Web 2.0 in healthcare

Presentation outline

What is Web 2.0? Why is it relevant? Current uses in healthcare – Health 2.0,

Medicine 2.0 (examples) A Web 2.0 toolbox Security, Data Protection, Privacy &

Copyright Patients and the Web General tips

Daniel F Pigatto at

http://www.flickr.com/photos/pigatto/332193181/

By Ben Sheldon using Inkscape (http://inkscape.org/) at: http://www.flickr.com/photos/bensheldon/212159782/

What is Web 2.0 – a definition

“Web 2.0 is the network as platform, spanning all connected devices; Web 2.0 applications are those that make the most of the intrinsic advantages of that platform: delivering software as a continually-updated service that gets better the more people use it, consuming and remixing data from multiple sources, including individual users, while providing their own data and services in a form that allows remixing by others, creating network effects through an "architecture of participation," and going beyond the page metaphor of Web 1.0 to deliver rich user experiences.”

(Ref:http://radar.oreilly.com/archives/2005/10/web-20-compact-definition.html)

Web 1.0 v Web 2.0

Web 1.0 Read only Web experts and web

visitors You visit sites Fairly static content Technology “slow” Sites Locked into PC

Web 2.0 Read & write Everyone can

participate Sites visit you Constant updating Permanent beta Tools & services Multiple devices

With it, you can manage your information http://www.connotea.org

..network with peers http://www.syndicom.com/spineconnect/

Choose how you search

http://www.gopubmed.org

Innovation & problem-solving http://spokentext.net/

Join (or create) virtual communities http://www.whatnow.org.uk/blogs/nurse

Attend Conferences remotely..http://jama.ama-assn.org/authorintheroom/authorindex.dtl

Why is it relevant?1. So many functions…..2. …so many benefits….. 3. ….. almost all of them FREE!4. It has changed the nature and scope of the

web forever5. It’s the next step in the evolution of the web,

and is central to the next phase6. It’s everywhere you look 7. Knowing what it is, you can be aware of its

pitfalls

Uses in Healthcare

Health 2.0 / Medicine 2.0

Eysenbach GMedicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and OpennessJ Med Internet Res 2008;10(3):e22 URL: http://www.jmir.org/2008/3/e22/

Healthcare consumers

Healthcare professionals

Scientific research

Use in the development of guidelines

“Using a single entry source for the entire anesthesia community to initiate and develop guidelines with true consensus is a realistic goal based on the model created by Wikipedia.”

(from: Glass, Peter S.A. “Practice guidelines for the management of postoperative nausea and vomiting: past, present, and future” Anesthesia & Analgesia 2007, 105(6) 1528-9)

Web 2.0 examples in medicine

Ref:BMJ VOLUME 333 23-30 DECEMBER 2006, pp 1283-1284

Application Website Purpose

Bloglines www.bloglines.com RSS reader

Citizendium www.citizendium.org/ Expert wiki

Connotea www.connotea.org Online reference organiser

Del.icio.us http://del.icio.us Website tagging

Flickr www.flickr.com/ Photo sharing

Ganfyd www.ganfyd.org Medical wiki

Google blogsearch http://blogsearch.google.com Blog searches

Google health http://www.google.com/coop/cse Create your own search tool

MedWorm http://medworm.com/ RSS aggregator

SlideShare http://slideshare.net Slide sharing

Wikipedia http://en.wikipedia.org/wiki/ All purpose wiki

YouTube www.youtube.com/ Video snippets

Online Journal Club

Hospital Education – Second Life

Sample Web 2.0 toolbox1. Tag & save references – sign up to Connotea (http://www.connotea.org); if

you use Firefox, get the Zotero reference management tool (http://www.zotero.org ), or tag and save your favourite sites with Delicious (http://delicious.com/ )

2. Choose a feed reader to manage RSS feeds from your preferred journals, blogs, podcasts or websites (or have feeds e-mailed to you using http://www.feedmailer.net/)

3. Use http://www.medworm.com/ to pull together a range of feeds on your topic

4. Use PubMed RSS feature to get updated anytime something new is published on your search.

5. Set up a Wiki to manage a project http://www.pbwiki.com (some nicely presented tips on maintaining a community/project wiki are in the slideshare presentation, at: http://slimurls.com/?UsingWikis )

6. Join or set up an Online Journal Club e.g. http://journalreview.org 7. Record a document with http://spokentext.net and listen to it on your

iPod/MP3 player on the way to or from work.8. See if Seminars or Conferences will be made available online. 9. Create an online demonstration from your PC with http://camstudio.org/10. Look for presentations or video tutorials on any topic with

http://www.slideshare.net or http://www.youtube.com

Manage your information – the web comes to youRSS “Really Simple Syndication”

Choose a feed reader / aggregator Register – they are usually available for free Start subscribing to feeds from your selected sites As new content is added to your chosen sites, it is

stored in your feed reader.

Selecting RSS feeds

Look for the logo on the page (see sample instructions below from BMJ site):

Tried & tested RSS readers

http://www.bloglines.com

http://www.newsgator.com/Individuals/FeedDemon/Default.aspx

http://www.netvibes.com

Useful sources of RSS feeds Your preferred e-journals

Referenced blogs/feeds

Try an RSS Aggregator

Find blogs with http://blogsearch.google.com

Useful sources of RSS…. Press or TV news websites

References from Healthcare bodies/associations or affiliations – including past or future Conferences

http://www.ecancermedicalscience.com/

Useful sources of RSS feeds Feeds referenced in other feeds Your PubMed searches

Copyright, privacy, data protection & security online

Protect yourself, and others

“Let’s go crazy”…..

http://www.youtube.com/watch?v=N1KfJHFWlhQ

Copyright & web 2.0 Once it’s published, protection exists

automatically. Licenses – as legislation can’t keep pace with

online evolution, the default legislation is the License Agreement.

Tip: you can double-check a license or policy - use Ctrl & F, look for keywords in the document e.g. “allow” “permit” “unauthori*” “illegal” “protect” etc. NB This is not by any means foolproof.

Creative Commons License Most Web 2.0 tools, and much of the content,

is protected by Creative Commons license Types of Creative Commons license (from

most to least restrictive) Attribution Non-commercial No Derivatives Attribution Non-commercial Share Alike Attribution Non-commercial Attribution No Derivatives Attribution Share Alike Attribution

Protecting your privacy

Create a separate e-mail account (gmail, yahoo etc) for social or networked sites

No need to provide your real name (unless you want people to recognise you)

Avoid providing any personal information – generally, this information is not necessary but if it is a required feature, then find out why they need it (e.g. DoB to verify you are over 18) but don’t be afraid to stretch the truth. Take a look at “the dangers of Facebook” :

http://student.bmj.com/issues/08/10/life/354.php Then consider using: http://www.thecandidatenetwork.com

Check a site’s privacy policy When the site allows it, go for the closed environment option e.g. “invite

only”, or “edit” permissions restricted to those you trust. Watch for “opt in” or “opt out” features (e.g. Google toolbar) For children use either http://kids.quintura.com or

http://www.gogooligans.com/

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Protecting patients HIPAA (The Health Insurance Portability & Accountability Act) set up to

protect patient privacy is summarised in: http://casesblog.blogspot.com/2005/07/case-reports-and-hipaa-rules.html

A good background article on patient behaviour plus the type of sites available is at: http://www.iht.com/articles/2008/10/02/arts/sninternet.php Schwartz: “Surfing for a second opinion”

Also, Broom, Alex et al: The role of the internet in cancer patients' engagement with complementary and alternative treatments. Health, 12(2):139-155 (2008)

Patients increasingly use the internet to source health information. Where possible, point them to authoritative sites on their condition; also provide them with guidelines on assessing sites e.g.

Get the HONcode toolbar: (http://www.hon.ch/HONcode/Plugin/Plugins.html) ..or search approved sites at: http://www.hon.ch/HONcode/Hunt/ Use the checklist at: http://www.virtualchase.com/quality/checklist_print.html

Google your specific discipline – see what appears in the first 2-3 pages

Patient tools The “Personally Controlled Health Record” -

they can store their family medical history using e.g. Google Health at: http://www.google.com/health

Patients can hold an interactive consultation with an ER physician at: http://www.freemd.com Read Mandl “Tectonic shifts in the health

information economy” N Engl J Med. 2008 Apr 17;358(16):1732-7.

Microsoft’s Health Vault:

http://www.healthvault.com/

Patient privacy & clinical trials/research

“Robert Shelton was a successful real estate developer who became wealthy creating buildings such as the Palm Springs Convention Center. But his world was rocked when his son was diagnosed with a rare genetic disorder. He then faced a

quandary. He needed to find treatment for his son, but doing so would cost his family its privacy.

That dilemma ultimately spurred a business, Private Access, which is coming out of stealth today at the Health 2.0 conference in San Francisco. The company allows

people with health conditions to describe their problems anonymously. It also posts news of clinical trials of new treatments. It thus allows medical researchers and

potential research subjects to find each other.”

Takahashi, Dean (23/10/2008): Private Access seeks to share health data for patients without giving up privacy from http://venturebeat.com, accessed 31st October 2008

Possible pitfalls.. There is a learning curve and this initially

takes a bit of time. Confidentiality? What do they want to know –

is it necessary? Hospital firewall blocks some of the

applications – will need to ask for release from ICT.

Legal issues – copyright (e.g. music downloading), privacy.

Trying to reference a transient source

TIP: Citing from a transient source e.g. Wikipedia

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