Introduction
Health care systems around the world are in desperate need of reform, facing rapidly
increasing service costs and aging patient demographics. In order to improve the sustainability
of their health care systems, many jurisdictions have invested significant
resources in the implementation of Information and Communication Technologies
(ICTs) in support of health care. Such so-called eHealth technologies include electronic
health records, clinical decision support systems, and tele-medicine applications.
Although there are many benefits to the use of ICTs in a health care setting, many
experts believe that long-term sustainable health care reform requires a paradigm shift
more fundamental than simply migrating paper-based health data to a computersupported
information systems. They postulate that patient empowerment is a pivotal
factor for success. Traditional approaches to health care delivery have involved
asymmetries of power and information, relegating patients to a mostly passive role.
Caregivers have not only exercised control over the nature and frequency of treatments,
but they have also acted as the primary source of knowledge.
From an abstract vantage point, the shift in health care towards patient empowerment
has been foreshadowed by changing service models in other industries. For
example, the situation in health care can be compared with the telecommunication
industry before the introduction of direct dialing technology, or with the financial
28 J.H. Weber-Jahnke and J. Williams
industry prior to the adoption of automated teller machines (ATMs) and Internet
banking. In both cases, new technologies have acted as catalysts for reforming industries
that were expected to become unsustainable in the future. Furthermore, these
technologies were explicitly intended to afford users the means to manage interactions
directly, thereby eliminating asymmetries of information.
Analogously, there is evidence indicating that Smart Internet technology may act
as a catalyst for sustainable reform of the health care industry, by empowering patients
to become active and equal partners in matters of their health. While the first
generation of Internet-based health services consisted of health portals that catalogue
information, a new breed of smart applications has reached the market, utlizing this
information in context of concrete health services. “Healthcare 2.0” has been defined
as the use of social software and its ability to promote collaboration between patients,
caregivers and medical professionals. In this chapter, we describe how the emerging
vision of the Smart Internet applies to the health care industry, including its unique
opportunities, current solutions and future challenges. Due to the sensitive nature of
health care, we will also emphasis issues pertaining to information security and privacy,
as well as governance.