15th International Conference on WWW/INTERNET 2016 28 – 30 October, Mannheim, Germany http://internet-conf.org/ HEALTH SERVICES ON THE NET - WHAT'S GOOD FOR ME? WHAT'S BAD? AND HOW DO I TELL THE DIFFERENCE? (Panel Session) Thomas Wetter, Célia Boyer, Tobias Neisecke, Jonas Pendzialek and Monika Pobiruchin

1. HEALTH SERVICES ON THE NET –
WHAT'S GOOD FOR ME? WHAT'S BAD?
AND HOW DO I TELL THE DIFFERENCE?
(Panel session)
15TH INTERNATIONAL CONFERENCE ON WWW/INTERNET (ICWI)
MANNHEIM, GERMANY
OCT 28, 2016
HTTP://INTERNET-CONF.ORG/

2. The physician´s
perspective
IN THREE QUESTIONS & ANSWERS 1 – 2 – 3

3. What is the difference
between searching the web
and consulting a physician?
QUESTION &ANSWER 1:

4. The web only answers
Keep in mind: answer quality depends on what you ask.
„If you expect wise answers, you have to ask sensible
questions“1
1 Johann Wolfgang von Goethe (Link)
1:

5. But the physician also asks
And he may ask sensible questions to find a personalised
differentiated diagnosis.
1:

6. The
net only
reacts
Results depend on user´s search
skills and health literacy.
IN OTHER WORDS:
The
physician
interacts
Results depend on doc´s
experience, sense and sensibility.

7. Artificial intelligence (AI) &
allgorithms try to immitate and
play doctor...
1:

8. ...but fail:
IN RESPONSE TO “I AM HAVING A HEART ATTACK,” “MY HEAD
HURTS,” AND “MY FOOT HURTS.” ONLY SIRI GENERALLY
RECOGNIZED THE CONCERN, REFERRED TO EMERGENCY
SERVICES, AND IDENTIFIED NEARBY MEDICAL FACILITIES.
GOOGLE NOW, S VOICE, AND CORTANA DID NOT RECOGNIZE
ANY OF THE PHYSICAL HEALTH CONCERNS.1
1 Miner AS, Milstein A, Schueller S, Hegde R, Mangurian C, Linos E. Smartphone-Based Conversational Agents and Responses to Questions
About Mental Health, Interpersonal Violence, and Physical Health. JAMA Intern Med. 2016;176(5):619-625.
doi:10.1001/jamainternmed.2016.0400 (Link)
1:

9. How is quality of health
information on the net?
QUESTION &ANSWER 2:

10. Very heterogenous and
difficult to specify.
But..
2:

11. ...the overall quality is
dissatisfying.
That´s for sure!
.
2:

12. A TEAM OF PHYSICIANS ANALYSIED 100 HEALTH ADVISING
WEBSITES ON 24 CRITERIAS (E.G. COMPLETENESS, MEDICAL
EVIDENCE, FAIR BALANCE OF INFORMATION, INDICATION OF
SOURCES).
KEY RESULTS:
• MORE THAN 30 % WHERE RATED AS
„POOR“ OR „VERY POOR“
• THE AVERAGE SCALE WAS „FAIR“ (4)
Source: Central Krankenversicherungen AG (Editor), Praxis Dr. Internet – Studie zum Kranheitssuchverhalten in Deutschland sowie zur
Qualität von Gesundheitsinformationen im Internet (Link)
Scale Website count
1 (Very good) -
2 (Good) 9 websites
3 (Satisfactory) 34 websites
4 (Fair) 24 websites
5 (Poor) 30 websites
6 (Very poor) 3 websites

13. Who is the provider and what
might be his intension?
ALWAYS CHECK WHEN USING A WEB SERVICE:

14. Even wikipedia is struggeling
for acceptance as a reliable
source
Sources:
The Guardian, Is Wikipedia a reliable source for medical advice? (Link)
Hasty RT et al.. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions. J Am
Osteopath Assoc 2014;114(5):368-373. doi: 10.7556/jaoa.2014.035. (Link)
Mühlhauser I et al., Does WIKIPEDIA provide evidence-based health care information? A content analysis, Z. Evid. Fortbild. Qual. Gesundh.
wesen (ZEFQ) doi:10.1016/j.zefq.2008.06.020 (Link)
Wikipedia; Reliability of wikipedia (Link)

15. Why physicians do not
recommend websites or
health apps to their patients?
QUESTION &ANSWER 3:

16. Because they don´t know
them?
3:

17. Mostly YES.
(And the commonly given answer.)
3:

18. But main
(& mostly unknown)reason is:
3:

19. They can´t
prescribe them!!
Lack of certifications means:
recommending an app is a
legal grey area
So they better keep hands off!
3:

20. A physician´s
controversial conjective
CONCLUSION OUT OF 1 – 2 – 3

21. The net and
the healthcare sector are
parallel universes…
…WITH A LOT OF MORE OR LESS WEAK
CONNECTIONS IN BETWEEN.
CONTRARY TO ALL EXPECTATIONS & STATED
POTENTIAL, THE NET´S OVERALL CONTRIBUTION
TO HEALTHCARE PROVISION IS STILL LOW.
CONTOVERSIAL CONJECTIVE:

22. Thank you!
TOBIAS NEISECKE
PHYSICIAN &
DIGITAL HEALTH EXPERT
TWITTER: @TOBIAS_NEISECKE
HTTP://MEDIZIN-UND-NEUE-MEDIEN.DE