Volume 15: e-Health: Current Evidence, Promises, Perils, and Future Directions
Editors: Timothy M. Hale, Wen-Ying Sylvia Chou, and Shelia R. Cotten
Volume 15: e-Health: Current Evidence, Promises, Perils, and Future Directions
It has been nearly 25 years since Howard Rheingold published The Virtual Community in 1993, introducing the concept of the “Net” and focusing attention on the growing use of computers and new information technologies to connect people in a “virtual village”. In the decade that followed, there was rapid adoption of the Internet and an expansion in the number and types services available online – electronic or e-services -- that challenged traditional business models and long-standing institutions. However, despite the incorporation of new information and communication technology (ICT) and e-services into our daily routines, there was little attention paid to how these changes might impact people’s health behaviors and the organization and delivery of health care.
It wasn’t until the turn of the century that health care strategists and academics turned their attention to these technologies and the topic of “e-Health”. Jeff Goldsmith (2000) and Shelia Cotten (2001) published two of the earliest papers outlining the opportunities and challenges associated with these new technologies. Goldsmith and Cotten highlighted the potential for technology to transform: (1) the way people seek and share information about their health and medical conditions, (2) the patient-provider relationship and empower patients with knowledge to take a more active role in medical care decisions, (3) how people build and maintain health-related communities and garner social support, (4) how people access health care services, (5) the organization of health care institutions and care team management, and (6) methods of data collection for use in remote monitoring and care management. They also identified several challenges, including: (1) the Digital Divide and disparities in access to technology, (2) privacy and security concerns that may pose a barrier to adoption, and (3) the quality and sometimes contradictory information available.
Research during the past 15 years has explored many of the potential benefits and challenges outlined by Goldsmith and Cotten. Findings show high potential for eHealth to improve people’s health and systems of care. For example, health behavior interventions disseminated via social networking sites have shown a positive effect on behaviors (Laranjo 2015) and remote monitoring of patients with heart failure can improve traditional care and reduce rates of hospitalization and mortality (Agboola 2015). However, there remain significant challenges associated with emerging eHealth services: Disparities in access and use of eHealth systems continues to limit the potential of eHealth to improve the care and health outcomes of the socially disadvantaged who are most at risk of chronic diseases and in need of care. Similarly, capitated reimbursement models are accelerating the shift to a consumer model of care focusing on prevention and self-management. This transformation poses substantial challenges to the practice and organization of medicine and to the research methods that support the design and evaluation of new consumer-focused applications and services. Another issue is the growing quantification of behaviors and biometrics enabled by sensor-based technologies. The potential for comprehensive, large data sets to aid individual and population level health care is tremendous – but also poses ethical, regulatory, and methodological challenges.
The purpose of this volume is to build on past research and explore the impact of the Internet and other ICTs on health care, health outcomes, illness management, and interactions with health care professionals, services, and peers. We are seeking papers that address one or more of the cross-cutting themes and topics highlighted below. Empirical work using quantitative or qualitative research methods are preferred over commentaries, reviews of previous research and trends, or papers focusing strictly on theory.
•Disparities: the Digital Divide, health literacy challenges and opportunities •Consumerism: new models of care, patient empowerment, shifting balance of power in medicine •Networks: social media, crowdsourcing, online communities •Ethics: privacy, security, and intellectual property •Quantification: sensors, Big Data, data analytics, communication and informatics
Example Topics of Interest:• Analyses of online health communities and social networks
• Evaluation of theory-driven technology-mediated behavioral interventions
• ICT impacts on clinical interactions, including patient-physician communication, care team coordination
• Patterns of health information seeking, educational programs, and eHealth literacy
• Innovative methods or data for individual risk assessment or population health management improvement
• Evaluation of technology interventions to improve patient self-management of chronic medical conditions
• Nature and dynamics of peer-to-peer health communication
• Implementation of sensors, Apps, and mobile devices in health promotion programs
• New models of patient self-tracking (i.e., Quantified Self) and participatory research (i.e., Patients Like Me)
Volume 15 Editors: Timothy M. Hale, Wen-Ying Sylvia Chou, and Shelia R. Cotten
Timothy M. Hale
M. Hale, PhD is a medical sociologist and Research Fellow at Partners
Center for Connected Health and Harvard Medical School. His main
research interest is the impact of information and communication
technologies (ICTs) on health care and health lifestyles. Prior to
joining the Center, he was a postdoctoral fellow at the University of
Alabama at Birmingham where he studied the social and psychological
impacts of ICT, focusing primarily on youth and older adults. Hale was
elected as a CITASA Council Member (2012-2014). His work has been
published in Information, Communication & Society; Computers and
Human Behavior; Journal of Health Communication and American Behavioral
Wen-Ying Sylvia Chou
Wen-Ying Sylvia Chou is a Program Director in the Health Communication and Informatics Research Branch (HCIRB) of the Behavioral Research Program (BRP) at the National Cancer Institute (NCI). Her recent research projects have included patient-provider communication, social media interactions (about cancer and obesity), health care team communication, health literacy and health disparities, and palliative care for advanced cancer patients. Trained as a sociolinguist, she has expertise in qualitative analyses and ethnography and has extensive publications using mixed methods to examine health care interactions, online user-generated content via social media, and illness narratives. As a Program Director, she is leading a number of NIH initiatives in social media, communication inequalities, and mixed methods research in health communication. Sylvia was a postdoctoral fellow of the NCI Cancer Prevention Fellowship Program. She holds a Master in Public Health degree from UC Berkeley and a MS and PhD in Linguistics from Georgetown University. Her doctoral dissertation examined end-of-life discourse between seriously-ill cancer patients and their caregivers.
Shelia R. Cotten
Shelia R. Cotten is Professor in the Department of Media and Information at Michigan State University.She has served as the Chair of CITAMS and has previously held appointments at the University of Alabama at Birminghm and the University of Maryland, Baltimore County. After earning her PhD from North Carolina State University in Raleigh, she was a postgraduate fellow at the Boston University School of Public Health. Her work has been funded by The National Science Foundation and the National Institute on Aging. Cotten’s work addresses key social problems with sociological tools related to technology access, use, and impacts/outcomes. She has published on a number of topics including the XO laptop program in Birmingham and the use of ICT resources to improve older Americans' quality of life. The body of her work was recognized by the CITAMS Award for Public Sociology in 2013 and the CITAMS Career Achievement Award in 2016.