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The impact of the Internet on health communication is so comprehensive that it has spawned a new discipline, which is called consumer health informatics, or e-health. The partial integration of health education, patient education, medical informatics, and health communication (the disciplines that preceded consumer health informatics) into e-health provides abundant opportunities and important challenges.

The opportunities include enhancing the nation's health literacy and creating the potential for health communication to evolve from social and commercial marketing to the use of informatics in provider–patient communication, patient-to-patient communication, patient education, and support for personalized medicine. Some of the challenges include the impact of the Internet on health disparities and discomfort among health care providers with the salience of the health information some people find on the Internet.

The Internet's transformative impact on the practice of—and research about—health communication is tied to the U.S. public's acceptance of the Web as a primary health information source. The National Cancer Institute's Health Information National Trends Survey (HINTS) recently found for the first time that the Internet eclipsed other mass media as a primary source of consumer health information. HINTS also reported that health information on the Internet sometimes is perceived as a more credible source than legacy media, such as broadcast health news or information on television and radio as well as print news/ information from newspapers, magazines, books, and brochures. The Pew Internet and American Life survey recently found that 70% of Americans (with access) now report they routinely seek medical information on the Internet, and recent surveys report rising trends in U.S. consumer Web-based health information seeking.

Electronic Communication in Patient Care

In addition to its popularity, the expansion of health information and communication on the Internet is tied to its unique attributes and functionality as a mass medium and to the evolving use and potential of information technology in patient care. In terms of its characteristics as a mass medium, the Internet fosters individual participation, enables a customization of information, and provides both instant consumer access and a search capacity to manage large stores of health information. The Internet uniquely blends all legacy media (audio, video, photography, print, display, and multimedia) to make either learning or Web surfing more compelling. Also in contrast to legacy media, the Internet gives a potential voice to the user by enabling mass communication without comparatively high start-up costs.

Health communication experts Linda Neuhauser and Gary Kreps add that in contrast to legacy media, the Internet alters the potential cost-effectiveness of direct-to-consumer mass communication, mass health education, noncommercial public health interventions, and social marketing initiatives by making it affordable for health care organizations to communicate directly with patients. Cost-effective consumer educational and health services–oriented Web sites now flourish in clinical centers, medical organizations, and provider groups throughout the United States and other nations.

The Internet also provides an unprecedented resource for interpersonal health communication, using e-mail as well as blogs and Listservs for interactive peer and affinity groups of patients with common illnesses or conditions. The Web provides a cost-effective, accessible medium to enable patients and caregivers to exchange information, experiences, and emotions, and it enhances the creation of often useful and uplifting support communities across geographical boundaries. The latter is especially advantageous to families and patients with rare diseases and conditions, or to advance health-related exchanges between persons who share similar sociocultural and religious backgrounds.

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