Web 3.0 and medicine

Crafting a positive professional digital profile to augment your practice

A digital profile is the sum content about a person on the Internet. A digital profile can be composed of personal or professional information shared on public Web sites posted personally or by others. One of the most effective ways to build a positive professional digital profile is through social media. It is increasingly important to maintain a positive digital profile as others mine the Internet to find out about a professional prior to meeting him or her. As the digital environment continues to grow, it will become increasingly difficult to neglect a professional digital profile without potential negative consequences. There are many benefits to creating a digital presence and using the tools available to learn about neurology and interact with other professionals and patients in ways that were not possible in the past. The spread of social media to a large part of the population makes it unlikely to go away.

Wikis and collaborative writing applications in health care: a scoping review

Background

Collaborative writing applications (eg, wikis and Google Documents) hold the potential to improve the use of evidence in both public health and health care. The rapid rise in their use has created the need for a systematic synthesis of the evidence of their impact as knowledge translation (KT) tools in the health care sector and for an inventory of the factors that affect their use.

Objective

Through the Levac six-stage methodology, a scoping review was undertaken to explore the depth and breadth of evidence about the effective, safe, and ethical use of wikis and collaborative writing applications (CWAs) in health care.

Methods

Multiple strategies were used to locate studies. Seven scientific databases and 6 grey literature sources were queried for articles on wikis and CWAs published between 2001 and September 16, 2011. In total, 4436 citations and 1921 grey literature items were screened. Two reviewers independently reviewed citations, selected eligible studies, and extracted data using a standardized form. We included any paper presenting qualitative or quantitative empirical evidence concerning health care and CWAs. We defined a CWA as any technology that enables the joint and simultaneous editing of a webpage or an online document by many end users. We performed qualitative content analysis to identify the factors that affect the use of CWAs using the Gagnon framework and their effects on health care using the Donabedian framework.

Results

Of the 111 studies included, 4 were experimental, 5 quasi-experimental, 5 observational, 52 case studies, 23 surveys about wiki use, and 22 descriptive studies about the quality of information in wikis. We classified them by theme: patterns of use of CWAs (n=26), quality of information in existing CWAs (n=25), and CWAs as KT tools (n=73). A high prevalence of CWA use (ie, more than 50%) is reported in 58% (7/12) of surveys conducted with health care professionals and students. However, we found only one longitudinal study showing that CWA use is increasing in health care. Moreover, contribution rates remain low and the quality of information contained in different CWAs needs improvement. We identified 48 barriers and 91 facilitators in 4 major themes (factors related to the CWA, users’ knowledge and attitude towards CWAs, human environment, and organizational environment). We also found 57 positive and 23 negative effects that we classified into processes and outcomes.

Conclusions

Although we found some experimental and quasi-experimental studies of the effectiveness and safety of CWAs as educational and KT interventions, the vast majority of included studies were observational case studies about CWAs being used by health professionals and patients. More primary research is needed to find ways to address the different barriers to their use and to make these applications more useful for different stakeholders.

Design of a Personal Health Record and Health Knowledge Sharing System using IHE-XDS and OWL

Personal Health Record systems (PHRs) provide opportunities for patients to access their own PHR. However, PHRs are teeming with medical terminologies, such as disease and symptom names, etc. Patients need readily understandable and useful health knowledge in addition to their records in order to enhance their self-care ability. This study describes a Personal Health Record and Health Knowledge Sharing System (PHR&HKS) whereby users not only can maintain and import their PHR, but also can collate useful health Web resources that are related to their personal diseases. Furthermore, they can share the collated Web resources with any user with the same diseases and vice versa. To fulfill these objectives, IHE Cross-Enterprise Document Sharing (XDS) architecture was adopted to share and integrate the PHR. A registry ontology, consisting of part of the XDS document metadata attributes, the ICD-9-CM code, and part of the Dublin Core Metadata Element Set (DCMES), was created to enhance the health knowledge collating and sharing functions. The system was then tested and evaluated by 30 users. Among these individuals, 24 (81 %) held positive views on the ease of use and usefulness of the system while the remainder, who held either neutral (14 %) or negative (5 %) attitudes, were identified as individuals who were somewhat unwilling to maintain any PHR or share any information with others.

Intelligent libraries and apomediators: Distinguishing between Library 3.0 and Library 2.0

Using the ‘point oh’ naming system for developments in librarianship is attracting debate about its appropriateness, basis and syntax and the meaning and potential of Library 2.0. Now a new term, Library 3.0, has emerged. Is there is any significant difference between the two models? Using documentary analysis to explore the terms, the authors conclude that Library 2.0 and Library 3.0 are different. Whereas Library 2.0 could be seen as attempting to weaken the role of librarians in the emerging information environment, Library 3.0 projects librarians as prominent apomediaries guiding library users on how best to locate, access and use credible information in myriad formats from diverse sources, at the point of need. The Library 3.0 model has revived hope amongst those who were uncomfortable with the crowd intelligence architecture on which the Library 2.0 model was founded. It provides the tools and framework to organize the infosphere that the Library 2.0 threw into disarray. The authors see the 3.0 library as a personalizable, intelligent, sensitive and living institution created and sustained by a seamless engagement of library users, librarians and subject experts on a federated network of information pathways.

Applying Semantic Web technologies to improve the retrieval, credibility and use of health-related web resources

The number of health-related websites is increasing day-by-day; however, their quality is variable and difficult to assess. Various "trust marks" and filtering portals have been created in order to assist consumers in retrieving quality medical information. Consumers are using search engines as the main tool to get health information; however, the major problem is that the meaning of the web content is not machine-readable in the sense that computers cannot understand words and sentences as humans can. In addition, trust marks are invisible to search engines, thus limiting their usefulness in practice. During the last five years there have been different attempts to use Semantic Web tools to label health-related web resources to help internet users identify trustworthy resources. This paper discusses how Semantic Web technologies can be applied in practice to generate machine-readable labels and display their content, as well as to empower end-users by providing them with the infrastructure for expressing and sharing their opinions on the quality of health-related web resources.

Delivering quality-evaluated healthcare information in the era of Web 2.0: design implications for Intute: Health and Life Sciences

The internet, though an invaluable and ubiquitous resource for health-related information, is perceived as being undermined by concerns about quality and reliability. Some recent developments, by permitting so-called user-generated content to be published on the internet, exacerbate these concerns. The impact of these developments, mostly characterized as Web 2.0, on the use of healthcare educational and information resources is explored in this article. There is a recognized need for an authoritative service that can address issues of quality. Intute: Health and Life Sciences is one such service, and its design in the context of meeting current Web 2.0 expectations and addressing concerns about quality is the focus of the article.

Realizing the promise of Web 2.0: engaging community intelligence

Discussions of Health 2.0, a term first coined in 2005, were guided by three main tenets: (a) health was to involve more participation, because an evolution in the web encouraged more direct consumer engagement in their own health care; (b) data was to become the new "Intel Inside" for systems supporting the vital decisions in health; and (c) a sense of collective intelligence from the network would supplement traditional sources of knowledge in health decision making. Interests in understanding the implications of a new paradigm for patient engagement in health and health care were kindled by findings from surveys such as the National Cancer Institute's Health Information National Trends Survey, showing that patients were quick to look online for information to help them cope with disease. This article considers how these 3 facets of Health 2.0--participation, data, and collective intelligence--can be harnessed to improve the health of the nation according to Healthy People 2020 goals. The authors begin with an examination of evidence from behavioral science to understand how Web 2.0 participative technologies may influence patient processes and outcomes, for better or worse, in an era of changing communication technologies. The article then focuses specifically on the clinical implications of Health 2.0 and offers recommendations to ensure that changes in the communication environment do not detract from national (e.g., Healthy People 2020) health goals. Changes in the clinical environment, as catalyzed by the Health Information Technology for Economic and Clinical Health Act to take advantage of Health 2.0 principles in evidence-based ways, are also considered.

DISMON

Information technology and, more precisely, the internet represent challenges and opportunities for medicine. Technology-driven medicine has changed how practitioners perform their roles in and medical information systems have recently gained momentum as a proof-of-concept of the efficiency of new support-oriented technologies. Emerging applications combine sharing information with a social dimension. This paper presents DISMON (Disease Monitor), a system based on Semantic Technologies and Social Web (SW) to improve patient care for medical diagnosis in limited environments, namely, organizations. DISMON combines Web 2.0 capacities and SW to provide semantic descriptions of clinical symptoms, thereby facilitating diagnosis and helping to foresee diseases, giving useful information to the company and its employees to increase efficiency by means of the prevention of injuries and illnesses, resulting in a safety environment for workers.

How the new web generations are changing library and information services

The new Web generations are influencing the minds and changing the habits of software developers and end users. Users, librarians, and information services professionals can interact more efficiently, creating additional information and content and generating knowledge. This new scenario is also changing the behavior of information providers and users in health sciences libraries. This article reviews the new Web environments and tools that give librarians opportunities to tailor their services better, and gives some examples of the advantages and disadvantages for them and their users. Librarians need to adapt to the new mindset of users, linking new technologies, information, and people.

[Concept and applications of the Web 3.0: an introduction for medical doctors]

The development of the Internet is continuous and appears to be never-ending, although with the arrival of Web 3.0 it could be said that the Internet is what its creators intended it to be from the first moment, an extraordinary and immense organised, understandable, and easy to access data base, characteristics still not achieved. The innovations and services included in Web 3.0 will result, in the first place, in better, faster and safer access to quality information. In the second place it should provide better personalisation of the health services that Internet users access, avoiding irrelevant information that may contain wrong, false and dangerous recommendations. However, these changes will have to be accompanied by the legal requirements common to the information society, by the ethical aspects associated with medical care, guaranteeing and contributing, in all cases, to improving the doctor-patient relationship.

Potential benefits and harms of a peer support social network service on the internet for people with depressive tendencies: qualitative content analysis and social network analysis

Background

Internet peer support groups for depression are becoming popular and could be affected by an increasing number of social network services (SNSs). However, little is known about participant characteristics, social relationships in SNSs, and the reasons for usage. In addition, the effects of SNS participation on people with depression are rather unknown.

Objective

The aim was to explore the potential benefits and harms of an SNS for depression based on a concurrent triangulation design of mixed methods strategy, including qualitative content analysis and social network analysis.

Methods

A cross-sectional Internet survey of participants, which involved the collection of SNS log files and a questionnaire, was conducted in an SNS for people with self-reported depressive tendencies in Japan in 2007. Quantitative data, which included user demographics, depressive state, and assessment of the SNS (positive vs not positive), were statistically analyzed. Descriptive contents of responses to open-ended questions concerning advantages and disadvantages of SNS participation were analyzed using the inductive approach of qualitative content analysis. Contents were organized into codes, concepts, categories, and a storyline based on the grounded theory approach. Social relationships, derived from data of “friends,” were analyzed using social network analysis, in which network measures and the extent of interpersonal association were calculated based on the social network theory. Each analysis and integration of results were performed through a concurrent triangulation design of mixed methods strategy.

Results

There were 105 participants. Median age was 36 years, and 51% (36/71) were male. There were 37 valid respondents; their number of friends and frequency of accessing the SNS were significantly higher than for invalid/nonrespondents (P = .008 and P = .003). Among respondents, 90% (28/31) were mildly, moderately, or severely depressed. Assessment of the SNS was performed by determining the access frequency of the SNS and the number of friends. Qualitative content analysis indicated that user-selectable peer support could be passive, active, and/or interactive based on anonymity or ease of use, and there was the potential harm of a downward depressive spiral triggered by aggravated psychological burden. Social network analysis revealed that users communicated one-on-one with each other or in small groups (five people or less). A downward depressive spiral was related to friends who were moderately or severely depressed and friends with negative assessment of the SNS.

Conclusions

An SNS for people with depressive tendencies provides various opportunities to obtain support that meets users’ needs. To avoid a downward depressive spiral, we recommend that participants do not use SNSs when they feel that the SNS is not user-selectable, when they get egocentric comments, when friends have a negative assessment of the SNS, or when they have additional psychological burden.

A Web-based graphical user interface for evidence-based decision making for health care allocations in rural areas

Background

The creation of successful health policy and location of resources increasingly relies on evidence-based decision-making. The development of intuitive, accessible tools to analyse, display and disseminate spatial data potentially provides the basis for sound policy and resource allocation decisions. As health services are rationalized, the development of tools such graphical user interfaces (GUIs) is especially valuable at they assist decision makers in allocating resources such that the maximum number of people are served. GIS can used to develop GUIs that enable spatial decision making.

Results

We have created a Web-based GUI (wGUI) to assist health policy makers and administrators in the Canadian province of British Columbia make well-informed decisions about the location and allocation of time-sensitive service capacities in rural regions of the province. This tool integrates datasets for existing hospitals and services, regional populations and road networks to allow users to ascertain the percentage of population in any given service catchment who are served by a specific health service, or baskets of linked services. The wGUI allows policy makers to map trauma and obstetric services against rural populations within pre-specified travel distances, illustrating service capacity by region.

Conclusion

The wGUI can be used by health policy makers and administrators with little or no formal GIS training to visualize multiple health resource allocation scenarios. The GUI is poised to become a critical decision-making tool especially as evidence is increasingly required for distribution of health services.

Health 2.0 and Medicine 2.0: tensions and controversies in the field

BACKGROUND

The term Web 2.0 became popular following the O'Reilly Media Web 2.0 conference in 2004; however, there are difficulties in its application to health and medicine. Principally, the definition published by O'Reilly is criticized for being too amorphous, where other authors claim that Web 2.0 does not really exist. Despite this skepticism, the online community using Web 2.0 tools for health continues to grow, and the term Medicine 2.0 has entered popular nomenclature.

OBJECTIVE

This paper aims to establish a clear definition for Medicine 2.0 and delineate literature that is specific to the field. In addition, we propose a framework for categorizing the existing Medicine 2.0 literature and identify key research themes, underdeveloped research areas, as well as the underlying tensions or controversies in Medicine 2.0's diverse interest groups.

METHODS

In the first phase, we employ a thematic analysis of online definitions, that is, the most important linked papers, websites, or blogs in the Medicine 2.0 community itself. In a second phase, this definition is then applied across a series of academic papers to review Medicine 2.0's core literature base, delineating it from a wider concept of eHealth.

RESULTS

The terms Medicine 2.0 and Health 2.0 were found to be very similar and subsume five major salient themes: (1) the participants involved (doctors, patients, etc); (2) its impact on both traditional and collaborative practices in medicine; (3) its ability to provide personalized health care; (4) its ability to promote ongoing medical education; and (5) its associated method- and tool-related issues, such as potential inaccuracy in enduser-generated content. In comparing definitions of Medicine 2.0 to eHealth, key distinctions are made by the collaborative nature of Medicine 2.0 and its emphasis on personalized health care. However, other elements such as health or medical education remain common for both categories. In addition, this emphasis on personalized health care is not a salient theme within the academic literature. Of 2405 papers originally identified as potentially relevant, we found 56 articles that were exclusively focused on Medicine 2.0 as opposed to wider eHealth discussions. Four major tensions or debates between stakeholders were found in this literature, including (1) the lack of clear Medicine 2.0 definitions, (2) tension due to the loss of control over information as perceived by doctors, (3) the safety issues of inaccurate information, and (4) ownership and privacy issues with the growing body of information created by Medicine 2.0.

CONCLUSION

This paper is distinguished from previous reviews in that earlier studies mainly introduced specific Medicine 2.0 tools. In addressing the field's definition via empirical online data, it establishes a literature base and delineates key topics for future research into Medicine 2.0, distinct to that of eHealth.