed by any networked device A social as opposed to economic cost in that the more individuals create, use or contribute to them the more useful, attractive and innovative the resource becomes

Not everyone is (or wants to be) connected Digital divide - individuals with no or little connection to the Internet e.g. older people, those living in poverty. Highlights need to recognise some groups will need ‘old’ - that is not Internet based information services. As health information and choices move online a risk that paper and face-to-face services - that may become residual or lack support This may reinforce established patterns of exclusion and ill health Points to role for broader ‘get connected’ initiatives e.g. older people need access to the technology but also help in learning how to use it. Once they are online the evidence suggests they feel less isolated, better informed – empowered

Opportunities Web 2.0 - Simple and cost effect way publishing information and advice about health Can target some ‘hard to reach’ groups e.g. sexual health information to young people through SNSs or Second Life… Help people – choose services – find medical help through map based visualisations Can engage with the public (and staff) through blogs, podcasts, wikis… Places the user at the centre of service provision

Demands on us as healthcare providers and educators To make use of Web 2.0 for our patients and public – if we do not others will To provide high quality interactive information across a range of platforms – blogs, maps, podcasts …. To welcome and make productive use of user-generated data To recognise we have new was of communicating quickly with To enhance the promotion of health and the quality of health services

Predictions? ‘ Computers in the future may weigh no more than 1.5 tons.’ - Popular Mechanics, 1949 ‘ There is no reason anyone would want a computer in their home.’ - Ken Olson, 1977 President and founder of Digital Equipment Corp. Mobile devices will be a major platform for connecting to the Internet worldwide - Japan: happened already Health providers will use Web 2.0 to communicate with citizens – faster and better Health information becomes more personalised ‘ Disconnect’ holidays regularly prescribed by your doctor?

Examples Wikis GANFYD - www.ganfyd.org -expert moderated version of wikis Medicine - http://davidrothman.net/list-of-medical-wikis/ Podcasts Johns Hopkins - www.hopkinsmedicine.org/mediaII/Podcasts.html SNSs Nursing for nursing professionals - LinkUp-http://nurselinkup.com-online Sermo - American Medical Association (AMA) social network - http://www.sermo.com- Hardey, M. (2008) Public health and Web 2.0, Journal of the Royal Institute of Health Promotion 128(4):171-179

Web 2.0 and Health by Michael Hardey

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Web 2.0 and Health by Michael Hardey