Toward an Informed-Patient Approach to E-Health Services

Introduction

This conceptual paper is a sociological and anthropological analysis of the effect of e-health services on the informed-patients' role and their ability to bring about social change through the Internet and their use of e-healthcare services through online community-growth dynamics. In this paper, the term e-health services refers to all new electronic means (the Internet and telecommunications) providing health resources, information and a platform for interaction between institutions, health professionals, health providers, health consumers and the public. Through examples of health-related websites, this analysis focuses on informed-patients and how they are able to seek health information and to demand better health services and standards for themselves and for their communities. This article focuses on the empowering role of the Internet for informed-patients to become active agents.

In the following sections, this paper provides examples from different websites to illustrate the use of e-health services, the social implications of this usage upon the physician-patient interactions and the limitations of the e-health services. The paper focuses on the basic interaction between physician and patient, in spite of the fact that their physicians are not necessarily the primary providers of information of health-services accessed from these online resources.

With the expanding utilization of digital and technological media by public health providers and healthcare consumers, there is a need to evaluate the patients' role. There is good evidence of the growing acceptability of the Internet in seeking health information (Ahmann, 2000; Diaz et al., 2002; Hardey, 1999; Nettleton & Burrows, 2003; Pemberton & Goldblatt, 1998). Murray et al (2003) argued that in the USA nearly one third of the population search for health information online. According to Schwartz et al (2005), it was estimated by the Pew Internet and American Life Project that on a typical day in 2004, 70 million Americans went online and seven million searched for health or medical information. The Pew survey also estimated that 75% of online men and 85% of online women had searched for health information at least once in the past. Consequently, Schwartz argues that as long as more people gain access to the Internet, the numbers seeking healthcare information are likely to increase. This rapid rise in health information technology (HIT) is reflected, for example, in American expenditure on the growth in health information technology- from $19 to $31 billion between 2000 and 2006 (Miller and West, 2009).

The question is: what makes the Internet more attractive than other media channels? Its attractiveness is intrinsic to its unique infrastructure. In their review, Azy and Fisher (2001), suggest that the Internet possesses a “Triple A Engine”: affordability, availability, and anonymity: “Affordability refers to the Internet's low cost, which has permitted it to penetrate many segments of society. Availability refers to the Internet's ease of use at any time and in many locations. Anonymity refers to the apparent obscurity of the Internet's users” (2001:325). Azy and Fisher (2001) added a fourth factor used by King (1999), Acceptability which refers to the Internet's legitimacy; and, a fifth factor aloneness, which refers to the fact that the Internet is typically used privately “in unobserved human-computer transactions.” (2001:325). These factors are most useful for healthcare information seekers.