On 26th October I have the opportunity to act as a moderator in a symposium called Communication in health 2.0, organized by the Institute for Continuing Education (IDEC) and the University of Pompeu Fabra’s Science Communication Observatory (OCC). First of all, I would like to thank Vladimir de Semir, Gemma Revuelta and Clara Armengou for their invitation and their organization of the symposuum. I really think that University has a role as a hub to disseminate and research about this topic in collaboration with the rest of the actors (industry, healthcare providers, professionals, Government,…).

Act as a moderator gave me the opportunity to work on the Health Communication field as a framework of part of the research I have been doing and develop the first step towards the conceptualization of Health Mass-Self Communication.

Yesterday I had the pleasure to attend the defence of Ismael Peña‘ thesis Measuring digital development for policy-making: models, stages, characteristics and causes, “which deals about the digital economy and whether governments should help in its development for it might have a positive impact on the real economy and on the society at large”.

Dissertation supervisor: Tim Kelly

Composition of the committee:

President: Tim Unwin (University of London)
Secretary: Joan Torrent Sellens (UOC)
Members: Robin Mansell (London School of Economics)
Bruno Lanvin (INSEAD)
Laura Sartori (Università di Bologna)

Substitutes:
Gustavo Cardoso (Instituto Superior de Ciências do Trabalho e da Empresa)
Rosa Borge Bravo (UOC)

CONGRATULATIONS Dr. Peña-López. I’m proud to work with you in the same research group I2TIC.

I have read Nijland, N., van Gemert-Pijnen, J. E. W. C., Boer, H., Steehouder, M. F., & Seydel, E. R. (2009). Increasing the use of e-consultation in primary care: Results of an online survey among non-users of e-consultation. International Journal of Medical Informatics, In Press, Corrected Proof.

Abstract

Objective
To identify factors that can enhance the use of e-consultation in primary care. We investigated the barriers, demands and motivations regarding e-consultation among patients with no e-consultation experience (non-users).

Methods
We used an online survey to gather data. Via online banners on 26 different websites of patient organizations we recruited primary care patients with chronic complaints, an important target group for e-consultation. A regression analysis was performed to identify the main drivers for e-consultation use among patients with no e-consultation experience.

Results

In total, 1706 patients started to fill out the survey. Of these patients 90% had no prior e-consultation experience. The most prominent reasons for non-use of e-consultation use were: not being aware of the existence of the service, the preference to see a doctor and e-consultation not being provided by a GP. Patients were motivated to use e-consultation, because e-consultation makes it possible to contact a GP at any time and because it enabled patients to ask additional questions after a visit to the doctor. The use of a Web-based triage application for computer-generated advice was popular among patients desiring to determine the need to see a doctor and for purposes of self-care. The patients’ motivations to use e-consultation strongly depended on demands being satisfied such as getting a quick response. When looking at socio-demographic and health-related characteristics it turned out that certain patient groups – the elderly, the less-educated individuals, the chronic medication users and the frequent GP visitors – were more motivated than other patient groups to use e-consultation services, but were also more demanding. The less-educated patients, for example, more strongly demanded instructions regarding e-consultation use than the highly educated patients.

Conclusion
In order to foster the use of e-consultation in primary care both GPs and non-users must be informed about the possibilities and consequences of e-consultation through tailored education and instruction. We must also take into account patient profiles and their specific demands regarding e-consultation. Special attention should be paid to patients who can benefit the most from e-consultation while also facing the greatest chance of being excluded from the service. As health care continues to evolve towards a more patient-centred approach, we expect that patient expectations and demands will be a major force in driving the adoption of e-consultation.

Summary points

What was already known on the topic?

• The increased public interest in medical information regarding health issues are driving forces for the growth of health services on the Internet. However, the growth of e-consultation in primary care has been minor.
• Access to healthcare and information technology is often most difficult for those populations who need it most. E-consultation can be beneficial for certain patient groups, such as frequent GP visitors and chronic users of medication. Yet, it is unclear whether access to e-consultation is most difficult for these populations.

What did this study add to our knowledge?

• Non-use of e-consultation was primarily due to lack of availability among GPs and to information deficits among patients, such as unawareness of the existence of the service and the possibilities of e-consultation. Proper education and instructions are necessary to increase the use of e-consultation.
• Patient groups who were most motivated to use e-consultation e.g., elderly patients, less-educated patients, chronic medication users and frequent GP-visitors, perceived the greatest barriers towards econsultation.
• Web-based triage systems may be promising, because this study indicates that patients are motivated to use such systems for primary evaluation of medical complaints and for self-care advice.

Again, the results of the empirical research revealed the gap between the potencial of ICTs uses in healthcare and the facts that shape these uses. The inverse care law is still working in the transition of healthcare systems to Network Society.

I would like to disseminate a paper entitled Knowledge, networks and economic activity: an analysis of the effects of the network on the knowledge-based economy written by Joan Torrent, director of ICTs Interdisciplinary Research Group (i2TIC), brand new research group I belong to.

This paper contextualises the disruptive change of the transition to a knowledge-based economy and discusses the social sciences postulations with regards to this phenomenon. Once the general context is explained, the article focuses on the microeconomic foundations, understanding knowledge as an input and as a commodity. Finally, after discussing the microeconomics of knowledge, the paper tackles network externalities and their  impact on economic functions and market structure.

Abstract

The progressive consolidation of a knowledge-based economy has caused network effects to become a focal point of analysis into the changes in behaviour evinced by economic agents. This article analyses the changes in production and demand for knowledge commodities arising from network externalities. The analysis reveals two distinct patterns of behaviour in knowledge-based economic activity. Observable knowledge commodities are governed by the effect of direct and indirect network externalities. Also, their demand curve and business strategy depend on new-user entry (marginal value) and the relative size of the network. However, tacit knowledge commodities are governed by learning network externalities and their demand curve and business strategies are dependent on the value generated by the addition of the goods themselves to the network (intrinsic value).

This paper could help towards a better understanding of  health care systems within the network society.

I’m glad to share my slides presented on World Internet Project 2009 - Macau entitled Health and the Internet: Autonomy of the User. The presentation is based on a paper written by Rita Espanha and myself for the book “World Wide Internet. Changing Societies, Economies and Cultures” edited by Gustavo Cardoso, Angus Cheong and Jeffrey Cole.

I’m delighted with the great atmosphere of the conference due to the different research perspectives that have been presented by researchers around the world. Twitter #wip200. Finally, thanks Rita for the opportunity to work together. This presentation and the book chapter are just the begining.

I’m so excited about World Internet Project 2009 Macao (July 8 - 10) where I’m presenting a paper done with Dra. Rita Espanha entitled Health and the Internet: Autonomy of the User.

Abstract:

Information access and distribution are growing and the ways in which this information and knowledge democratisation occurs are many, scattered and diverse. Individual health, and its daily management, never involved as much information as nowadays.

The aims of this paper are: to identify and characterise the role of daily information and communication practices for health individual management in Portugal and to identify and characterise some trends on a global scale of the Internet use for health purpose.

Considering all Internet activities within WIP database 2007, cluster analysis was carried out to define an e-readiness index to the Network Society. Citizens who have more probability to be in worse health status due to their age are those who have also more probability to be less e-readiness or even dropped out of the Internet.

Parallel to the “informed patient” concept, we must consider also in our approaches the “generation divide” and the “e-readiness divide” concepts associated with health.

The World Internet Project (WIP) is a major, international, collaborative project looking at the social, political and economic impact of the Internet and other new technologies. Conceived as the study of the Internet that should have been conducted of television in its early days, the WIP believes that the Internet’s influence will ultimately be far greater than television. Whereas television has mostly been about entertainment, the Internet has the potential to transform how the world plays, works and learns… +info

I’m working on the presentation but after the meeting it will be uploaded. Finally I would like to thank Imma Tubella, Carlos Tabernero and specially Joan Torrent, colleagues from Internet Interdisciplinary Institute (IN3) at Open University of Catalonia, for their support to travel to Macao.

Today I have started my day reading [Air-L] blogs on death and dying for agnostics and atheists and I can’t stop thinking about it.

Hi AoIRers!

My father was diagnosed 6 months ago with Stage III esophageal cancer. After one round of radiation and chemotherapy, he recently decided to enter hospice. He’s a retired psychology professor and as a social scientist he’s trying to gather as much information as possible about the process of dying from the personal perspective of an agnostic or atheist. He’s most interested in finding agnostics and atheists facing death who are blogging (or have blogged) about their experiences. I haven’t had much luck identifying blogs that fit this somewhat narrow parameter. He has set up a blog
http://agnosticsfacingdeath.blogspot.com/
in the hopes he can start a conversation with others in similar circumstances.

If you have any suggestions for specific websites, blogs, search terms, etc., please email me off list at sjcoopman@yahoo.com

-Stephanie

Stephanie J. Coopman, Ph.D.
Professor
Communication Studies
Advising Liaison, College of Social Sciences
http://www.sjsu.edu/advising/
Faculty in Residence, Accessible Technology Initiative
http://www.sjsu.edu/cfd/resources/instructional/accessibility.shtml
San Jose State U
San Jose, CA 95192-0112
http://www.sjsu.edu/people/stephanie.coopman/

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Reading this message and the second post entitled Good Day I have realised again the complexity around health and its relationship with moral and beliefs issues and also to what extend the Internet is embedded in everyday life and furthermore death.

I hope the spread of this message could help Stephanie and Bob.

This paper could help us to frame into scientific medial journals the differences between  Utilised ICT physicians and Integrated ICT physicians and also fix into the drivers of the transition from utilization to integration.

Masters, K. (2008). For what purpose and reasons do doctors use the Internet: A systematic review. International Journal of Medical Informatics, 77(1), 4–16.

Objectives: To determine doctors’ reasons for using the Internet, and the factors that influence their usage.
Data sources: A systematic review of 38 studies, from 1994 to 2004, describing surveys of doctors’ Internet usage.
Results: All of the studies were in the developed world, primarily in North America. Approximately 60–70% of doctors have access to the Internet, but in several studies access is more than 90%. Access is steadily increasing. Most Internet activity focuses on email and searching in journals and databases, but there is a very wide range of activities. Professional email with colleagues and patients is low, but increasing. The major factors discouraging usage are time, workload and cost, while too much information, liability issues and lack of skills
also feature as discouraging factors. Factors encouraging use are unclear, but overall patient satisfaction and belief in improved service delivery, time saving and demand from patients are factors. There is a trend that males use the Internet more than females, young more than old, and specialists more than generalists, but these differences are not across the board, and show variations between studies.
Conclusion: In spite of the limitations, it is clear that doctors are highly connected to the Internet, and their professional usage is increasing. Factors encouraging and discouraging usage are more complex than simple connectivity. Usage differences between demographic groups do exist, but are equalising. More and consistent research is required in this area.

I have finished to check the proof of my article entitled Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration for Informatics for Health and Social Care (An International Journal of Informatics in Health Care).

Here goes the abstract:

The Internet has become one of the main drivers of e-health. Whilst its impact and potential is being analysed, the Web 2.0 phenomenon has reached the health field and has emerged as a buzzword that people use to describe a wide range of online activities and applications. The aims of this article are: to explore the opportunities and challenges of the Web 2.0 within the health care system and to identify the gap between the potential of these online activities and applications and the empirical data. The analysis is based on: online surveys to physicians, nurses, pharmacist and patient support groups; static web shot analysis of 1240 web pages and exploration of the most popular Web 2.0 initiatives. The empirical results contrast with the Web 2.0 trends identified. Whereas the main characteristic of the Web 2.0 is the opportunity for social interaction, the health care system at large could currently be characterised by: a lack of interactive communication technologies available on the Internet; a lack of professional production of health care information on the Internet, and a lack of interaction between these professionals and patients on the Internet. These results reveal a scenario away from 2.0 trends.

The article has been done with Miquel Angel Mayer and Joan Torrent, colleagues from Interdisciplinary Research Group on ICTs (i2TIC), and will be published on September 2009.