‘Jakob Nielsen’s Digital Divide: The Three Stages’ posted by Ismael Peña talking about Empowerment Divide and a conversation with him make me think about empowerment in health and the consequences of Internet in this topic.

Roma Harris and Tiffany Veinot wrote The Empowerment Model and Using E-Health to Distribute Information. In this working paper they tackle the issue of empowerment: definition, the social context of ‘Patient Empowerment, and the most interested part for me the critical perspectives on ‘patient empowerment’

The idea of ‘patient empowerment’ is based on underlying assumptions that bear further examination. These include the ideas that:

• patients want to be in control of their health and health care;
• it is good for patients to have choice and control;
• health care providers support patient effors to gain control;
• providing health information to patients ‘empowers’ them; and
• ‘informed’ and ‘empowered’ patients take better care of their health

In summary the authors raise the Patient Empowerment Paradox.

I think this paradox is also related with the problems of the importance of expert system in modern society explained by Giddens and the critique of information made by Lash. Taking into account those authors I wonder if Does Internet empower patients? physicians? hospital managers? politicians? and is there a rivality among agents for empowerment? (“more empowered ones implies less empowered others”)

Improving health is a key concern of OECD societies, as it can contribute to higher economic growth and improved welfare.

OCDE Observer

The OECD Observer magazine presents concise, up-to-date and authoritative analysis of crucial world economic, social and environmental issues. Since 1962 it has been keeping policymakers, business people, NGOs, researchers and journalists ahead of the policy debate. It is a catalyst for new discussion and ideas, and a source of key data.

has published “Health care: Towards quality performance” remind us the importance of quality performance in health care taking into account:

Two prospects seem certain to influence health care policy in the years ahead: costs, which are set to rise due to technology and ageing populations; and public demand, as older populations expect ever better outcomes from their health care services.

and:

Right now, such are the gaps in national reporting on data that meaningful, constructive answers to these questions are hard to give. That is why quality measurement is finding greater prominence on national agendas for monitoring and reporting, and is even mandated by some legislatures. Some countries have to improve health care for specific subpopulations, but lack the tools of measurement and analysis to assure delivery of quality care across regions or groups.

So the author remarks:

As data is gathered and updated, more lessons will be learned, more gaps plugged and new telling patterns revealed.

The OCDE has developed Health Working Papers, to make available to a wider readership health studies prepared for use within the OECD, and Health Technical Papers, to make available to a wider readership methodological studies and statistical analysis presenting and interpreting new data sources, and empirical results and developments in methodology on measuring and assessing health care and health expenditure.

OCDE Health Working Papers No.22 and No.23 address quality indicators project. As ICT and its consequences on health information systems seem key topics to gather and share information among agents. May we pay attention to develop indicators related with those topics? I have identified the e-Business W@tch Iniciative (but isn’t it too market-oriented?) and SIBIS (Statistical Indicators Benchmarking the Information Society)

We can also learn from the ancient China:

In ancient China wealthy emperors paid their doctors only when they were well, and penalised them when they fell ill. Being sick simply meant the medicine was not working, being well meant that the doctor was doing his job. A healthy outcome was the goal.