Discussion: Call for new research – the emergence of ehealth & a health 2.0 This is an increasingly innovative area for research, design, commerciality and ‘everyday’ interaction. The area leads on from other discussions about ‘eCitizens’, website analysis related to ehealth (e.g. Clinical Websites that are ‘dangerous to health’ Roberts JM, Copeland, KL Int. Jnl. Medical Informatics 62 (2001) 181-187), or as a ‘Health 2.0’. To date, my own work reviews various online health portals as patients seek information about health and wellbeing as part of elective surgeries overseas (see Lunt et al. 2009). Part of the aim (and responsibility) of current research is to set up important questions and directions for possible future investigations.

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Summary Paper
eHEALTHCARE – The self‐serve world of Health 2.0
November, 2009
Author: Dr Mariann Hardey
Subject matter: Social media, web platforms, patients, health professionals, web
information, user‐generated content, user‐reviews, consumer, e‐healthcare, self‐
service, medical, wellbeing, online portals, pro‐active patient, medical informatics
Type of paper: Discussion Topic
Specification: The patient as consumer; ‘self service model’ of health care; medical &
wellbeing online portals
Relevance: This is an increasingly innovative area for research, design,
commerciality and ‘everyday’ interaction. The area leads on from other
discussions about ‘eCitizens’, website analysis related to ehealth (e.g. Clinical
Websites that are ‘dangerous to health’ Roberts JM, Copeland, KL Int. Jnl.
Medical Informatics 62 (2001) 181‐187), or as a ‘Health 2.0’. To date, my own
work reviews various online health portals as patients seek information about
health and wellbeing as part of elective surgeries overseas (see Lunt et al.
2009). Part of the aim (and responsibility) of current research is to set up
important questions and directions for possible future investigations.
Discussion: Call for new research – the emergence of ehealth & a health 2.0
Social media, and in particular the social platforms that we label as a ‘Web 2.0’ e.g.
Social Network Sites (SNSs), blogs, forums, user‐review sites etc. have opened up
new mediations (Hardey, 2007; 2009b) between people as ‘patients’ and ‘health
professionals’. In addition these provide new forms of access to health related
resources as well as forums for community based discussions and reviews of
services. Recently, the social commentator Andrew Keen (2005) has cautioned users
of the web about the loss of expert and specialist guidance amid such a diversity of
information. This discussion seeks to describe the types of resources that non‐
medical, or ‘lay’ users access for health information. By doing so, I also seek to
identify the need for more research into this area, as well as dialogue with health
professionals and the commercial sector.
The web provides a range of access points (via mobile phones, PCs etc.) and options
for health and medical information. By ‘surfing the web’ patients have become
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2. ‘consumers’ of health information, as they seek to access data, purchase health
products, post to discussion forums, share experiences, join member only pages,
read advertisements and so forth (c.f. Lunt et al. 2009). The preference for elective
procedures represent one means by which consumer patterns have changed in
terms of health care information and provision. Increasingly, individuals are
influenced by the number of reviews of a product, the trust invested in other users
and marketing strategies e.g. ‘personalised suggestions’ from websites such as
Amazon.com (e.g. Hardey, 2009; Hardey & Hardey 2009). To Google ‘surgery
abroad’, or ‘cosmetic enhancement’, or a particular elective procedure such as
‘breast augmentation’ opens the consumer to an array of social media options and
increasingly participatory platforms where they can interact with other ‘patients’
and medical ‘experts’. There is often little guidance about the validity of such
information either in the management of content, or how both patients and medical
professionals should treat such mediations (see also Lunt el al. 2009). Where once
the web was as seen as a static series of pages with the user ‘detached’ from the
main resources, today Web 2.0 encourages users to share information and to affect
their own decisions, consumer practices etc. with access to a particular service,
resource or information (c.f. Leadbeater, 2007; 2008).
The conditions that have involved the emergence of Web 2.0 and medical
information involve, commercially led organisations, the media as well as more
official Government agencies including national health services. What is important
to note is that there is no standard or official representation to adhere to for either
patients or health professionals. Indeed, some sites have ‘dead’ links, making them
hard to navigate and provide confusing and/or poor quality information (e.g.
Hernández‐Borges and Macías‐Cervi (1999), and where much of the emphasis is
given over to the promotion of advertising space. In contrast other sites may provide
content based on evidence‐based medicine but require a good English reading ability
on the part of users. The digitisation of medical records that are made available to
practitioners within healthcare organisations has been accompanied by initiatives
such a Goole’s health records, which can be created by individual users. Such
resources highlight the potential for increasing social and health inequalities as more
health information and services move onto the web.
Generally websites visited are viewed by consumers who search for information with
‘something’ to do with ‘health’, ‘medicine’, ‘treatment’, ‘surgery’ ‘wellbeing’ and so
forth, and which relate to broad and open definitions. Such tags are underwritten
through the software code that strives to deliver information that a know user may
require (Hardey and Hardey, 2009). In addition sites that provide patient reviews of
health resources and individual practitioners are continuing to grow, such the site,
ratemds.com that allows patients to rate and read about professional health
practitioners. Therefore, the consumer, or ‘pro‐active patient’ is expected to be
responsible for his/her health and to have sought the ‘right’ information to inform
lifestyle choices (Entwistle et al, 1998; Giddens, 1990). In other words, these
patients face the possible risk of making ‘wrong’ as well a ‘right’ choices on the basis
of information that may be largely gathered from the web. The pro‐active patient
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3. may, for example, feel that they ‘know’ a doctor and/or service on the basis of other
patients’ experiences before they have visited a specific clinic. Particularly if the
services offered are for elective procedures overseas. In addition, in the light of the
proliferation of information from other pro‐active patients, the marketing and
pharmaceutical industries as well as medical practitioners there greater need for
people to be not only web literate, but also have confidence in the health
information that they access. Such literacy may now include the need to be aware of
how code may shape the information that they access (Lash, 2002).
In sum, there is a range in the quality and usability of the web‐based resources
available to visitors of medical, health and wellbeing websites and services. The
consultation of one source is unlikely provide the reliable health information (see
also Kim et al. 1999). As a result, the role of the consumer as a pro‐active patient
has become one of a participator based on his/her inter/active engagement. Here
the selection, assessment and contribution of information is important (c.f. Lash,
2002). Moreover, how such resources may provide an effective and efficient way of
providing knowledge and services, must be carefully observed and analysed.
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