Health 2.0

"Health 2.0" is a term introduced in the mid-2000s, as the subset of health care technologies mirroring the wider Web 2.0 movement. It has been defined variously as including social media, user-generated content, and cloud-based and mobile technologies. Some Health 2.0 proponents see these technologies as empowering patients to have greater control over their own health care and diminishing medical paternalism. Critics of the technologies have expressed concerns about possible misinformation and violations of patient privacy.

History

Health 2.0 built on the possibilities for changing health care, which started with the introduction of eHealth in the mid-1990s following the emergence of the World Wide Web. In the mid-2000s, following the widespread adoption both of the Internet and of easy to use tools for communication, social networking, and self-publishing, there was spate of media attention to and increasing interest from patients, clinicians, and medical librarians in using these tools for health care and medical purposes.^[1][2]

Early examples of Health 2.0 were the use of a specific set of Web tools (

Public Health 2.0 is a movement within public health that aims to make the field more accessible to the general public and more user-driven. The term is used in three senses. In the first sense, "Public Health 2.0" is similar to "Health 2.0" and describes the ways in which traditional public health practitioners and institutions are reaching out (or could reach out) to the public through social media and health blogs.^[7][8]

In the second sense, "Public Health 2.0" describes public health research that uses data gathered from social networking sites, search engine queries, cell phones, or other technologies.^[9] A recent example is the proposal of statistical framework that utilizes online user-generated content (from social media or search engine queries) to estimate the impact of an influenza vaccination campaign in the UK.^[10]

In the third sense, "Public Health 2.0" is used to describe public health activities that are completely user-driven.

The "traditional" definition of "Health 2.0" focused on technology as an enabler for care collaboration: "The use of social software t-weight tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health."[14]

In 2011, Indu Subaiya redefined Health 2.0^[15] as the use in health care of new cloud, Saas, mobile, and device technologies that are:

1. Adaptable technologies which easily allow other tools and applications to link and integrate with them, primarily through use of accessible
   APIs
2. Focused on the user experience, bringing in the principles of user-centered design
3. Data driven, in that they both create data and present data to the user in order to help improve decision making

This wider definition allows recognition of what is or what isn't a Health 2.0 technology. Typically, enterprise-based, customized client-server systems are not, while more open, cloud based systems fit the definition. However, this line was blurring by 2011-2 as more enterprise vendors started to introduce cloud-based systems and native applications for new devices like smartphones and tablets.

In addition, Health 2.0 has several competing terms, each with its own followers—if not exact definitions—including

1. Personalized search that looks into the long tail but cares about the user experience
2. Communities that capture the accumulated knowledge of patients, caregivers, and clinicians, and explains it to the world
3. Intelligent tools for content delivery—and transactions
4. Better integration of data with content

Wider health system definitions

In the late 2000s, several commentators used Health 2.0 as a moniker for a wider concept of system reform, seeking a participatory process between patient and clinician: "New concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care".^[16]

Health 2.0 defines the combination of health data and health information with (patient) experience, through the use of ICT, enabling the citizen to become an active and responsible partner in his/her own health and care pathway.^[17]

Health 2.0 is participatory healthcare. Enabled by information, software, and communities that we collect or create, we the patients can be effective partners in our own healthcare, and we the people can participate in reshaping the health system itself.^[18]

Definitions of

Overview

Health 2.0 refers to the use of a diverse set of technologies including

Partly due to weak definitions, the novelty of the endeavor and its nature as an entrepreneurial (rather than academic) movement, little empirical evidence exists to explain how much Web 2.0 is being used in general. While it has been estimated that nearly one-third of the 100 million Americans who have looked for health information online say that they or people they know have been significantly helped by what they found,^[26] this study considers only the broader use of the Internet for health management.

A study examining physician practices has suggested that a segment of 245,000 physicians in the U.S are using Web 2.0 for their practice, indicating that use is beyond the stage of the early adopter with regard to physicians and Web 2.0.^[27]

Types of Web 2.0 technology in health care

Hughes et al. (2009) argue there are four major tensions represented in the literature on Health/Medicine 2.0. These concern:[3]

1. the lack of clear definitions
2. issues around the loss of control over information that doctors perceive
3. safety and the dangers of inaccurate information
4. issues of ownership and privacy

Several criticisms have been raised about the use of Web 2.0 in health care. Firstly,

• e-Patient
• Health 3.0
• Patient opinion leader
• Digital health

References