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I. Introduction

 

Internet becomes our primary information source since it is really easy to access information. It is used as a research tool by nearly 90% of adult internet users and as a primary source for science news and information for 40 million Americans according to the study from the Pew Internet & American Life Project in collaboration with the Exploratorium.

Nearly 9 in 10 (87%) online users have used the internet to look up the meaning of a scientific concept, answer a specific science question, learn more about a scientific breakthrough, help complete a school assignment, check the accuracy of a scientific fact, downloaded scientific data, or compare different or opposing scientific theories.[8]

If we need to define the Internet: it is a worldwide, publicly accessible network of interconnected computer networks. It is a "network of networks" that consists of millions of smaller domestic, academic, business, and government networks, which together carry various information and services, such as electronic mail, online chat, file transfer, and the interlinked Web pages and other documents of the World Wide Web.

 

The Internet was the result of some visionary thinking by people in the early 1960s that saw great potential value in allowing computers to share information on research and development in scientific and military fields. J.C.R. Licklider of MIT, first proposed a global network of computers in 1962, and moved over to the Defense Advanced Research Projects Agency (DARPA) in late 1962 to head the work to develop it. Leonard Kleinrock of MIT and later UCLA developed the theory of packet switching, which was to form the basis of Internet connections. Lawrence Roberts of MIT connected a Massachusetts computer with a California computer in 1965 over dial-up telephone lines. It showed the feasibility of wide area networking, but also showed that the telephone line's circuit switching was inadequate. Kleinrock's packet switching theory was confirmed. Roberts moved over to DARPA in 1966 and developed his plan for ARPANET. [1]

 

The Internet was designed in part to provide a communications network that would work even if some of the sites were destroyed by nuclear attack. If the most direct route was not available, routers would direct traffic around the network via alternate routes.

 

The early Internet was used by computer experts, engineers, scientists, and librarians. There was nothing friendly about it. There were no home or office personal computers in those days, and anyone who used it, whether a computer professional or an engineer or scientist or librarian, had to learn to use a very complex system.

 

Since the Internet was initially funded by the government, it was originally limited to research, education, and government uses. Commercial uses were prohibited unless they directly served the goals of research and education. This policy continued until the early 90's, when independent commercial networks began to grow. It then became possible to route traffic across the country from one commercial site to another without passing through the government funded NSFNet Internet backbone.[2]

 

And nowadays internet has a new concept, which is called Web 2.0.

 

Current Trends on the Internet

 

Web 2.0 creates rich media by integrating data sources and Internet- (and thus intranet-) provided services. That means Web 2.0 can act as a flexible and lightweight user interface, relying on network accessible services that are built on an SOA (Service Oriented Architecture) foundation. The interaction between the two enables businesses to create and manage business processes with greater flexibility. Users can create enterprise mashups by collecting, assembling and sharing existing enterprise content whether to simplify business integration efforts or to provide portals that monitor and improve systems information and transactional flows.

 

All of this spells benefit for corporations. After all, the drivers that make Web 2.0 compelling to consumers—such as its ability to provide contextualized, personal information, and to use community and social connections to improve communication—are equally important in a business context.[3]

 

Health care industry has been using web 2.0 concepts for different needs and creates solutions which were not possible without the current technology. They do not only provide expert medical content, but also connect patients to each other through disease-specific online communities, virtual support groups, real-time Web chats, and other features whereby patients share experiences and advice, and even rate their doctors. Many of the sites feature educational videos and health-assessment quizzes. Others offer an online "personal health record," along with tools that track patients' health goals (such as blood sugar and exercise goals) or send users e-mailed reminders to get recommended health screenings.

 

There are several different web technologies which is using web 2.0 concepts. Most commons are:

 

Social networking site

A Web site that provides a virtual community for people interested in a particular subject or just to "hang out" together. Members communicate by voice, chat, instant message, videoconference and blogs, and the service typically provides a way for members to contact friends of other members. Such sites may also serve as a vehicle for meeting in person.[6]

Samples:

http://www.starlight.org

 

Starlight Starbright brings together experts from pediatric health care, technology, and entertainment to create programs that educate, entertain and inspire seriously ill children. Whether it’s finding friends online, learning more about a disease, or just spending time together as a family, Starlight Starbright’s programs help children and families cope with the challenges they face daily.

 

http://sermo.com

 

On Sermo, there is no cost to physicians to participate. In fact, Sermo also enables physicians to be financially rewarded for their astute observations and clinical insights. The source of the rewards is financial institutions who access a stream of fresh and actionable information on emerging trends and market-changing events in healthcare.

 

http://Patientslikeme.com

 

Their goal is to enable people to share information that can improve the lives of patients diagnosed with life-changing diseases. To make this happen, they have created a platform for collecting and sharing real world, outcome-based patient data (patientslikeme.com) and are establishing data-sharing partnerships with doctors, pharmaceutical and medical device companies, research organizations, and non-profits.

 

Wiki

Wiki is a piece of server software that allows users to freely create and edit Web page content using any Web browser. Wiki supports hyperlinks and has a simple text syntax for creating new pages and crosslinks between internal pages on the fly.

Wiki is unusual among group communication mechanisms in that it allows the organization of contributions to be edited in addition to the content itself.[9]

 

http://www.fluwikie.com/

 

The purpose of the Flu Wiki is to help local communities prepare for and perhaps cope with a possible influenza pandemic.

 

http://wikihealthcare.jointcommission.org/twiki/bin/view/Home

 

WikiHealthCare is The Joint Commission's interactive forum for health care professionals. It is designed to enable and encourage discussion and collaboration among all users for the purpose of improving health care quality. While The Joint Commission provides the forum, users of the site control its content.

 

http://campaigns.wikia.com/wiki/Health_care

 

Campaigns Wikia has the goal of bringing together people from diverse political perspectives who may not share much else, but who share the idea that they would rather see democratic politics be about engaging with the serious ideas of intelligent opponents, about activating and motivating ordinary people to get involved and really care about politics.

 

Mashup

A mashup Web site is characterized by the way in which it spreads roots across the Web, drawing upon content and functionality retrieved from data sources that lay outside of its organizational boundaries.[5]

 

Sample:

http://whoissick.org/sickness/

 

Who Is Sick was started in 2006 with a mission to provide current and local sickness information (an epidemiological mashup) in the Los Angeles area of the U.S. With the belief in the power of people and faith that user-generated content is valuable, this mashup links sickness "data" with maps of the region. Given the slow adoption of "web 2.0' technology by the healthcare industry, this tool is meant to be a simple, user-friendly prototype for health consumers who wish to see disease outbreaks geographically as they are occuring.

 

http://www.omnimedix.org/dossia.html

 

The Dossia personal health information network - actually, a network of networks - will provide a universally accessible data capture and authentication system for all patients and consumers, regardless of where they get their medical care, who pays for it, where they work, or where they live.

 

http://healthmap.org/

 

HEALTHmap brings different data sources together to achieve a unified and comprehensive view of the current global state of infectious diseases, and their effects on human and animal health. It also combines Google Maps and RSS feeds from different news sources, including Google News, ProMED, the World Health Organization and Euro Surveillance. Through an automated text processing system, the data is aggregated by disease and displayed by location for user-friendly access to the original alert. HEALTHmaps may be invaluable for health professionals and librarians who want to stay up-to-the minute with information on global health news.

 

 

RSS

RSS is a format for syndicating news and the content of news-like sites, including major news sites like Wired, news-oriented community sites like Slashdot, and personal weblogs. But it's not just for news. Pretty much anything that can be broken down into discrete items can be syndicated via RSS: the "recent changes" page of a wiki, a changelog of CVS checkins, even the revision history of a book. Once information about each item is in RSS format, an RSS-aware program can check the feed for changes and react to the changes in an appropriate way.

RSS-aware programs called news aggregators are popular in the weblogging community. Many weblogs make content available in RSS. A news aggregator can help you keep up with all your favorite weblogs by checking their RSS feeds and displaying new items from each of them. [10]

 

Samples:

http://www.usa.gov/Topics/Reference_Shelf/Libraries/RSS_Library/Health.shtml

 

 Official information and services from the U.S. government

 

http://www.medworm.com

MedWorm is a medical RSS feed provider as well as a search engine built on data collected from RSS feeds. RSS stands for Really Simple Syndication and it is a technology used to simply publish and gather details of the very latest information on the internet.

MedWorm collects updates from over 3500 authoritative data sources (growing each day) via RSS feeds. From the data collected, MedWorm provides new outgoing RSS feeds on various medical categories that you can subscribe to, via the free MedWorm online service, or another RSS reader of your choice, such as Bloglines, Newsgator, Google Reader or FeedDemon.

The best way to get a feel for the information that MedWorm can provide is to have a browse through the various categories on the menu above. New categories are being added all the time and we are happy to receive requests for new ones if you can't find the category of your choice.

 

Widget

The term has multiple meanings. It is used to describe software components used as Web services in this content.

 

Samples:

 


From infectious diseases to cancer prevention and environmental health, let the top experts in the field keep you up to date on research that addresses the most pressing health concerns of today. The Johns Hopkins Bloomberg School of Public Health is the largest, oldest, and number one school of public health in the world.

 

 

Retrieves Internet Health metrics once an hour from InternetTrafficReport.com. Great Widget to have on your desktop to give you advanced warning of DDoS attacks, worms, etc.

 

VoIP

Voice over Internet Protocol (VoIP), is a technology that allows you to make voice calls using a broadband Internet connection instead of a regular (or analog) phone line.[7]

 

Samples:

 

Cisco Systems, Inc. announced that solutions from its Unified Communications product portfolio are being deployed in one of the world's first voice and video over Internet Protocol call centers as a part of the Health Care Interpreter Network.

 

WebOS

WebOS is a virtual operating system that runs in your web browser. More precisely, it’s a set of applications running in a web browser that together mimic, replace or largely supplement a desktop OS environment. It’s a tough field to start in for a Web 2.0 entrepreneur, because to be successful you need to create several applications that are at least as good as other competitors, and you need to connect them all into a usable bundle. What’s also expected by most users is that all this looks decent, operates similarly to a “real” OS and behaves as a real “OS” would, and is relatively bug-free.[4]

 

Sample:

http://www.connectingforhealth.org

Thirteen major health and information technology organizations, in an unprecedented joint collaboration, today endorsed a "Common Framework" to support improved health information exchange in the United States while protecting patient privacy. The collaborating organizations have identified the vital design elements - of standards, policies, and methods-for creating a new information environment that would allow health care professionals, institutions, and individual Americans to exchange health information in order to improve patient care. These recommendations were developed in response to the Request for Information related to a "National Health Information Network" issued by the U.S. Office of the National Coordinator for Health Information Technology (ONCHIT) within the Department of Health and Human Services in November 2004.

 

Blog

A blog is a web page made up of usually short, frequently updated posts that are arranged chronologically—like a what's new page or a journal. The content and purposes of blogs varies greatly—from links and commentary about other web sites, to news about a company/person/idea, to diaries, photos, mini-essays, project updates, even fiction.

 

Samples:

 

Clinical Education

http://casesblog.blogspot.com/

 

CEO Blogs

http://RunningAHospital.blogspot.com

 

 

Physician experience blogs

Kevin MD: http://www.kevinmd.com/blog/

 

 

Health IT blogs

Healthcare IT Guy: http://www.healthcareguy.com/

 

 

As a result we can list the core principles of the Web 2.0 :

 

  • The Web as Platform
  • You control your own data
  • Services, not packaged software
  • Architecture of participation
  • Cost-effective scalability
  • Remixable data source and data transformation
  • Software above the level of a single device
  • Harnessing collective intelligence

 

II. Type of healthcare services on the internet

 

Healthcare is an information-intensive industry that remains highly fragmented. Therefore, the uses of information technology, in delivering clinical care, performing administrative functions, and supporting the public health infrastructure, is crucial for both cost saving and improvements in the care itself.

 

There are many different sites which deal with health care information. It is not easy to cover them all; we can list those under five groups:

    1. Commercial services
    2. Government services
    3. Hospital & Health Plan services
    4. New trends

 

A. Commercial services

 

Sites in this group provide consumer information from a variety of reputable sources. There are several good samples; couple of them:

 

http://webmd.com

 

WebMD is a provider of online health information services to consumers, physicians, healthcare professionals, employers and health plans through public and private online portals and health-focused publications. Their interactive services enable consumers to obtain in-depth information on a particular disease or condition, research and plan for a healthy lifestyle goal, search for relevant health information across the web, and watch originally produced videos. They have developed unique features that help consumers check symptoms, locate physicians, assess your personal health status, receive e-newsletters and alerts, and participate in online communities with peers and medical experts.

 

http://www.revolutionhealth.com/

 

 

By putting individuals at the center of their own healthcare, Revolution Health allows them to make informed choices and offers more convenience and control over their individual healthcare decisions.

 

Revolution Health currently is focused on:

  • RevolutionHealth.com: The cornerstone of Revolution Health is RevolutionHealth.com, a free, comprehensive health and medical information site, specifically designed with the Family's Chief Medical Officer — women and other caregivers — in mind.RevolutionHealth.com offers best-of-breed health information as well as more than 125 online tools aimed at helping individuals take control of their well-being. Revolution Health has partnered with more than 50 companies and teamed with a number of leading health nonprofits and experts to make its innovative approach to health a reality.
  • Membership: A service primarily targeting businesses, Revolution Health Membership provides peace of mind through a series of telephone-based services that help people obtain answers to their health questions and provide assistance with settling health insurance claims, as well as scheduling appointments and much more.
  • Insurance: Revolution Health is an unbiased source that enables consumers to easily browse and compare health insurance products, then puts consumers in touch with trusted brokers. Revolution Health provides these services, as well as benefits solutions for corporate America, through its affiliate Extend Health.

 

http://www.purplepill.com/

 

 

This is a sample for how some informational sites designed and sponsored by pharmaceutical companies. These sites are positioned as general consumer sites and can be easily found when searching for a specific condition, and provide information, but they are part of a large marketing campaign.

 

B. Government Services

 

Governments and universities have traditionally produced large amounts of health information, which is now readily available online. The National Institutes of Health (NIH), in the United States produces comprehensive information on most major conditions. NIH is also home to the Clinical Trials Database that contains medical studies around the country and information about whether or not clinical trials are right for an individual. In addition, NIH provides a direct link to more than 9,000 medications on MEDLINE. On the NIH site you will also find research on a wide range of subjects including Complementary and Alternative Medicine, Rare Diseases, Minority Health, Bioethics, and Social Science. And the Centers for Disease Control (CDC) is recognized as the leading US federal agency for protecting the health and safety of people in the US and abroad, with their focus on developing and applying disease prevention and control, environmental health, and health promotion and education activities.

 

 

 

http://medlineplus.gov/

 

 

C. Hospital & Health Plan Services

 

A book could be written for this group: The list for how internet is used for hospitals and health plan services is huge: It can be used as communication tool with customers, vendors, suppliers and organizations; research tool; marketing tool; scheduling tool for patient and doctors; telemedicine tool… As a summary; using the Internet has changed the way health care business is being done.

 

Management of such services on the Internet reduces the need for specialized personnel such as Webmasters and network managers within traditional health care institutions. Emergence of software applications - ASPs (Application Service Providers) - and infrastructures on the Internet reduces software licensing as well as human resources and other administrative costs associated with local acquisition and management. Database management outsourced to Internet infrastructures reduces network complexity and overload while increasing the speed, reliability, and rigor of information searching and processing.

 

The Internet is transforming health care management as well as the dynamics of health care service markets. The costs of health care delivery systems, products, and services continue to rise everywhere, but performance of health care delivery is associated with institutional and ideological considerations as well as availability of financial and technological resources.[12]

 

http://www.kaiserpermanente.org/

 

The main purpose of the site is to provide a service for interacting with KP members as an alternative to telephone calls and office visits. The service includes health learning materials, communication capabilities, and information about Kaiser Permanente. Members may do research on health concerns through the drug and health encyclopedias, complete a personal health assessment, or browse links to other Internet Web sites. Members may also communicate with KP staff or with other members. For example, advice nurses and pharmacists provide answers to routine questions, and discussion groups with the participation of KP staff members offer opportunities to share experience on a variety of health-related themes, including the Web site itself. Kaiser Permanente's strategy is to offer members attractive services as a foundation for more valuable interactions, contributing to perceptions of self-efficacy and for patients' responsibility in decision making regarding their own health care [11]. Monitoring discussion groups creates an opportunity to collect data concerning member needs and satisfaction. KP peer discussion moderators are trained to create an atmosphere of trust, to inform participants without directly offering medical advice, and to facilitate mutual support among members.

 

 

 

 

 

 

D. New Trends

 

A new generation of internet-based tools promises even more interactivity and will make available tools such as interactive buying sites to help consumers choose healthcare benefits. Bringing individual patient records online is on the horizon. And with breakthroughs in guided learning and artificial intelligence, it is possible to see a world where we interact with a machine for many of our health needs. Consumers are driving developments.   

 

We have had several samples already in the previous sections. We can have some other samples to show how consumer drives the development from different angles:

 

http://www.ratemds.com

 

The purpose of the site is to be a resource for people who want to find a good doctor. It also gives the user a place to voice their opinion, and this opinion will help others to find a good doctor.

 

http://www.vimo.com/

 

Vimo allows businesses and consumers to research, rate and purchase health insurance plans and Health Savings Accounts (HSAs), and choose doctors from across the country. Vimo brings together a variety of private and public data sources so that shoppers can find a physician and compare hospital prices for medical procedures. Vimo users can read and post reviews about any of the services or products available.

 

http://www.medseek.com/

 

 

MEDSEEK provides healthcare organizations with online portal management technology for more efficient communication and interaction among institutions, caregivers and patients. They launched a rapid application development tool; HyperRAD that enables users to create custom applications and enhanced web functionality without the expertise of programmers. MEDSEEK created this tool to make building enterprise-class web applications faster and easier.

 

 

http://www.practicefusion.com

 

Practice Fusion addresses the complexities and critical needs of today's healthcare environments by proving an application and delivery model for physicians and patients at no cost. Practice Fusion offers an integrated, on-demand healthcare platform delivered in a software-as-a-service model. Practice Fusion's services require no on-site software installation, eliminating the complexities of licensing, implementing and supporting traditional enterprise software solutions. Practice Fusion removes the need for integration, hardware and software for physicians, dramatically reducing cost and complexity, while enabling providers to deliver the highest level of care possible to their patients.

 

What is special about the application is rather than force doctors to buy a pricey electronic medical records system, it will use Google’s AdSense program to support itself.

 


 

Conclusion

According to the Pew Internet & American Life Project, most Americans are not practicing due diligence when searching
the Internet for health content.  Pew’s findings raise some interesting questions about how people are consuming
healthcare information online, including:

  • Do Americans trust online content because they are frequenting Websites they consider well established and credible?
  • Are they being exposed to user-generated media (UGM)? This is important because it is generally assumed that people tend to be highly trusting of online content developed by their peers.  

Envision Solutions, using data provided by Hitwise, the leading online competitive intelligence service, set out to answer these questions in late 2006.  This study reveals:

  • Americans looking for online health content are exposed to a significant amount of UGM.
  • People are relying on government, corporate and non-profit produced Websites for health information.  In certain cases, blogs and wikis are receiving significant traffic.[8]

 

As these sites move into the mainstream, they're affecting how patients get health information and advice, how they manage their medical conditions, and how they interact with their doctors.

 

It is not all positive using the internet with new trends: Millions of consumers are using the Internet to get health information, and thousands of web sites are offering health information. Some of those sites are reliable and up-to-date; some are not. How can you tell the good from the bad?

 

U.S. Food and Drug Administration provide the following information: First, it's important to carefully consider the source of information and then to discuss the information you find with your health care professional. These questions and answers can help you determine whether the health information you find on the Internet or receive by e-mail from a Web site is likely to be reliable.

 

Quick Checklist

You can use the following checklist to help make sure that the health information you are reading online can be trusted.

  • Can you easily see who sponsors the Web site?
  • Is the sponsor a government agency, a medical school, or a reliable health-related organization, or is it related to one of these?
  • Is there contact information?
  • Can you tell when the information was written?
  • Is your privacy protected?
  • Does the Web site make claims that seem too good to be true? Are quick, miraculous cures promised? [13]

 

 

Resources

 

  1. http://www.walthowe.com/navnet/history.html
  2. http://en.wikipedia.org/wiki/Internet
  3. http://www.cio.com/article/101614/ABC_An_Introduction_to_Web_._/3
  4. http://franticindustries.com/blog/2006/12/21/big-webos-roundup-10-online-operating-systems-reviewed/
  5. http://www.ibm.com/developerworks/xml/library/x-mashups.html
  6. http://www.answers.com/topic/social-networking-site?cat=technology
  7. http://www.fcc.gov/voip/
  8. http://www.pewinternet.org/press_release.asp?r=133
  9. http://www.wiki.org/wiki.cgi?WhatIsWiki
  10. http://www.xml.com/pub/a/2002/12/18/dive-into-xml.html
  11.  Williams R, Cothrel J. Four smart ways to run online communities. Sloan Management Review 2000 Sep;41(4):81-91.
  12.  World Health Organization. Macroeconomics and health: investing in health for economic development. Report of the Commission on Macroeconomics and Health. 2001
  13. http://www.fda.gov/oc/opacom/evalhealthinfo.html

  

 

HOW INTERNET IS USED for the HEALTHCARE

Umit Kaya

Table of Contents

 

  1. Introduction
    1. Internet technology
    2. Current trends
  2. Type of healthcare services on the internet
    1. Commercial services
    2. Government services
    3. Hospital & Health Plan services
    4. New trend
  3. Conclusion