Creating Patient-Centered E-Health

As e-health applications have increased in number and variety, the generalized concept of e-health as “health services and information delivered or enhanced through the Internet” (Eysenbach, 2001) has lost much of its value as a mechanism for guiding development and research in this emerging field (Pagliari et al., 2005). E-health has expanded to comprise purely clinical applications (e.g., physicians consulting on a diagnosis) (Wiecha & Pollard, 2004), emergency health communication applications (e.g., for distributing information about SARS) (Rizo, Lupea, Baybourdy, Anderson, Closson & Jadad, 2005), disease-focused applications (e.g., diabetes self-management support) (McKay, Glasgow, Feil, Boles & Barrera, 2002), applications to support electronic communication between patients and physicians (Wilson, 2003), and commercial applications that have no association with a patient’s own health care provider (e.g., WebMD) (Itagaki, Berlin & Schatz, 2002). It is clear that the needs of both users and researchers vary widely across these diverse applications, and I argue that both groups would benefit from development of finer-grained approaches to thinking about e-health.