Online Business Review of SCIBC

by MIGUEL CABRER GONZÁLEZ, eHealth Advisor; Member of HIMSS EMEA Governing Council

For some time now we have seen how the ‘new Internet’ is revolutionising the way users communicate and relate to each other. New social networks allow any Internet user to establish a personal or professional relationship with other users or groups anywhere in the world. Platforms like Facebook, Flickr, Youtube, Twitter, Amazon, Wikipedia and Google offer up new kinds of relationships as well as new challenges.

This new trend is the so-called web 2.0. Web 2.0 is the representation of the advances in traditional applications towards web applications focused on the final user. There is a series of web 2.0 tools (blogs, wiki, RSS, files) that allow any user, without much technical knowledge, to be able to create their own web page.

Since its appearance, web 2.0 has grown exponentially. In March 2007² there were 70 million blogs (doubling in number every 6 months), Wikipedia had more than 2 million articles. Facebook currently has over 150 million users, which would make it the sixth largest country in the world. And it is still early days if we take into account that only 3% of Internet users actually create content.

In parallel, the application of technology in the area of health has been slow compared to other sectors. Although it is certainly true that the drive on the part of health organisations and the benefit obtained is clear, the implementation, starting up of projects and resistance to change are all tough obstacles. Nonetheless, considerable advances have been made in the last few years and the future is hopeful.

Health authorities are betting heavily on the digitisation and implementation of Health Information Systems (HIS), showing clear benefits. Kaiser Permanente (insurance company with 8.6 million patients) has invested 4 billion dollars in its HIS, which has allowed it to lower the average number of visits per patient by 26%. The NHS (UK) is investing 13 billion pounds in a controversial digitisation plan that is starting to bear fruit. A study by the RAND Corporation forecasts that digitisation might save as much as 6% of the 2.6 trillion dollars which are spent annually on healthcare in the USA and foresees that by 2020 90% of hospitals will have been digitised.

The journal Archives of Internal Medicine published in January a comparative study of two hospital groups, one with and the other without an information system. The hospital group using an advanced information system boasted a decrease of 15% in mortality rates and 16% fewer complications together with significant cost reductions.

At the same time, social platforms and interactive networks between patients, professionals and patients with professionals are being set up. New services and Internet portals devoted to healthcare are appearing every day. Health is a social concept and as such has an important presence on the Net.

So we find ourselves at an interesting moment in time when it seems the digitisation of clinical information is converging with the great potential of social networks in a globalised world. Regarding web 2.0 use, it is interesting to take a look at the following analysis of hospitals in the US which are using social networking tools like Facebook, YouTube, Twitter to connect with users / patients. There are 163 Hospitals that use web 2.0 tools:

109 have a YouTube channel
73 have pages on Facebook
59 use Twitter
14 have Blogs

We are in the initial stages of adoption, since only 2.5% of hospitals are using web2.0 tools to “connect” with outside.

However, web 2.0 goes further than health authorities. Users are the ones who decide and take part. Several patient-oriented social platforms exist on the Internet. The best-known is PatientsLikeMe, which began in 2004 and currently has over 25 thousand users. The patients make use of spaces where they have the opportunity to relate to other patients with the same diagnoses, problems or medication.

In a recent issue, The Economist³ discusses Health 2.0 as more of a reform than a revolution. In fact, the collective knowledge generated by a group of patients stemming from a discussion about a new medicine, new clinical trials or similarly related topic is valuable information that will flow in several directions. Furthermore, these networks play an important role in the emotional support of patients who can speak to other patients with similar problems.

There are many other platforms focused on patients: diagnosis-based, platforms which help to watch over health monitoring diet and exercise, unusual diseases patient groups, etc.

Without doubt, one of the greatest challenges lies in the success of Personal Health Records (PHR). In this area various websites have appeared; Revolution Health is an ambitious idea led by the founder of American Online (Steven Case). Some, like MiVitals.com, have shut down due to inactivity. The reason is that it is difficult for users to keep health records online without some kind of motivation or clear added value. What’s more, doubts inevitably arise about data privacy and ownership. Some platforms, like MyHLZ.com have focused their model on a health register which is anonymous, portable, multi-language and geared towards the tourist market.

Google and Microsoft have recently burst on the scene with their own Personal Health Records (Google Health and Microsoft Vault). It remains to be seen if these big Internet players are successful in their health initiatives. Social networks are also proliferating in the relationships among professionals. Doctors’ groups on Facebook, social networks, blogs, specialised wikis. Specialised platforms are also appearing with exclusive services for the medical sector. Sermo is the largest social network of professionals in the USA with over 50,000 subscribed doctors. iMedexchange, SocialMD, Doctor Networking are similar platforms which act as a social network for doctors both in professional and social topics.

There are some other platforms with social capabilities that also provide a powerful tool for the global exchange of clinical content. One example would be Medting.com, a web platform that allows physicians to share medical images and videos and build clinical cases online. It’s a professional tool that integrates SNOMED and PubMed, supports DICOM and provides automatic translation into more than 40 languages. Medting is useful for creating a clinical social network for case collaboration, knowledge exchange or second opinion, but it’s also a tool that some organizations can license to get a private, exclusive tool.

It seems very clear that the time is right for global reform in the area of eHealth. For instance, the drive to digitise clinical records in all countries and health organisations, making special mention of the new US administration’s stimulus package. Furthermore, digitisation not only improves the health service but also reduces costs and increases patient satisfaction.

If we add to all of this the concept of web 2.0 and social media in the health area, we find ourselves before a new scenario in which doctors have access to information in a digital format, they can share it with other doctors, seek advice from others via global social networks as well as interacting with the patient. We are heading towards a new concept of health, which is networked and globalised, without limits.

1.         http://es.wikipedia.org/wiki/Codigo_abierto
2.         Source: “Web 2.0 in Government: Why and How?” David Osimo; European Commission; Joint Research Centre; Institute for Prospective Technological Studies  http://ftp.jrc.es/EURdoc/JRC45269.pdf
3.         “Medicine goes Digital”, a special report on Healthcare and technology, The Economist, April 2009.

Article submitted on 18th May, 2010; All Rights Reserved ©, SCIBC Business Review

About the Author Miguel Cabrer was born in Barcelona. He graduated with a Computer Science degree from Balearic Islands University (1996). From the very beginning of his professional career he showed a particular interest in IT applied to healthcare. In 1995, he obtained a Research and Development grant for the evaluation of Telemedicine projects in the U.S.A., developed at Stanford Medical University Center (Palo Alto) and Emory University (Atlanta). He started his career at the BIT Institute of the Balearic Government as Telemedicine researcher in 1996, then went to the University of the Balearic Islands as Computer Science technician until 2001. In parallel, he developed eHealth projects at Manacor Hospital, Son Dureta Hospital, the Red Cross, and private clinics as an advisor. From August 2001 until June 2006, Miguel Cabrer was the CIO at Hospital Son Llatzer. Son Llàtzer has received numerous awards for its Digital Hospital project, highlighting the eEurope for eHealth Awards 2004. From September 2003 until June 2006, Miguel was eHealth Coordinator of Balearic Islands Health Service. Currently, Miguel Cabrer is an independent eHealth advisor working on worldwide initiatives and eHealth projects. Furthermore, he is Member of the HIMSS EMEA Governing Council and participated on the Advisory Board of World of Health IT 2006 (October 2006, in Geneva). Member of IMIA (International Medical Informatics Association; www.imia.org) Web 2.0 taskforce workgroup defining a Strategic Plan up to 2015. Miguel Cabrer’s main areas of interest and specialisation are: Digital Hospitals, EHR – RHIO Initiatives, Integration Competence Centres and Health 2.0 (web 2.0 and healthcare). Miguel is the CEO and Founder of Medting.com