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Information technology has dramatically changed our lives in areas ranging from commerce and entertainment to voting. Now, policy advocates and government officials hope to bring the benefits of enhanced information technology to health care. Already, consumers can access a tremendous amount of medical information online. Some physicians encourage patients to use email or web messaging to manage simple medical issues. Increasingly, health care products can be purchased electronically.Yet the promise of e-health remains largely unfulfilled.
Digital Medicine investigates the factors limiting digital technology's ability to remake health care. It explores the political, social, and ethical challenges presented by online health care, as well as the impact that racial, ethnic, and other disparities are having on the e-health revolution. It examines the accessibility of health-related websites for different populations and asks how we can close access gaps and ensure the reliability and trustworthiness of the information presented online.
Darrell West and Edward Miller use multiple sources, including original survey research and website analysis, to study the content, sponsorship status, and public usage of health care-related websites, as well as the relationship between e-health utilization and attitudes about health care in the United States. They also explore the use of health information technology in other countries. The result is an important contribution to our understanding of health information innovation in America and around the world.
This book is based on an extensive public opinion survey exploring attitudes toward electronic health communications initiated by West (vice president & director of Governance Studies, Brookings Inst.) and Miller (public policy, Brown Univ.) in 2005. The authors closely examined various web sites providing medical information for readability, authority, and objectivity, and they here provide useful appendixes listing medical web sites and pertinent standards for evaluating their content. Although they briefly outline some of the problems of implementing a national health-care provider network for medical records—one of President Obama's highly publicized new initiatives—West and Miller deal primarily with the consumer side of digital medicine. Four years from now, it will be apparent to librarians that while the general public avidly seeks medical information on the web, "digital divides" of poverty, language, literacy, and generational differences still remain significant barriers to widespread implementation of digital medical consumer services. Verdict West and Miller's exploration of the costs, concerns, and possible benefits of digital medicine is both thoughtful and timely. Librarians, health advocates, and policymakers on both sides of the issue will chew on this food for thought.—Kathy Arsenault, St. Petersburg, FL
1 The e-health revolution 1
2 Online content and sponsorship status 19
3 Use of technology 42
4 Relationship between use of digital technology and attitudes toward health care 59
5 Digital disparities 74
6 Information acquisition 86
7 International comparisons 97
8 Improving digital medicine 118
App. A National e-health public opinion survey 135
App. B American health Websites 139
App. C Government health department Websites around the world 143
App. D Content analysis protocol for health care Websites 146