health and the internet: still web 1.0

Health and the Internet: still Web 1.0Francisco Lupiáñez-Villanueva

Lecturer Information and Communication ScienceOpen University of Catalonia

http://www.uoc.edu

TOWARDS A SOCIAL SCIENCE OF WEB 2.05-6 SEPTEMBER 2007

NATIONAL SCIENCE LEARNING CENTRE, UNIVERSITY OF YORK

http://www.uoc.edu/

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• Introduction

• Methodology

• Results

• Discussion

• Conclusions

Health and the Internet: still Web 1.0 - TOWARDS A SOCIAL SCIENCE OF WEB 2.0

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Introduction


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Research Programme

Project Internet Catalonia directed by Prof. Castells and Prof. Tubella and supported by Catalonia Government.

http://www.uoc.edu/in3/pic/cat/index.html

Internet and the Catalan Public Health System. Technological Modernisation, Organizational Change and Service Delivery in the Catalan Public Health System directed by Prof. Castells and supported by Catalonia Government

http://www.uoc.edu/in3/pic/cat/salut.html

Health and Technology - IN3 Research Programme







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Wikipedia definition Web 2.0

Informationalims: theoretical blueprint by Prof. Castells

Interactive communication – W.W.W browser and editor

Flexibility, that allows the distribution of processing power in various contexts and applications

The three major, distinctive features of the technologies that are at the heart of the system are:

1. Their self-expanding processing and communicating capacity in terms of volume, complexity, and speed.2. Their recombining ability on the basis of digitization and recurrent communication.3. Their distributing flexibility through interactive, digitized networking.

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But…due to the dynamic of these technologies, those actors are in front of another challenge

related to Web 2.0.

Health field is also involved by the informationalim paradigm.

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Purpose

The aim of this paper is to analyze the Internet use made by physicians, nurses, pharmacists, patient support groups and Internet users.

In this analysis, we put specially emphasis on two objectives.

• To identify the possible interactive communication processes allowed by the applications available on the Net.

• To study in depth the social consequences of the change on the information and communication dimension caused by the Internet.

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Methodology


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Web Content Analysis

Online surveys


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Web content analysis

In order to approach the analysis of webs of health in Catalonia we have to delimit the object of study of our investigation, in two scopes:

• The thematic approach: "health"

• The geographic approach "Catalonia"

1240 web resourcesOctober 2005 – January 2006

Online survey to webmaster – March 2006388 emails – 112 answer (28,86%)

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Web content analysis

Criteria

Content

Interaction

Quality

Communication

Services

Content

Interaction

Web resource

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Web content analysisContent

Health content YES / NO

Postal Address YES / NO

Telephone number YES / NO

Advertising YES / NO

Interaction

Communication

email YES / NO

Email list YES / NO

Electronic forums YES / NO

Chat YES / NO

Online surveys YES / NO

Services

Electronic Commerce YES / NO

Electronic formulary YES / NO

Login - password YES / NO

Other YES / NO

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Web content analysisQuality

Contents

Author YES / NO

Professional profile YES / NO

Date YES / NO

Communication and services

Privacy – Legal advices YES / NO

Web resources

Web Map YES / NO

Languages YES / NO

Search YES / NO

FAQ: Frequent Asked Question YES / NO

Help YES / NO

Technological Standards YES / NO

Accreditation YES / NO

Aim of the web YES / NO

Agents

Personal Web

Patient Support Groups

Healthcare providers

Professional Associations

Public Administration

Healthcare professionals

Research Centres

Other providers

Teaching Centres

NGO

Media

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Online surveys – Healthcare actors

This type of surveys offers an alternative to the postal, telephone or face to face surveys as long as technical and methodological considerations are taking into account

The main obstacles of this type of surveys are associate to the representation of the sample and the suitable rates of answer

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Online surveys – Rates

Healthcare Actors Date Population Rate Questions - Variables

Patient Support Groups

October 2005 215 Groups 52 (24,18%) 32 questions

237 variables

Webmaster March 2006 388 contact email

112 (28,86%) 3 questions

34 variables

Physicians June 2006 16531 Barcelona (COMB)

2199 (13,3%) 272 variables

38 questions

Internet users June 2006 435 48 questions

279 variables

Nurses October 2006 13583 Barcelona (COIB)

1170 (8,61%) 42 questions

278 variables

Pharmacist November 2006

7.648 Barcelona (COFB)

898 (11,74%) 30 questions

234 variables

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Results


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Web content analysisContent

Telephone number 72.6 %

Postal Address 70.6 %

Health content 55.9 %

Advertising 13.7 %

Interaction

Communication

email 78.9 %

Electronic forums 9.2 %

Email list 8.8 %

Online surveys 6.4 %

Chat 2.3 %

Services

Electronic formulary 14.6 %

Login - password 10.1 %

Electronic Commerce 4.1 %

Physicians appointments 4.8 %

Other 4.8%

Library services 3.5%

Healthcare services 1.4%

Online learning 0.4%

Payments 0,5%

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Web content analysisQuality

Contents

Author 66,3%

Professional profile 60,6%

Date 50,2%

Communication and services

Privacy – Legal advices 20,8%

Web resources

More than one language 37,6%

Aim of the web 35,9%

Search 16,9%

Web Map 12,6%

Accreditation 11,5%

Help 4,9%

FAQ: Frequent Asked Question 4,3%

Technological Standards 1,2%

Agents

Professional Associations 25%

Healthcare professionals 22.2 %

Patient Support Groups 17.1 %

Healthcare providers 12.8 %

Personal Web 5.9 %

Public Administration 5 %

Teaching Centres 4 %

NGO 2.4 %

Research Centres 2.3 %

Other providers 2.3 %

Media 1 %

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Online surveys – Webmasters

What are the main objectives of your website?

To offer contact data details 81,3%

To offer health information 75,9%

To obtain non economic benefits (prestige, recognition…)

64,3%

To offer a new communication channel

63,4%

To offer face to face services 63,4%

To offer online services 33,9%

To obtain economic benefits 18,8%

What are the main barriers to the development of your website?:

Lack of time 70,5%

Lack of money 47,3%

Human resources 38,4%

Enough knowledge about Internet applications

34,8%

Technological infrastructure 31,8%

Private sponsorship 28,6%

Support from your own organization

21,4%

Enough knowledge about the Internet potential

21,4%

Lack of ideas about what I can do on the Internet.

14,3%

Lack of interest 2,7%

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Online surveys – Internet users

Internet Health information seek frequency %

Daily 7,5

Weekly 17,6

Monthly 45,0

Never or almost never 30,1

Total 100,0

Have you sought Patient Support Groups information on the Internet

%

YES 47,6

NO 50,8

As a result of your Internet search do you… %

keep searching for more advice or information on the health question

43,9%

calm down with the medical advice received 34,5%

look for a health professional 27,4%

try to diagnose a health problem 12,2%

worry about the medical advice received 11%

Try to treat a health problem 10,8%

Look for the support of no health professional 5,7%

Other 4,1%

Have you talked with your physician about the health information you found on the Internet?

%

YES 18,8%

NO 81,2%

Do you have the email of your physician? %

YES 11,1

NO 88,9

Which of the following health services will you never use?

%

Online appointments with your physician 2.9

Online consultation with your physician 8.9

Online prescription 5,6

Online monitoring 15.2

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Online surveys – Patient support groups

Do you have Internet connection? %

YES 92,3%

NO 7,7%

Do you have a website? %

YES 76,9%

NO 23,1%

Do you have any electronic newsletter? %

YES 30,8%

NO 69,2%

Do you have any electronic forum? %

YES, it is just for our patient support group 7,7%

YES, it is opened for anyone 17,3%

NO 75%

Do you have the email of the group members %

YES, we ask them for the email 40,4%

YES, they give it although we do not ask for it 34,6%

NO 25%

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Online surveys – Physicians

Do you use the Internet for professional purpose? %

YES 93,3%

NO 6,7%

Do you recommend to your patients the consult of health information on the Internet?

%

Frequently 7,7%

Sometimes 38,1%

Never 543%

Do you have… %

A personal website 19,1%

A collective website 49,1%

A blog 5,1%

What are the main reasons? %

Share information with people 15,4%

Share information with my friends and families 12,5%

Spread my own scientific work 11,1%

Discussion about clinical issues related with my medical speciality

6,8%

Share information with my patients 5,5%

Spread no scientific work 2,7%

Do you use the email to contact or communicate… %

With other healthcare professionals 89,1%

With your patients 21,9%

When you have doubts on treatments or diagnoses, do you use any electronic discussion list or look for information on the Internet?

%

Very Frequently - Frequently 45,5%

Rarely - Never 54,5%

Do you participate in Internet sites explaining or clarifying doubts?

%

Very Frequently - Frequently 9%

Rarely - Never 91%

Do you participate in Internet sites as an advisor of patients?

%



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Online surveys – Nurses


YES 74,3%

NO 25,7%


%

Frequently 7%

Sometimes 36,8%

Never 52,2%

Do you have… %

A collective website 40,7%

A personal website 30,9%

A blog 9%


Share information with my friends and families 21.4%

Share information with people 10.7%

Spread my own scientific work 9.3%

Discussion about clinical issues related with my speciality

7.6%

Spread no scientific work 6.2%

Share information with my patients 2.9%


With other healthcare professionals 74%

With your patients 7,7%


%




%




%



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Online surveys – Pharmacist


YES 92,9%

NO 7,1%


%

Frequently 8,4%

Sometimes 40,2%

Never 51,2%

Do you have… %

A collective website 47.5%

A personal website 20.5%

A blog 15,5%


Share information with people 46.7%

Share information with my friends and families 38.0%

Share information with my clients 18.8%

Spread my own scientific work 9.2%

Spread no scientific work 8.7%

Discussion about clinical issues related with my speciality

7.4%


With other healthcare professionals 73%

With your clients 38%


%


Rarely - Never 67%


%




%


Rarely - Never 64%

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Discussion


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Discussion - Web content analysis

The presence in the Internet of the Catalan health care system is led by the professionals who offer mainly different information and contents on health and few applications related to communication processes and/or services.

Quality is still a challenge

The Network is constituted mainly as a space of contents with little presence of applications of communication and services, therefore with a little degree of interaction.

The little presence of the healthcare providers and of the Government (in comparison with the rest of identified agents) added to the little number of applications of communication and services available do not allow the attention or the management of the users demand

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Discussion - Internet users

Internet users are characterized by: the high proportion of women, a high education level, facility of access to Internet from its own home, and a high frequency of use. These users of Internet integrate the use of different sources of information in their activities related to the health. But physicians are the key source.

Women have a more active role than the men with all the sources, including Internet

The problem of the use of the Internet for the people with more age and the consequences that the use of the consulted information can have on the health, since a smaller level of education could suppose an irregular use of the information.

The frequency of use of the Internet for questions related to the health is far away from of the levels that would allow us to call to "the cibercondriacs".

The interest of the individuals by the associations of patients like a source of information remind us the importance of the no expert knowledge, since the utility and the confidence in this source is very high.

The main consequence of the use of Internet for questions related to the health is the increase of information available. Just a minority percentage of individuals makes decisions relative to the diagnosis or the treatment of the health problem. These data support the hypothesis of the conscience of the individuals when they manage the inherent tension to the use of Internet. emphasize the need of physicians as an expert.

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Discussion - Patient support groups

Internet is used by these organizations like a space of contents that allows then to spread information relative to the organization and the health thematic.

The electronic mail is used like unidirectional communication channel producing a little interaction.

There are just a very few applications related to interactive processes of communication and a lack of professional working online

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Discussion - Health care professionals

Professionals are connected to Internet and make an intensive use of the Net, mainly for questions related to the search and consultation of information.

The use of Internet as communication media with other professionals of the sector are extended between all the professionals, but the levels of use of Internet or the electronic mail to communicate or interact with its patients or users is scarce.

The increase of the information flows available in Internet has not come accompanied by an increase of the communication flows.

However, we have to emphasize a tendency that indicates that those professionals who develop their professional practice in competitive markets make more intensive use of the Internet and the electronic mail to interact with their patients or users.

Most of the professionals positively values the relevance of the contents available in the Internet and they do not consider that the patient search of information is negative neither for the professional - patient relationship or for the management the patients make of their disease.

However just a minority percentage of professionals recommend to their patients the consultation of health information on the Internet or talk about the Internet. Probably because on the lack of time during their face to face meetings

Nevertheless, the behavior of the phamacists shows us a new case where the factors related to the market oriented context are the key. These professionals do not have time barriers and are more accessible that the rest of professionals, given the physical distribution of the pharmacies by the territory.

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Conclusions


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The Internet as a content platformNot as an interaction space


The Internet reproduces the social

organization of the healthcare system

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http://wisdom.blogs.com/health/2007/06/why_web_20_matt.html

Thank you for your attention

Francisco Lupiáñ[email protected]

http://www.ictconsequences.netLecturer Information and Communication Science

Open University of Cataloniahttp://www.uoc.edu

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mailto:[email protected]

http://www.ictconsequences.net/

http://www.uoc.edu/