New directions in eHealth communication: Opportunities and challenges
Introduction
There is a communication revolution brewing in the modern health care system fueled by the growth of powerful new health information technologies (HITs) that hold tremendous promise for enhancing the delivery of health care and the promotion of health. The development, adoption, and implementation of a broad range of new eHealth applications, such as ubiquitous health information websites (such as Medline Plus, Healthfinder, and Web MD), online social support networks, interactive electronic health records, health decision support systems, tailored health education programs, health care system web portals, mobile health communication devices, and advanced telehealth applications, promise to increase consumer and provider access to relevant health information, enhance the quality of care, reduce health care errors, increase collaboration, and encourage the adoption of healthy behaviors [1]). With the growth of new and exciting HIT opportunities, however, comes the daunting responsibility to design eHealth tools that communicate effectively with a diverse array of health care consumers, providers, and policy makers. These tools must be designed to effectively communicate the right information needed by different audiences at the right time, in the right place, and in the best ways to guide health care and health promotion. eHealth tools need to be interactive, interoperable, easy to use, engaging, adaptable, and accessible for diverse audiences [2], [3]. This article reviews key communication issues involved in the design of effective and humane eHealth applications to help guide strategic development and implementation of HITs that will really improve the quality of care and the promotion of health.
While more health care consumers and providers now understand that communication is a central social process in the provision of health care delivery and the promotion of public health, many do not always recognize that effective communication is a complex and fragile human process that demands strategic design, careful monitoring, and responsive adaptation [4], [5], [6]. This is particularly true in the development and implementation of new health information technologies. Often, it appears that eHealth designers are more enamored with the technical elegance and innovation of new information technologies than with the utility of these tools for health care consumers and providers. Are the technologies easy for these audiences to understand and use? Do the new eHealth tools fit comfortably within the policies, practices, and technical infrastructure that are built into existing health and social systems? Are these new tools affordable and accessible for all intended audiences? Are the messages delivered on eHealth programs designed so that diverse populations of users can understand and apply the health information provided? Are the information systems adaptive, interactive, and self-correcting? Do they provide interesting, relevant, and engaging information for users? Too often, the answers to these questions are disappointing.
Section snippets
Information technologies and behavioral health
eHealth tools have tremendous potential to encourage adoption of healthy behaviors by consumers to promote disease prevention, health promotion, and early detection [1]. Key behavioral factors (such as problematic lifestyle choices concerning diet, exercise, alcohol use, tobacco use, drug use, sexual practices, and exposure to environmental risks) are key contributors to many worldwide health problems (including obesity, injuries, diabetes, heart disease, alcoholism, sexually transmitted
The promise of eHealth communication
Since its inception in the late 1980s, eHealth communication has been thought to have great promise to improve upon traditional heath communication through user-centered design and interactivity, broad social connectivity, deeper understanding of what motivates behavior change beyond “risk,” and the use of multimodal media that expand people's access to health information and discourse across time, place, and cultures [15]. eHealth communication offers opportunities for customization that were
Evidence from eHealth research on interventions?
In 2003, we reviewed the outcomes of the first decade of eHealth interventions and found promising results, particularly in the use of computer-controlled telephone counselling, personally tailored communication, and online support groups for promoting health [15]. These outcomes were linked to key eHealth features of enhanced user control, interactivity, information customization, and social networking. We tempered our general conclusions with important caveats that not all studies showed
Challenges to the development of effective eHealth communication interventions
Based upon our review of the relevant literature evaluating the applications of eHealth interventions we have identified four major communication directions for designing HITs to achieve their full potential for promoting health. First, eHealth interventions must be designed to maximize interactive communication with users to encourage their active involvement in health care and health promotion. Second, HITs must be designed to work effectively and transparently across different communication
Discussion
The historic growth of health information technologies provides tremendous opportunities to combine the eHealth features of interactivity, customization, contextualization, and multimedia that have been touted as having the potential to revolutionize health communication. The first 15 years of eHealth research document that our efforts to bridge the theoretical potential and empirical reality of computer-mediated communication are gradually being realized. The promising, but limited, results of
Conflict of interest
There are no conflicts of interest.
Role of the funding source
There is no external funding supporting the preparation of this manuscript.
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