As I mentioned before, I have been invited to participate in the International Seminar “Aplicación de las nuevas tecnologías a la prevención y asistencia en adicciones (”New technologies applications to prevention and assistance of addictions” (26th and 27th, June). Here goes my presentation:

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As a result of Health and Web 2.0 in the Information Age Conference: from empirical data to Web 2.0 trends,  three videos and two power point presentations are available. Furthermore, the conference’s speaker and I had a interesting conversation with  Salvador Tordera, a journalist from Open University of Catalonia. A few days ago, Salvador has written a report titled Medical consultation 2.0:

Chatting about sexuality in Second Life, receiving a text message from your doctor to remind you to take your medication, checking on your position in a hospital waiting list online… All of these actions are already possible thanks to the application of information and communication technologies (ICTs) in the health sector. The internet is a very powerful tool that gives users greater autonomy and control over their health –which surveys around the world have shown to be the greatest concern in people’s lives. As with all processes involved in the rapid changes in the information age, ICTs open up very interesting possibilities –but not without certain risks.

Using the internet for medical questions has increased both among service users and professionals in the sector. In Catalonia, 40% of internet users carry out searches or procedures relating to health. Despite the increase in the amount of information available, it has not led to greater interaction between those involved in the system, increased flexibility or decentralisation. The vast majority of the content related to health on the internet is limited to informative sites giving advice or guidance from institutions and professionals, or user associations and individuals.

According to experts in the field, the internet is used just like any other media with the added problem that its channels have not yet completely developed; in other words, they do not make full use of the unique nature and benefits of the net. These are some of the conclusions outlined in the UOC’s Project Internet Catalonia (PIC) study coordinated by professor Manuel Castells, which dedicated one of its lines of investigation to the use of ICTs in the health sector.

With the arrival of web 2.0, the user has ceased to be just another consumer and has become a producer of content. With this new development now a reality, Professors Rita Espanha, from Portugal’s Sociological Research Centre - Communication Observatory, and Michael Hardey, from the Hull York Medical School, UK, were invited to a seminar by the TicSalut Foundation and the UOC to talk about the results of their latest research.

Information control

Studies show that 25 percent of the information relating to health on the internet is incorrect. Faced with this fact, an inevitable question emerges: what can be done to control the information on a subject that is so crucial to people’s lives? “Virtually nothing. As with the rest of the information on the internet, certification is an initiative devised by providers, but users are free to choose which source they use and decide whether to believe it or not; it is up to them,” argues Professor Espanha.

According to this sociologist’s research in Portugal, “users always trust information more when it is published by public institutions and when it has close cultural links to them”. However, she also considers that we need to bear in mind that the internet is global: “if someone with gastroenteritis in Brazil (where the illness can be fatal) consults a website in Portugal (where the illness is less serious due to the existence of an established health infrastructure), incorrect advice can be extremely dangerous for the patient”. Although it can be difficult at times, due to the vastness of the internet, users need to take an active and responsible role and adapt the information to their own situation.

The expansion of web 2.0

In the majority of countries, such as Portugal or Catalonia, health technology is still using the first version of the internet, although the new participative web tools (wikis, blogs, social networks, etc.) are opening up the way and bringing with them new benefits. Professor Michael Hardey has been studying the evolution of the internet in relation to health in the English-speaking world for some years. Hardey assures us that “web 2.0 has become an inseparable part of people’s daily activities. This is particularly apparent with the under-30s and nowadays the health sector, as well as other professional sectors, cannot ignore it.” Social networks are being established as a platform for measuring the quality of the services and, in particular, for sharing experiences and concerns relating to illnesses (www.patientslikeme.com). These tools were discovered and pioneered by HIV sufferer associations, who were the first to organise themselves over the internet.

In California, USA, which has a market led healthcare system, there are some initiatives where patients rate hospitals and doctors online (www.rateMd.com). Likewise, mash-up websites have also been developed that allow patients to anonymously enter details relating to their illness and then monitor it on a map and locate patients with similar symptoms (www.whoissick.org). According to Hardey, mash-up applications allow very useful variables to be combined from a health point of view; for example, a user who has asthma could be warned by mobile phone that they are about to enter a street with a high level of pollution.

Moreover, in the USA, Google Health has been created by the computer giant to create medical profiles that can be consulted online, with the details that users themselves have entered protected by a password. At the moment, it is only available to those in the US, although its coverage will be worldwide in the future. However, as Professor Espanha states, “the main problem with this application is that the patient can decide to hide important information from their medical records”, and this means that we cannot be sure that we are looking at a genuine, professional medical history online. Google’s great competitor, the multinational Microsoft, has a similar application called HealthVault.

John Hopkins Hospital in Maryland, USA, has also developed web 2.0 tools for health that allow its patients with reading difficulties to download news, reminders and advice in podcast format. Institutions in a number of countries have also created virtual worlds, such as Second Life, to make health issues more accessible to the young (in Spain, the Spanish Society of Family Medicine has an initiative in this area).

Health 2.0 in Catalonia

The Catalan government has various initiatives relating to health and web 2.0 applications. Examples include the creation of an online and personalised communication channel from the Health Department and a single clinical history that is accessible and editable from any point on the territorial network.

Changes in the patient-doctor relationship

According to Hardey, one of the sensitive points of this new paradigm (e-health) is the erosion of the, traditionally paternalist (“doctor knows best”), relationship between patient and doctor. This restructuring towards an online model can reduce the support for the traditional channels (face-to-face/paper) and experts warn of the risk of reinforcing pre-established patterns which impede access to health services for certain groups.

The so-called digital divide is also present, as not all users have access to the internet and cannot benefit from these advances, either because of socio-economic factors or a fear of the new technologies. On the other hand, some evidence shows that medical consultations made over the internet help to bring older people closer to the new technology and as a consequence improve their ability to keep up-to-date and reduce their feeling of isolation. In short, e-health encourages users to take a more active, autonomous and efficient role in the management of their own health and, in turn, offers health service providers a better, faster and more personalised way of communicating with their users.

I would like to thank Salvador for his report that summarize our talk.

Little by little Web 2.0 movement is being approached by theory and empirical data. As an example of empirical data approachs, OECD has launched Participative Web and User-Created Content. Web 2.0, wikis and social networking

The concept of the “participative web” is based on an Internet increasingly influenced by intelligent web services that empower users to contribute to developing, rating, collaborating and distributing Internet content and customising Internet applications. As the Internet is more embedded in people’s lives users draw on new Internet applications to express themselves through “user-created content” (UCC).

This study describes the rapid growth of UCC, its increasing role in worldwide communication and draws out implications for policy. Questions addressed include: What is user-created content? What are its key drivers, its scope and different forms? What are new value chains and business models? What are the extent and form of social, cultural and economic opportunities and impacts? What are associated challenges? Is there a government role and what form could it take?

These kind of initiatives help us to a better understanding of Web 2.0 phenomenon and to analyse in what way and in what measure the ICT’s, especially the Internet, are appropriated by the current social structure, the Network Society.

On 17-18 June 2008 in Seoul holds OECD Ministerial Meeting: The Future of the Internet Economy

The Internet is a key infrastructure for global economic growth and social development. Three major trends – Convergence, Creativity and Confidence – are influencing the policy environment for the Internet Economy. Each of these trends reflects significant shifts in the use and functionality of the Internet. Collectively, they represent a major transition in the evolution of the Internet and the economic system that has developed around it. Therefore, it has become increasingly necessary that policies supporting the Internet Economy be carefully crafted and co-ordinated across policy domains, borders and multiple stakeholder communities.

Ministers and stakeholders meeting on 17-18 June 2008 in Seoul will consider social, economic and technological trends shaping the development of the Internet Economy. They will forge broad principles that can provide an enabling policy environment for the Internet Economy.

As background for the Ministerial meeting analytical reports are being released:

A Policy Brief on the Future of the Internet Economy: Major changes are affecting the scope and scale of the Internet. As a result, the Internet is increasingly high on the policy agenda in many OECD and non-OECD countries. This Policy Brief reviews likely future developments in the Internet economy and how policy-makers can help the Internet to adapt to evolving requirements caused by convergence, continue to drive innovation, and be trustworthy.

Convergence and Next Generation Networks: OECD has just issued a new report on convergence and next generation networks and their potential impact on policies and regulations. The report addresses issues of competition in the new fibre environment, convergence of video, voice and data services, the rapid growth of new technologies, such as HDTV and mobile television, and the related demand for spectrum, as well as new possible “divides” between urban and rural areas created by the uneven development of high-speed fibre networks.

Consumer empowerment in communication services: Improving the ability of consumers to choose between competing suppliers is important for well functioning markets. The report examines how to increase market flexibility for consumers in communication services, and improve access to information.

Development of Policies for Protection of Critical Information Infrastructures: Some information systems are critical because their disruption or destruction would have a serious impact on the economic well-being of citizens or the effective functioning of government or the economy. Based on two studies conducted in 2006 and 2007, this OECD report analyses security policies to protect critical information infrastructures in Australia, Canada, Japan, Korea, The Netherlands, the United Kingdom, and the United States.

Malicious Software (Malware): A Security Threat to the Internet Economy: Malware has evolved from occasional “exploits” to a multi-million dollar criminal industry. This report informs policy makers about the evolution and impact of malware, as well as the counter-measures being taken. It concludes with suggestions for greater co-operation across the various international communities addressing malware.

Broadband and the Economy: Broadband and networked ICTs are diffusing rapidly, but there are significant differences in use among countries, sectors and firms, and their impacts are only beginning to be felt. Broadband and networked ICTs are important in meeting health, demographic and environmental challenges, and policy plays an important role in expanding their use and enhancing their impact.

I have been invited by Government of La Rioja, through the Regional Ministry of Health, to participate in the International Seminar “Aplicación de las nuevas tecnologías a la prevención y asistencia en adicciones (”New technologies applications to prevention and assistance of addictions” (26th and 27th, June) located at CIBIR, the Biomedical Research Centre of La Rioja. The seminar is organized by Drojnet an European project that evaluates the usefulness of new media in informing teenagers about drugs and their effects on their health. Deadline for registration is June 13, 2008.

I’m going to participate in the track “Health , Communication and New technologies” talking about “Health and the Internet. The transition of health system to Network Society: an empirical analysis of Catalonia” based on E-Health and Society: an empirical study of Catalonia directed by Prof. Castells.

I’m excited about this Seminar for many reasons: I will meet interesting people who are working in eHealth in Spain and Europe; Drojnet project looks like a good initiative to explore eHealth and Digital Natives topics and I will have the opportunity to talk with their authors; and it will be a good opportunity to know Regional Ministry of Health of La Rioja initiatives in eHealth. Finally, I would like to thank to the organization of the seminar for the invitation.

I’m glad to announce that Health and Web 2.0 in the Information Age videos are available at YouTube.

Health in the Information Age by Rita Espanha

Health and Web 2.0 by Michael Hardey

Health and Web 2.0: initiatives from Catalonia Government by Joan Guanyabens

Enjoy them! Thanks again to those who made this conference possible. Of course, Feedbacks are welcome!

First of all I would like to thank Gustavo Cardoso, Miquel Angel Mayer and indeed Rita Espanha and Michael Hardey for the marvellous working days we had in Barcelona. It was a honour to have the opportunity to share during three days thoughts, reflections, past researches and ideas about health and the Internet. I’m sure those are just the beginning of future collaborations. Thank you very much for such a wonderful days.

The conferences matched the audience’s expectations. Michael and Rita have allowed me to upload their presentations to the Internet as long as many people have showed their interest in the conference but they were not able to attend to Barcelona. I ‘m pleasure to announce that both conferences were video recorded and will be available in two week at UOC YouTube Channel.

Rita Espanha and Gustavo Cardoso have been reserching the transition to Network Society in Portugal. Most of the researches are available at OberCom. OberCom (Observatory for the Media) is directed by Gustavo Cardoso. He and Rita Espanha supervise the centre’s scientific research development; manage the centre research networking and institutional relations. OberCom is a non-profit research centre whose main goal is the production of data and diffusion of information about the Media, thus contributing to better knowledge of the field of communications in Portugal.

As I posted before, they have developed a research project titled Health in the Information Age. Their main conclusions were showed in Rita’s presentation

In 1999 Michael Hardey wrote Doctor in the house: the Internet as a source of lay health knowledge and the challenge to expertise. He was one of the first researchers who started to analyse Health and the Internet and the transformation of the relation between health professions and their clients/users/patients. In 2001, “E-Health”: the Internet and the transformation of patients into consumers and producers of health knowledge was published. Is it sound like Web 2.0?. His forthcoming paper will be Hardey, M. (2008) Public health and Web 2.0, Journal of the Royal Institute of Health Promotion 128(4):171-179

Finally, I would like to thank International Graduate Institute (Open University of Catalonia) and TicSalut Foundation for sponsoring the conference.

I’m pleasure to announce “Health and Web 2.0 in the Information Age Conference” on 15th May at Barcelona Biomedical Research Park. The speakers are:

• Prof. Rita Esphana (CIES-ISCTE - OberCom, Portugal) - “Health in the Information Age”
• Prof. Michael Hardey (Hull/York Medical School - SIRU, UK) - “Health and Web 2.0″

The conference is sponsored by International Graduate Institute (Open University of Catalonia) and TicSalut Foundation and is open to the public (the lectures will be in English. A simultaneous interpretation service will be available) :

• Programme
• Free registration

I’m excited with Michael and Rita conferences and even more excited with the two days before the conference. After many emails and a visit to Lisbon we are going to meet face to face to all together to strengthen future collaborations. Network is great!

Yesterday, I was invited by Cristina Iniesta, Hospital del Mar Manager Director and Health Promoting Hospital Network Coordinator, to present the results from Internet, Health and Society in Catalonia in one of the network meetings at Hospital Sant Joan de Deu.

The aims of the presentation were: (1) to analyse in what way and to what extent the Internet is adopted and embedded by Catalan health system; (2) to discuss the implications for health promotion, taking into account Health Promoting Hospital objectives and, (3) to find ways of future collaborations.

The atmosphere of the session was excellent. I’m sure we will find many ways of future collaboration. Finally, I’m grateful to Kathryn O´Connor, my wonderful English teacher at UOC, for introducing me Cristina Iniesta and, last but not least, I would like to thank Cristina Iniesta for her kind invitation and her open thinking.

On 23th and 24th of April I was at Lisbon invited by Gustavo Cardoso and Rita Espanha to the presentation of the research project Health in the Information Age supported by Fundação Calouste Gulbenkian

Brief description:
The first objective of the study is to analyse in what way and in what measure the ICT’s, especially the Internet, are appropriated in the health field (internet and information systems) in the following domains: ICT’s and the Health Professionals; Users and ICT’s; The Health Information Systems; ICT’s and Media contents about Health.

Research funding:
Serviço de Saúde e Desenvolvimento Humano da Fundação Calouste Gulbenkian.

Project Coordinators:
Rita Espanha and Gustavo Cardoso

Results are already available in Portuguese.

This research project had been developed at the same time as E-health and Society: An empirical study of Catalonia. During that time, methodological issues were shared so comparative studies will be done in further collaborations.

I would like to thank indeed Gustavo and Rita for their invitation to the meeting and their hospitality. It’s a pleasure to have the opportunity to collaborate with you. Congratulations for you work!