Designing Internet Health Applications

It is generally assumed that access to and use of internet health tools by consumers creates better outcomes, partly by leading to more informed, more involved patients, and that notion is supported by some research.  A study of 165 fibromyalgia patients attempted to ascertain what aspects and features of an internet health application and a patient’s interaction with that application led to the improvement.   (JMIR Article)   The authors hypothesized that the interactivity features of an application lead to greater patient knowledge and higher scores on measures of empowerment–the feeling of mastering or controlling an issue.  They believed these would in turn be reflected in better health outcomes.  The outcomes measured in this study were derived from patient-reported areas such as pain, sleep disturbance and fatigue.  The authors developed a web interaction which allowed patients to interact with health professionals and lay people such as other patients in an asynchronous and synchronous manner, to gather information, get questions answered and share experiences.

Different sub-groups of the test subjects used different versions of the web application, with different functionality, one version had only static features, one only interactive ones and the third had both components.  It should be noted, as has been reported in other similar studies, that in general usage of the application was low, which suggests that many patients don’t actually find internet health applications that compelling or useful.  And the results of this study were that there was no difference in self-reported fibromyalgia outcomes among the three groups.  In fact, the patients with the less full-featured versions of the application scored higher on empowerment dimensions, although overall the application did not appear to improve knowledge or most aspects of empowerment.    This is an important line of research, and although this study has limitations, it is not inconsistent with other rigorous research suggesting minimal benefits for use of internet health tools.  It is highly plausible that such tools could be helpful, but more research is needed to maximize their design and content to actually provide benefits.