SCOTT C. RATZAN
In the midst of the Internet boom, the U.S. Science Panel
on Interactive Communication and Health (Eng, 1999) presented a compelling
document to address the extensive potential that new technologies might
offer for advancing health. The Panel offered a new term, Interactive
Health Communication (IHC) to highlight the promise. IHC was defined
as: interaction of an individual - consumer, patient, caregiver or professional
- with or through an electronic or communication technology device to
access or transmit health information, or to receive/provide guidance
and support on a health-related issue.
Broader terms such as telehealth and telemedicine are
often used. Today, telehealth encompasses the full spectrum of applications
using digital technology and telecommunications systems for health,
including health professions education, continuing education, consumer
health education, community health information networks, public and
school health, research, administration, assessment, teleconferencing,
and applied health informatics (e.g., computer modeling, database development,
storage/retrieval/mining, electronic record development, consultation,
third party billing, etc.). While these terms are often interchanged
with similar intent, the field has been moving in a variety of ways.
This issue of the Journal offers a variety of articles with original
research and ideas that explore how the field has advanced.
This new communication technology and Internet boom has
brought us closer to what McLuhan envisioned as a global village despite
the diversity of consumers. In the United States, women have become
the leading users of the Internet and the ``wired and retired’’
continue to be a growing segment of society apt to use the Internet
to access health information resources. Of course there are pitfalls,
as those who could benefit from IHC often remain marginalized. Regardless,
what has become clear is that as the users grow, they require credible
sources providing tailored communication. Merely placing a library of
data and information and increasing ``access’’ does not de
facto improve knowledge, understanding, or health. Current wisdom continues
to suggest what is needed is information tailored to the way the individual
comprehends, thinks, and behaves. Essentially, we need to match health
consumer demands with applications that address his or her individual
needs.
The three areas of telehealth applications can be summed
up well with our public health jargon: primary, secondary, and tertiary
prevention. Translated for the public: staying healthy, getting better,
and living with disease. It has been clear for some time that disease
prevention and health promotion are the principal ways to insure public
health. Yet, most consumer demand in IHC is similar to traditional health
care delivery; it relates to the other areas when salient information
is required to address new exigencies - personal illness, signs and
symptoms of disease, new treatment modalities, etc.
Health Information ``therapy’’might add another salient element
to the health provider’s treatment plan.
While all areas of advancing health are important, the greatest promise
in increasing quality health lies in prevention, early detection, and
health literacy. However, over-emphasis on health system applications
at traditional health facilities focusing on electronic medical records
and related areas implies disease and clinical data mitigated by health
professionals.
One idea might be the promise of individual ``health citizens’’
developing a personal lifetime health ``page.’’ This page
can be established based on individual health needs and history, geographic
susceptibility, age/gender sensitivity, as well as genetic predisposing
factors (family, genetic markers etc.). Given the well-established preventive
services recommendations from immunizations, screenings, nutrition ,
prophylaxis (e.g. aspirin for cardiovascular disease), etc., such an
interactive page can be updated and provide reminders, queries, and
plans for personalized health care that includes prevention and other
areas that actually contribute to ``health as we know it.’’
With data, video, and text
available on this page, health information could become more ubiquitou
s with the page accessible on new age internet devices - whether handhelds,
televisions, or computers. This page could easily be encrypted for security,
owned by the individual , and tailored to health literacy and knowledge
base so that consumers could self-manage, interpret, and
act so that they could function well in the complex health system.
Transformation of the telecommunication e-everything hype
into hope for better health is a challenge for all of us in the field
of health communication. While the progress and application are ultimately
at the individual level, they require global thinking and development
of networks. Ultimately, IHC should be developed in partnership of all
in the health polity - medicine, industry, health delivery, etc. along
with the tele-communication sector. Our challenge ahead is to transform
data and health information into health intelligence that can be used
to benefit the health and well being of people worldwide.
Reference
Eng T.R., Gustafson D.H. (1999). Wired for Health and Well-Being: the
Emergence of Interactive Health Communication. Washington, DC: Science
Panel on Interactive Communication and Health, US Department of Health
and Human Services, U.S. Government Printing Office.
Available at: http://www.health.gov/scipich/pubs/finalreport.htm
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Scott C. Ratzan MD, MPA is Editor of the Journal of Health Communication:
International Perspectives.
