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[[File:Health 2.0 interactions-en.svg|thumb|400px|Health 2.0]]
"'''Health 2.0'''" is a term introduced in the mid-2000s, as the subset of [[health care]] technologies mirroring the wider [[Web 2.0]] movement. It has been defined variously as including social media, user-generated content, and cloud-based and mobile technologies. Some Health 2.0 proponents see these technologies as empowering patients to have greater control over their own health care and diminishing [[medical paternalism]]. Critics of the technologies have expressed concerns about possible misinformation and violations of patient privacy.
==History==
Health 2.0 built on the possibilities for changing [[health care]], which started with the introduction of [[eHealth]] in the mid-1990s following the emergence of the [[World Wide Web]]. In the mid-2000s, following the widespread adoption both of the Internet and of easy to use tools for communication, [[social network]]ing, and [[self-publishing]], there was spate of media attention to and increasing interest from patients, clinicians, and medical librarians in using these tools for health care and medical purposes.<ref>{{
Early examples of Health 2.0 were the use of a specific set of Web tools ([[blogs]], email list-servs, online communities, [[podcast]]s, search, tagging, [[Twitter]], videos, [[wikis]], and more) by actors in health care including doctors, patients, and scientists, using principles of [[Open-source model|open source]] and user-generated content, and the power of networks and social networks in order to personalize health care, to collaborate, and to promote health education.<ref name="jmir.org">{{
==Current use==
While the "2.0" moniker was originally associated with concepts like collaboration, openness, participation, and [[social networking]],<ref name="ReferenceA">{{
Providers, Trackers, & Money: What You Need to Know About Health 2.0
http://thehealthcareblog.com/blog/2014/01/14/providers-trackers-money-what-you-need-to-know-about-health-2-0/</ref>
=== Public Health 2.0 ===
''Public Health 2.0'' is a movement within public health that aims to make the field more accessible to the general public and more user-driven. The term is used in three senses. In the first sense, "Public Health 2.0" is similar to "Health 2.0" and describes the ways in which traditional public health practitioners and institutions are reaching out (or could reach out) to the public through [[social media]] and [[health blog]]s.<ref>{{Cite journal |last1=Wilson, Kumanan |last2=Keelan, Jennifer |date=May 2009 |title=Coping with public health 2.0 |journal=Canadian Medical Association Journal |volume=180 |issue=10 |pages=1080 |doi=10.1503/cmaj.090696 |pmc=2679846 |pmid=19433834}}</ref><ref>{{Cite journal |last1=Vance, K. |last2=Howe, W. |last3=Dellavalle, R.P. |date=April 2009 |title=Social internet sites as a source of public health information |journal=Dermatologic Clinics |volume=27 |issue=2 |pages=133–136 |doi=10.1016/j.det.2008.11.010 |pmid=19254656}}</ref>
In the second sense, "Public Health 2.0" describes public health research that uses data gathered from social networking sites, search engine queries, cell phones, or other technologies.<ref>{{Cite web |date=24 April 2007 |title=Public Health 2.0: Spreading like a virus |url=http://governmentfutures.com/images/stories/documents/PublicHealth2-0NotesPRINT.pdf |access-date=13 June 2011}}</ref> A recent example is the proposal of statistical framework that utilizes online user-generated content (from social media or search engine queries) to estimate the impact of an influenza vaccination campaign in the UK.<ref name="DMKD">{{Cite journal |last1=Lampos |first1=Vasileios |last2=Yom-Tov |first2=Elad |last3=Pebody |first3=Richard |last4=Cox |first4=Ingemar J. |date=2 July 2015 |title=Assessing the impact of a health intervention via user-generated Internet content |journal=Data Mining and Knowledge Discovery |volume=29 |issue=5 |pages=1434–1457 |doi=10.1007/s10618-015-0427-9 |doi-access=free}}</ref>
In the third sense, "Public Health 2.0" is used to describe public health activities that are completely user-driven.<ref>{{Cite web |last=DLSPH Conference Planning Committee |title=Public Health 2.0 FAQs |url=https://patientscanada.ca/blog/health-2-0 |archive-url=https://web.archive.org/web/20240515091308/https://patientscanada.ca/blog/health-2-0 |archive-date=15 May 2024 |access-date=15 May 2024 |publisher=Public Health 2.0 Conference}}</ref> An example is the collection and sharing of information about [[environmental radiation]] levels after the March 2011 tsunami in Japan.<ref>{{Cite web |last=D. Parvaz |date=26 April 2011 |title=Crowdsourcing Japan's radiation levels |url=http://english.aljazeera.net/news/asia/2011/04/201142317359479927.html |access-date=13 June 2011 |publisher=Al Jazeera}}</ref> In all cases, Public Health 2.0 draws on ideas from [[Web 2.0]], such as [[crowdsourcing]], [[information sharing]], and [[user-centred design|user-centered design]].<ref>{{Cite journal |last=Hardey, Michael |date=July 2008 |title=Public health and Web 2.0 |journal=Perspectives in Public Health |volume=128 |issue=4 |pages=181–189 |doi=10.1177/1466424008092228 |pmid=18678114 |s2cid=11413676}}</ref> While many individual healthcare providers have started making their own personal contributions to "Public Health 2.0" through personal blogs, social profiles, and websites, other larger organizations, such as the [[American Heart Association]] (AHA) and United Medical Education (UME), have a larger team of employees centered around online driven [[health education]], research, and training. These private organizations recognize the need for free and easy to access health materials often building libraries of educational articles.{{Citation needed|date=August 2017}}
==Definitions ==
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The "traditional" definition of "Health 2.0" focused on technology as an enabler for care '''collaboration''': "The use of social software t-weight tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health."<ref>Adapted from Jane Sarasohn-Kahn's "Wisdom of Patients" report, by Matthew Holt, Last updated June 6, 2008</ref>
In 2011, [[Indu Subaiya]] redefined Health 2.0<ref>Subaiya/Holt; Introduction & Definition of Health 2.0, Health 2.0 Europe Conference 2011: http://www.health2con.com/tv/?p=2047&viddlertime=572.524{{Dead link|date=August 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> as the use in health care of new cloud, Saas, mobile, and device technologies that are:
#Adaptable technologies which easily allow other tools and applications to link and integrate with them, primarily through use of accessible [[Application programming interface|APIs]]
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In the late 2000s, several commentators used Health 2.0 as a moniker for a wider concept of system reform, seeking a participatory process between patient and clinician: "New concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care".<ref>Last updated on May 25, 2007 Scott Shreeve, MD - January 24, 2007)</ref>
Health 2.0 defines the combination of health data and health information with (patient) experience, through the use of ICT, enabling the citizen to become an active and responsible partner in his/her own health and care pathway.<ref>"Patient 2.0 Empowerment", Lodewijk Bos, Andy Marsh, Denis Carroll, Sanjeev Gupta, Mike Rees, Proceedings of the 2008 International Conference on Semantic Web & Web Services SWWS08, Hamid R. Arabnia, Andy Marsh (eds), pp. 164–167, 2008, http://www.icmcc.org/pdf/ICMCCSWWS08.pdf {{Webarchive|url=https://web.archive.org/web/20090219075920/http://www.icmcc.org/pdf/ICMCCSWWS08.pdf |date=2009-02-19 }}</ref>
Health 2.0 is participatory healthcare. Enabled by information, software, and communities that we collect or create, we the patients can be effective partners in our own healthcare, and we the people can participate in reshaping the health system itself.<ref>Ted Eytan MD, June 6, 2008, http://www.tedeytan.com/2008/06/13/1089</ref>
Definitions of [[Medicine 2.0]] appear to be very similar but typically include more scientific and research aspects—Medicine 2.0: "Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.<ref>Eysenbach, Gunther. Medicine 2.0 Congress Website launched (and: Definition of Medicine 2.0 / Health 2.0)</ref><ref>Gunther Eysenbach's random research rants (Blog). URL: http://gunther-eysenbach.blogspot.com/2008/03/medicine-20-congress-website-launched.html. Accessed: 2008-03-07</ref>
Published in JMIR Tom Van de Belt, [[Lucien Engelen]] ''et al.'' systematic review found 46 (!) unique definitions of health 2.0<ref>{{
== Overview ==
[[File:Swan Health 2.0 model.jpg|thumb|A model of Health 2.0]]
Health 2.0 refers to the use of a diverse set of technologies including [[Connected Health]], [[electronic medical records]], [[mHealth]], [[telemedicine]], and the use of the Internet by patients themselves such as through [[blog]]s, [[Internet forum]]s, online communities, patient to physician communication systems, and other more advanced systems.<ref>{{Cite journal |
Much of the potential for change from Health 2.0 is facilitated by combining technology driven trends such as Personal Health Records with social networking —"[which] may lead to a powerful new generation of health applications, where people share parts of their electronic health records with other consumers and 'crowdsource' the collective wisdom of other patients and professionals."<ref name="ReferenceA" /> Traditional models of medicine had patient records (held on paper or a proprietary [[computer system]]) that could only be accessed by a physician or other [[Health profession|medical professional]]. Physicians acted as gatekeepers to this information, telling patients test results when and if they deemed it necessary. Such a model operates relatively well in situations such as acute care, where information about specific blood results would be of little use to a [[Laity|lay person]], or in general practice where results were generally benign. However, in the case of complex chronic diseases, [[Mental illness|psychiatric disorders]], or diseases of unknown etiology patients were at risk of being left without well-coordinated care because data about them was stored in a variety of disparate places and in some cases might contain the opinions of healthcare professionals which were not to be shared with the patient. Increasingly, [[medical ethics]] deems such actions to be [[Paternalism|medical paternalism]], and they are discouraged in [[Medicine|modern medicine]].<ref>{{Cite journal |last=Bassford |first=H. A. |date=1982-01-01 |title=The justification of medical paternalism |journal=Social Science & Medicine |volume=16 |issue=6 |pages=731–739
A hypothetical example demonstrates the increased engagement of a patient operating in a Health 2.0 setting: a patient goes to see their [[primary care physician]] with a presenting complaint, having first ensured their own [[medical record]] was up to date via the Internet. The treating physician might make a diagnosis or send for tests, the results of which could be transmitted directly to the patient's electronic medical record. If a second appointment is needed, the patient will have had time to research what the results might mean for them, what diagnoses may be likely, and may have communicated with other patients who have had a similar set of results in the past. On a second visit a referral might be made to a specialist. The patient might have the opportunity to search for the views of other patients on the best specialist to go to, and in combination with their primary care physician decides
== Level of use of Web 2.0 in health care ==
Partly due to weak definitions, the novelty of the endeavor and its nature as an entrepreneurial (rather than academic) movement, little [[Empirical research|empirical evidence]] exists to explain how much Web 2.0 is being used in general. While it has been estimated that nearly one-third of the 100 million Americans who have looked for health information online say that they or people they know have been significantly helped by what they found,<ref>Levy, M. 2007. Online Health. Assessing the Risk and Opportunity of Social and One-to-One Media. Jupiter Research. Accessed at http://www.jupiterresearch.com/bin/item.pl/research:vision/103/id=98795/ {{Webarchive|url=https://web.archive.org/web/20081128155537/http://www.jupiterresearch.com/bin/item.pl/research:vision/103/id=98795/ |date=2008-11-28 }} on 20/1/2008</ref> this study considers only the broader use of the Internet for health management.
A study examining physician practices has suggested that a segment of 245,000 physicians in the U.S are using Web 2.0 for their practice, indicating that use is beyond the stage of the [[Diffusion (business)|early adopter]] with regard to physicians and Web 2.0.<ref>Manhattan Research, LLC. 2007. White Paper: Physicians and Web 2.0: 5 Things You Should Know about the Evolving Online Landscape for Physicians. Accessed at {{
== Types of Web 2.0 technology in health care ==
[[Web 2.0]] is commonly associated with technologies such as podcasts, [[RSS (file format)|RSS feeds]], [[social bookmarking]], weblogs ([[health blog]]s), wikis, and other forms of [[many-to-many]] publishing; [[social software]]; and [[web application]] programming interfaces (APIs).<ref>{{Cite journal |last=Boudry |first=Christophe |date=2015-04-01 |title=Web 2.0 applications in medicine: trends and topics in the literature |journal=Medicine 2.0 |volume=4 |issue=1 |pages=e2 |doi=10.2196/med20.3628 |pmc=5823613 |pmid=25842175 |
The following are examples of uses that have been documented in academic literature.
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| Staying informed
| Used to stay informed of latest developments in a particular field
| Podcasts, RSS, and search tools<ref name="Giustini">{{
| All (medical professionals and public)
|-
| Medical education
| Use for professional development for doctors, and public health promotion for by public health professionals and the general public
| How podcasts can be used ''on the move'' to increase total available educational time<ref>{{
| All (medical professionals and public)
|-
| Collaboration and practice
| Web 2.0 tools use in daily practice for medical professionals to find information and make decisions
| Google searches revealed the correct diagnosis in 15 out of 26 cases (58%, 95% confidence interval 38% to 77%) in a 2005 study<ref name="TanNg">{{
| Doctors, nurses
|-
| Managing a particular disease
| Patients who use search tools to find out information about a particular condition
| Shown that patients have different patterns of usage depending on if they are newly diagnosed or managing a severe long-term illness. Long-term patients are more likely to connect to a community in Health 2.0<ref>Ferguson, T. ePatients white paper. www.e-patients.net. 2007. URL: http://www.e-patients.net/e-Patients_White_Paper.pdf {{Webarchive|url=https://web.archive.org/web/20080723113355/http://e-patients.net/e-Patients_White_Paper.pdf |date=2008-07-23 }} on 22/1/08</ref>
| Public
|-
| Sharing data for research
| Completing patient-reported outcomes and aggregating the data for personal and scientific research
| Disease specific communities for patients with rare conditions aggregate data on treatments, symptoms, and outcomes to improve their decision making ability and carry out scientific research such as observational trials<ref>{{
| All (medical professionals and public)
|}
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# safety and the dangers of inaccurate information
# issues of ownership and privacy
Several criticisms have been raised about the use of Web 2.0 in health care. Firstly, [[Google]] has limitations as a [[Diagnosis|diagnostic tool]] for [[Physician|Medical Doctors]] (MDs), as it may be effective only for conditions with unique symptoms and signs that can easily be used as search term.<ref name="TanNg" /> Studies of its accuracy have returned varying results, and this remains in dispute.<ref>{{Cite journal |
== See also ==
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