Late last week, Susannah Fox of the Pew Internet & American Life project announced
that the nonprofit had updated its statistics on the number of adult Americans using the Internet. Currently, 73 percent are Web users. Of this group, three-quarters have looked for health or medical information online. Fox notes that regardless of whether the number of online health searchers increases or decreases from year to year, “Internet users are doing something [and] the horse is out of the barn.” The growing power of the Internet has generated enthusiasm in some and dismay in others. It has also exacerbated long-standing tensions between patients and medical professionals –- especially physicians. For example, in a famous Time magazine essay, Dr. Scott Haig admonished some medical “Googlers” for possessing a wealth of information, but lacking the expertise to interpret it correctly.
James Cooley works for a big Texas state agency doing health care policy analysis and research, with a specialty in health care IT. His research and analysis projects cover e-prescribing, telemedicine, EHR & PHR and beyond. That is his way-cool day gig. At night, he is a passionate computer gamer who builds his own custom rigs and struggles to squeeze out a few more frames per second with everything maxed out.
I admit to a fascination with Health 2.0. I see it as the place where a lot of the things that look promising in health care and technology are all mashing together.
As a follower of developments in both the health 2.0 movement and the gaming industry, I came across the following article that piqued my interest. It deals with the deal reached between Netflix and Microsoft to facilitate movie downloads to those using the XBOX Live network.
Reading this, I got to thinking it might have implications for Health 2.0. The question: Why not use these emerging gaming and movie delivery platforms to deliver interactive health care and fitness content.
Hmm, I wondered further: Would Netflix consider a deal with Microsoft to permit XBOX 360 users access to free download of certain interactive health care information content? I could see modules for management of certain diseases (including those that impact young people, such as asthma). There could also be modules with health and fitness activities that incorporate interactive video and gaming elements.
I am known for throwing an occasional “Dude” into my jocular speech. Ok, maybe more than a couple when excited. OK, maybe more than a couple when I am not so excited as well. OK, maybe I use it indiscriminately at random times. But hey, I am just following Merriam-Webster definition of the appropriate usage of the term “practically anywhere” within a sentence.
But dude! Have you actually read the recent GAO reports regarding the status of the current VistA modernization project? I was literally shocked – let me save you the trauma by pulling in the highlights (where is WorldVistA, VistA Software Alliance, Roger Maduro, or any of the VistA luminaries in terms of reporting on this?)
Two of the new data points relate to health and health care. The October-December 2007 national phone survey shows that 75 percent of internet users answered yes to the single-line question, "Do you ever use the internet to look for health or medical information?"
Ten percent of internet users say they searched for health information "yesterday," which in a tracking survey like this one yields a picture of the "typical day" online. Health has moved up in the "typical day" list (from 7 percent in 2006 to the current 10 percent of internet users), but for most people the average day includes lots of emails (60 percent of internet users), general searches (49 percent), and news reading (39 percent) if they are online at all (30 percent of internet users are offline on a typical day).
Yesterday, Google launched Knol, immediately branded as Google’s answer to Wikipedia. As health care adviser to the project, I’ll say a few words about Knol, but focus on how it – and other forms of electronic self-publishing – may signal the end of medical publishing as we have known it.
First, a word about Knol (the name is short for “a unit of knowledge”). Google’s vision is that providing a tool for people to write about “things that they know” will make the world a better place. Unlike Wikipedia’s anonymous, collaborative writing/editing process, Knols have authors, with names, faces, and reputations. (Authors can choose to have their identity verified, through a cross-check on their credit card or phone records.) Google provides Knolers a tool; authors enter their content and click “publish.” And poof, there it is, on the Web. Users can rate and comment on Knols, send them to friends, and suggest changes. But the author remains the sole owner of the content, able to update and modify it (or remove it) at any time.
The Facebook/MySpace generation is now graduating from medical school, and their
profiles along with much embarrassing personal information has been indexed in cyberworld for many to see.
The Associated Press wrote an interesting story about how researchers from the University of Florida combed through the social web sites and found embarrassing pictures of future doctors “grabbing their breasts and crotches or posing with a dead animal. They also found many photos of students drinking heavily.”
About half of the medical students they looked at had Facebook pages but only 37 percent of those limited viewership.
Clearly, the take-home message is to refrain from putting things you wouldn’t want your mother to see on your profile and to restrict who can see your profile.
Still, the info is out there. Perhaps, doctor rating sites could incorporate this readily accessible information onto their physician profiles. That would be scary.
Joshua Seidman is the president of of the Center for Information Therapy
that aims to provide the timely prescription and availability of evidence-based health information to meet individuals’ specific needs and support sound decision making.
I had a fun meeting recently with some smart folks from the Robert Wood Johnson
Foundation that raised questions about Ix that could use some clarification. When we talk about information therapy (Ix), we often drift into “evidence-based information” to help with some specific health condition.
That certainly is an important component of Ix, but it’s too limiting in many circumstances. When we talk about the “proactive delivery of the right information to the right person at the right time,” that has to encompass whatever the information needs of the consumer are.
One of the fun parlor games of Election ’08 is to look at Internet data and figure out what they mean.
The answer may be "nothing," of course.
But let’s play along and look at the latest Hitwise data on popular search terms. HitWise, a company that tracks Internet traffic, counted the search words that sent people to John McCain or Barack Obama’s websites. [Here’s a press release about the findings on the candidates’ top Internet search terms.]
"Health care" didn’t make Obama’s top 5 search terms in the first quarter of 2008. In the second quarter, health care took the number 4 slot. [Q1’s top term was "gay marriage," Q2’s "abortion."]
Meantime, "health care" took the tops spots for John McCain in both Q1 and Q2.
So: Does this mean people think they already know Obama’s healthcare plan and don’t need to search about it on the Internet? Or, don’t they have much interest in the issue?
As for McCain, do the searches mean his plan is little-known and people want information on it? Or do those interested in McCain care more about healthcare than Obama’s voters?
The plan is more than two years overdue and came only after scolding from a Government Accountability Office report in 2006 and an internal, semi-secret review of ONC’s doings by the Institute of Medicine late in 2007. The IOM criticized ONC for the lack of a viable strategic road map almost four years after President Bush’s call for interoperable health information technology and personal health records. A lot has happened since 2004 in this area, though you’d hardly know it reading the ONC Plan.
ONC is a top-down, heavily bureaucratic,
large-medical-enterprise-centric, and large-IT-vendor-led juggernaut
that has always been out of touch with what goes on down on the ground
where consumers, patients, nurses, and primary care doctors live and