Health Information for Health-Conscious, Resourceful People

Berglund Authority Level 4

by Kevin Kawamoto<barlowj@pacificu.edu>

Index:

.01 Health Informatics
.02 Why is Health Information Popular?
.03 Caveats
.04 The Future is Here!
.05 References

.01 Health Informatics (return to index)

There was a time not too long ago when most people who were confronted with an obscure or even commonplace medical condition would not be able to sit down at an Internet-connected computer and search to their heart’s content for anything they could find out about that condition. Instead, if they had the wherewithal, they would have to go to the brick-and-mortar repositories of medical information – e.g., a university’s research library or a medical library – and pore through books and articles, many of which might not have been suitable for a layperson’s sensibilities.

Today, the trouble is more likely not to be where to find health-related information but rather how to manage the volume of it, how to determine whether it is credible, and how to use that information in a way that is productive.

Health informatics refers to the use of computers, electronic networks, and databases to store, organize, manipulate, transmit, and retrieve electronic health information. A myriad of activities can fall under the broad rubric of health informatics: health news on the Web, hospital Web sites, patient information online, picture archiving systems (for storing and evaluating diagnostic images), online health care education, electronic scholarly article databases, patient peer discussion groups online, patient-physician communication, and so forth. The list goes on and on and will continue to grow.

There is so much health information online that some people worry there is too much – that the important “stuff” gets lost in a sea of overabundance. Be that as it may, it is clear the public wants and uses electronic health information. As far back as 2000, the Pew Internet and American Life project was reporting that more than half (55%) of American adults with Internet access had searched for health information online. Of that number, 70% said that the information they found affected their health decisions, and 48% said that advice from the Internet improved their self-care. These numbers should not be a surprise and are probably even higher today. Studies indicate that young people (e.g., college-age students) already use the Internet extensively for consumer health information [1]. Older adults are using the Internet for health information as well but also face more barriers than college students due to lack of access to the technology, lack of training, and so forth.

.02 Why is Health Information Popular? (return to index)

Health information is popular for a number of reasons. Sometimes people search for health topics that currently impact their lives or which they anticipate will have an impact on their lives in the future. For example, someone may learn that he or she has a genetic predisposition to a particular disease and wants to learn as much about it as possible, including ways to discourage the expression of that disease. Or perhaps a physician has already diagnosed a disease but did not have time to provide the volume of information necessary for the patient to really understand what the disease is all about. The Internet can help enhance the basic explanation. In fact, it would not be unusual these days for some physicians or other health care providers to refer the patient to a particular Web site or set of Web sites that can provide additional information, assuming the patient uses the Internet.

Sometimes people are just curious about a disease or health condition they’ve heard about in the news or which they’ve learned that someone – perhaps a relative or a celebrity – has. Other people may be fascinated by health news as a part of their overall health and nutrition program. Still others may be hypochondriacs, consumed by the variety of diseases and illnesses that they fear they might already have or be especially vulnerable to. And others find community in cyberspace with others who share their conditions and concerns and desire a social network.

In short, health information-seeking behavior is driven by a wide variety of motivations. Health may be such a popular topic because it is something that affects so many people. It is in everyone’s best interest to be healthy, and health information can lead to the knowledge that increases one’s chances for optimum health. Moreover, health news is sometimes just interesting for its own sake. WebMD released a list of top health issues in 2004 [2]. Whether you’re directly affected by any of the following issues, you’re likely to have read or heard about them:

No. 1 -- Drug Safety in the Spotlight

In September, the pain reliever Vioxx was pulled off the market due to an increased risk of heart attack and stroke, and concerns over Celebrex and Aleve arose this month after links to heart disease were reported. As a result, consumers became more aware of how they can protect themselves from potential drug hazards, like having a better understanding of the potential risks and side effects, and taking medication as directed.

No. 2 -- Flu Vaccine Shortage

For years, Americans were accustomed to getting flu shots. In 2004, when half the supply of flu vaccine was unavailable due to contamination, they received a very different message. As a result, Americans have learned alternative ways to protect themselves from the flu. In fact, because so many people did not take the flu shot this fall, health officials have expanded the priority list to include adults between ages 50-64 and individuals in contact with people who are considered high-risk.

No. 3 -- Kids and Antidepressants

As more children are treated for depression with antidepressants, there is more information that perhaps the drugs affect children differently than adults. Following a warning from the FDA and studies that questioned safety risks, parents became aware they need to watch their children more closely and take great care in considering treatment options.

No. 4 -- The Celebrity Factor: Lights, Camera, Reaction

It was first called the Clinton Effect. Shortly after former President Bill Clinton underwent bypass surgery, thousands of men went to the doctor to get checked out. Similar reactions occurred when Chief Justice William Rehnquist and Elizabeth Edwards received diagnoses. While sparked by troubling news, the Celebrity Factor resulted in the positive outcome of raising the public's awareness about a disease.

No. 5 -- A Super-sized Nation Amidst the Low-Carb Craze

Americans continued to embrace the low-carb diet craze in 2004, with two thirds of Americans struggling with being overweight or obese. But dieters started to recognize this year that a long-term commitment to healthy weight management, and not a short-term quick fix, will lead to effective, lifelong weight loss.

No. 6 -- "Food-aceuticals": Drink -- and Eat -- For Disease Prevention

Certain foods and beverages get a bad rap for affecting sleep, clogging arteries and thickening waistlines. But there is a flip side. New studies this year showed that coffee may help prevent type II diabetes, and that red beans, Russet potatoes and cinnamon are rich in disease-fighting antioxidants. A recipe for better health can be found in the pantry as well as the medicine cabinet.

No. 7 -- Drugs for Seniors

More people are living longer, and that means more people rely on prescription drugs to help maintain their quality of life. The continued rise in cost of prescription drugs, however, complicates the picture. According to the AARP, price increases for name-brand prescription drugs rose another 6.9% in 2003. Steps began this year to put Medicare discount cards in the hands of seniors in anticipation of a new drug benefit plan in 2006.

No. 8 -- Cholesterol Levels: How Low Can We Go?

Cholesterol guidelines went even lower this year for some people, as the medical community made new recommendations to drop "bad" LDL cholesterol levels from less than 100 to less than 70 in patients who are at high risk of heart disease. Simultaneously, medical advances made possible the availability of new drugs. Armed with more treatment options, Americans are in a better position to meet these guidelines and take another step toward disease prevention.

No. 9 -- Stem Cells: Science v. Fiction

Stem cells became a political hot button this year, with a lot of talk about their promise. Do stem cells really offer cures for some diseases, and if so, when? Scientists believe stem cells are one of the great hopes for Americans, potentially treating virtually every disease that currently affects them. Stem cells have already been used to treat several diseases in humans, and as research on their effectiveness and safety continues, there is no telling what the future could bring.

No. 10 -- Mother May I: Late Motherhood Emerges

A 57-year-old woman gave birth this year to twins. While this example is not the norm, it is an everyday reality that women in their 40s, or older, are giving birth. Advances in fertility and obstetrics have helped even high-risk pregnancies result in better outcomes. And since risks like preeclampsia and lower birth rates increase as a woman ages, mothers who give birth later in life are benefiting from just how far science has come.

But these are just the big stories. What about the more obscure ones that perhaps only a relatively small number of people would be interested in? Chances are, you’ll find it on the Internet without much time or effort as well through the use of search engines or links for related Web sites.

.03 Caveats (return to index)

While the Internet is a boon to health information-seekers, it should be remembered that health information online has to be reviewed critically by the health information consumer. There are many excellent sources of health information on the Internet – everything from scientific journals to health sections on general news Web sites – but there are also questionable sources of information that the consumer should regard with caution, if not skepticism. Indeed, all health information should be regarded with a certain degree of caution and skepticism, regardless of the source, since previous health insights and claims are often revised based on new information and discoveries. The savvy health information consumer knows that online health information is one part of a broader program of inquiry and investigation.

While there are always concerns that people will use the Internet for unsound medical advice, the research seems to suggest that many people are not using the Internet in place of their health care provider’s advice. In fact, people often go to their health care provider because of something they’ve learned on the Internet or to help them ask better questions. Also, patients may learn about so-called alternative therapies (e.g., meditation, guided visualization, massage, music therapy, etc.) that their primary health care provider would consider safe, if not beneficial, to practice – even though the primary health care provider may not recommend it outright.

The trade-off for abundant, easy-to-access online health information is the necessity for a higher level of critical thinking. This is where education can play a valuable role – and already has been – in preparing students for their explorations into cyberspace, what they might find there, and how to make best use of that information and experience.

.04 The Future is Here! (return to index)

Health informatics is no longer a thing of the future. It is already here in many different forms (see links to past columns in this series [3] below) and will continue to grow and manifest itself in innovative and interesting ways. People have never had more access to health information than they do today, and they have the opportunity – now more than ever – to take on a greater responsibility for their health in partnership with their selected health care providers. There are many considerations yet to be ironed out. For example, as patient medical records and diagnostic images are stored digitally, there are concerns about privacy, access, and security. These concerns are being addressed at many different levels (industry, government, civil society, etc.).

Computer technology has entered the health field far beyond health news on the Internet. Virtual surgery, computer-based continuing health education, electronic civic engagement, peer support groups, blogs, health care policy planning, electronic marketing and public relations – these are all areas that fall under the rubric of health informatics. The field is rich with possibilities for growth and positive social development. People who are interested and/or knowledgeable about this intersection between health and technology can play an important role in ensuring that this development is in the public interest.

The health-related series of 14 articles (including this one), which began in 2002, has been an extended contemplation of health informatics in the 21st century. Although the subject will retain its currency for a long time into the future, most of the salient details, concepts and links to other information sources have been deposited into this and past articles. Thus, this series has reached what seems like a natural conclusion. Wishing you good health, and good health informatics!

.05 References (return to index)

1. Cam Escoffery, Kathleen R Miner, Daniel D Adame, Susan Butler, et al. “Internet Use for Health Information Among College Students,” Journal of American College Health. Washington: Jan/Feb 2005.Vol. 53, Iss. 4, pp. 183-188.

2. “ Top 10 Health Stories of 2004: WebMD Ranks the Year's Most Significant Health Events; Vioxx Recall, Flu Vaccines and "The Celebrity Factor" Among the Top Stories,” PR Newswire, December 22, 2004.

3. To read past articles about health informatics, see:

“Health Information Online Abundant and Varied”
http://bcis.pacificu.edu/journal/2002/11/kawamoto.php

“Teaching Students About Cyberhealth Information”
http://bcis.pacificu.edu/journal/2003/01/kawamoto.php

“Older Adults and the Internet”
http://bcis.pacificu.edu/journal/2003/02/kawamoto.php

“Computer Technology in Health Care Settings”
http://bcis.pacificu.edu/journal/2003/04/kawamoto.php

“Privacy and Personal Health Information”
http://bcis.pacificu.edu/journal/2003/06/kawamoto.php

“Healthy Learning Can Be Fun: Digital Media and Health Education”
http://bcis.pacificu.edu/journal/2003/07/kawamoto.php

“Compassion Knows No Border: The Research of Patricia Radin”
http://bcis.pacificu.edu/journal/2003/09/kawamoto.php

“Health Related Blogs”
http://bcis.pacificu.edu/journal/2004/01/kawamoto.php

“Health information and Numerical Data”
http://bcis.pacificu.edu/journal/2004/03/kawamoto.php

“Learning About Health Care Policy: Part I”
http://bcis.pacificu.edu/journal/2004/05/kawamoto.php

“Learning About Health Care Policy: Part II”
http://bcis.pacificu.edu/journal/2004/06/kawamoto.php

“Genealogy, Technology, and Health”
http://bcis.pacificu.edu/journal/2005/01/kawamoto.php

“Health Behavior Changes Often Take Time”
http://bcis.pacificu.edu/journal/2005/03/kawamoto.php