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Internet and Health care: Extensive Knowledge Lessons Learned -5 · · · · patients’ bringing Internet information to their doctor’s appointments affected various outcomes for physicians and patients depending on how the physicians’ assessed the reliability of the information , doc’s attitudes toward general popular access to health information , patient’s education and attitude site map and orientation guides necessary for website designs social support and interpersonal utility needs structural indicators of website quality and accreditation seals may not be highly related to accuracy and quality of its medical content Internet and Health care: Extensive Knowledge Lessons Learned -6 · · · · patients’ bringing Internet information to their doctor’s appointments affected various outcomes for physicians and patients depending on how the physicians’ assessed the reliability of the information , doc’s attitudes toward general popular access to health information , patient’s education and attitude site map and orientation guides necessary for website designs social support and interpersonal utility needs structural indicators of website quality and accreditation seals may not be highly related to accuracy and quality of its medical content Internet and Health care: Extensive Knowledge Lessons Learned -7 · · - users rate online health information quality much higher than physicians do visualization of system prototypes helpful for users to understand and comment on design possibilities widespread use of Internet by physicians but much less so for interaction with patients The future challenges in ICT and Health care: Developments · · · · · · · · context- or location-sensitive services disabled patients using embedded sensors to interact with their environment electronic learning environments electronic research environments evaluating e-health behavioral and management interventions bio genetic engineering high-speed broadband wireless Internet integration of various treatment and response media (such as online assessment generating advice to contact a telephone hot line o send an email) interactive voice-response applications miniaturization http://www.youtube.com/watch_popup?v=Ahs2W-TafYQ Internet and Health care: Developments – 2 - · · · · · · - mobile telephone-based or converging media -based health information and communication services nanomedicine online databases of rare pathologies and cases online diagnosis tools online health monitoring and personal health management online or mobile health monitoring or reminder systems portable digital personal medical records territorial health information organizations Internet and Health care: Developments – 3 - · · · - use of Internet2 for medical research networks using wireless devices as data entry interface for Internet-accessible databases, digital cameras to capture and transmit medical images virtual reality anatomy demonstrations and medical training web-based store-and-forward health information applications (such as for X-rays) Internet and Health care: Trends · · · · · · · · · - accuracy and privacy certifications and criteria broadcasting baby births through the Internet business-related applications developing national medical databases electronic patient records (use for public health purpose) electronic prescribing services electronic publication of medical research email between health providers and patients (legality) health group discussion threads hospital and health resource portals for patients Internet and Health care: Trends – 2 - · · · · · - increased emphasis on health problems and disparities increased system security increasing business-to-consumer and business-to-business Internet transactions increasing online intermediaries massive increase in healthcare sector investments and expenses moderated health discussion sites online medical education (physicians, students, patient) Internet and Health care: Trends – 3 - · · · · · - online medical textbooks , journals and CME online test results personalized and customized online portals and medical training physician referral of patients to health websites (including more formally as “information prescriptions”) physicians turning to the Internet to keep up to date with current research real-time and asynchronous monitoring and reporting individual health status as well as disease outbreaks and diffusion Internet and Health care: Trends – 4 - · · · · · - remote diagnosis rise of online appointments, transaction processing services technology-enhanced clinical applications telehealth in remote areas telesurgery (robotics) traditional print and broadcast media providing links to online health sites virtual clinics Internet and Health care: Facilitators · · · · - broadband infrastructure cooperation and coordination among service and infrastructure providers government promotion of access and infrastructure for e-health e-health policy interconnectivity across systems and channels Internet and Health care: Facilitators – 2 - · · · · · - mobile/wireless devices and convergence patients demand to be involved in their medical decisions physician recommendations of health sites positive perceptions of innovation attributes reimbursement to doctors for online time and services support by national medical associations & gov. Barriers · · · · · · access and knowledge computer fears computer/ICT skills cultural divides concerning technology use and social norms toward health behaviors differences in procedures for reimbursement and health coverage across economic sect and national boundaries difficulties in assessing online knowledge acquisition Barriers - 2 · · · · · · - digital divide (cultural divide) high costs of technology overwhelm low cost of access and communication individuals’ perceptions of current medical information rights insufficient bandwidth insufficient control or awareness of third party access to personal medical records insufficient health dedicated staff joint involvement by local service providers/physicians /patients Barriers - 3 · · · · · lack of basic infrastructure lack of standard evaluation criteria lack of support for sustainability of online interventions and health projects large gap between those with Internet access and those offline with chronic health problems (such as HIV/AIDS) limited vision by government and health care agencies as to potential applications Barriers - 4 · · · · · · · · - legal limitations of online medical practice majority of health sites in English language national and cultural norms and policies online privacy concerns physician resistance/hesitancy poor management of ICT personnel and projects standard codes for practices and protocols sustainability (costs, updating, link stability) time required to learn new systems usability CURRENT EMPIRICAL EVIDENCIES: Shocking Uses Of The Internet In Body Part Commercialization http://www.eggdonor.com/ Fig http://www.eggdonor.com/?page=donordb Beaut http://www.eggdonation.com/SampleDonor/Donor1.html Today, thanks to advanced scientific and technological medical practices thousands of babies are born, also thanks to the internet… Body Parts Donation and Surrogate Mothers Over the Net Body Parts Donation - Men http://www.spermcenter.com/ http://www.spermcenter.com/content/fertility-professional-search http://www.youtube.com/watch?v=9LQeCdBT8YU&feature=fvw While donations and trade of body parts like eggs is a diffused practice, man also are part of the business. sperm bank opened in india for tourism... https://www.fer tilitymiracles.com/P arents/fee_schd ules.html http://maps.google.com/maps?f=q&source=embed&hl=en&geocode=&q=surrogacy+agencies,+egg+donor+agencies&sll=37.0625,-95.677068&sspn=31.371289,56.513672&ie=UTF8&ll=37.0625,-95.677068&spn=24.455808,37.353516&z=4 Future trends in Building human beings: What is going to happen? What information on the WWW in future years ? Tomorrow genetic engineering opens new dilemmas and possibilities to internet users (Video) of building a human being Ethical, legal social implications Every year thousands of people die waiting ... and waiting ... ...and waiting ... waiting for a transplant http://www.youtube.com/watch?v=XuXYVLTisW4&NR=1 E-buy me an organ: the new opportunities of Web 2.0 Social networks, blogs offer easy access to unprecedented information? Living donors Online blog http://www.livingdonorsonline.org/experiences/experiences.htm http://www.philippines-medical.com/ http://kidneytransplantgroup.org/index.php?option=com_c ontent&task=view&id=1&Itemid=1 More controversial and shocking implications: The Illegal trade of children’s organs http://www.youtube.com/watch?v=zj-rfHvPxsk&feature=related How far should we go in developing info highways for body parts procurement (… and effective sensibilization campaings) ? How far should we go in developing info highways for e-health (body parts procurement) ? Conclusions: E-Health: An interdisciplinary and International approach to Research & Methods. Political, legal, social, economical aspects for policy making Internet and Health care: Conclusions Policy Issues . · · · · · · · - codes of ethics cross-state and cross-border regulations (commerce, drug prescription etc.) digital and cultural divide electronic medical records for public health use enforcement of online pharmacies health web site licensure identify theft infrastructures national/regional/international e-health policies privacy (collection, accessibility, security, , anonymity, verification) telecommunications policy reform in developing countries telecommunications tariffs [email protected]