Untitled - socium.ge

e-health networks and social transformations 297now being made accessible by the Internet. For example, Wikgren (2001)found that the bulk of citations in discussion group postings came fromabstracts of professional journals, such as the Medline database.However, despite the fact that centralized sources could (and in many casesdo) provide up-to-date and individualized assistance, too often they do not.Few take advantage of website certification services. Varieties of helpfulservices, which are technologically feasible, are also often not available fromleading institutions of centralized medical care (discussed below). Despite theimpressive promise of Internet technology, substantial numbers of these topdowninitiatives have been weak (though many have valuable and timelyinformation and have been a success). For instance, a surprising number ofsites have out-of-date or misleading information; and many of those that donot are but little visited, which often means closure. Six factors may accountfor poor performance.• Nonprofit, centralized sources may not be widely promoted to the relevantaudiences – online or offline. Sigouin and Jadad (2002) studiedcancer patients, their general practitioners, and all oncologists andoncology nurses at the Hamilton Regional Cancer Center in Ontario.They found that few patients were aware of local, official cancer informationwebsites (3 percent) or Medline (13 percent). While oncologistsreported high levels of awareness, less than a third of family practitionershad used any online sources other than Medline.• To use centralized sources, training is often required. Even if users ofsystems do not require training, they invariably have to face a learningcurve. Further complicating matters is the fact that different protocolsare usually required for each e-health resource. For instance,Surgerydoor.com (a British commercial health website) offers a specializedsearch engine linked to high-quality medical information.However, Williams et al. (2002) note that even deft users had difficultyusing it as they were accustomed to generic search engines.• Old habits die hard. Bamford et al. (2003) implemented a country-widenetwork of physician webcams throughout 35 histopathology departmentsin the UK. A year after installation, they found that 71 percent hadnot been used, due to the physicians’ excessive workloads and IT staffreluctance, but above all, because of negative attitudes toward the technology.Technology in general, and centralized systems in particular, donot seem to fit in with the “social side” of how people – whether physicians,nurses, technicians, administrators, or patients – gain and evaluatehealth information and participate in medical service (Rice, 2004).• While centralized sources use peer-reviewed literature, which tends tohave the highest quality, this literature is also the most difficult to read.