The Mashup of Informatics, eHealth, and Social Media in Healthcare

To both insiders and outsiders nurses working in informatics use a confusing mixture of verbage to describe the use of technology and innovation in healthcare attempting to describe ‘what they do’.

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Over the last decade in nursing, the discipline of informatics has seen and witnessed some exponential changes. The word ‘informatics’ had been used in practice and literature since the mid-1970s, and was picked up by nursing in the early 1980s. As nursing entered the late 1990s, the term ‘eHealth’ began to collect support as the catch-all term used to describe practically anything that crossed between health and technology. With the rise and plateau of the eHealth vernacular both in professional and lay audiences in the latter part of this decade, other neologisms have gained momentum within healthcare – namely, Web 2.0 and social media.

To both insiders and outsiders, this confusing mixture of verbage to describe the use of technology and innovation in healthcare has long confounded individuals attempting to describe ‘what they do’. In my discussions with colleagues of the Ontario Nursing Informatics Group , I have realized that I am not the only person out there who sometimes does not know how to describe this informatics/eHealth/social media mixing pot.

A few months ago I began to critically question why I chose to use certain words, in specific writings or situations. For instance, why would I choose to use the word informatics, as opposed to eHealth to describe a hospital information system? Or, why would I select eHealth as opposed to informatics to outline the use of PDAs in clinical care? I didn’t really have an answer until I started looking at the network of actors (both human and non-human) that formulated and inscribed my past and present thought processes.

Web 2.0
Social Media
Has been used the longest, seems to outline basic understanding of the topic by lay audiences. People seem to align themselves with it as a descriptor and noun. Has a business feel to it (e.g.,ebanking, ecommerence). Came after informatics and has always seemed more inclusive than the term informatics. Arose in the mid 2000s – caught on in the vernacular – everyone started naming things 2.0. E.g., Medicine 2.0, Nursing 2.0, Health 2.0 With the rise of social networking, social media became a term that involved the technology of Web 2.0, but went further. The ‘social’ aspect of the word seems to resonate better with people than ‘Web’ or ‘2.0’ could. In essence, it seemed that this term just was more intuitive than Web 2.0
A significant amount of time invested in this term by organizations, researchers, educators, and some business Looking at the Google Trends for the word eHealth, it would seem that as of May 2009, this term became popularized in the media in Ontario, and subsequently probably most of Canada (and not in a good way). I have not really seen this term adopted in to political agendas or documentation E.g., 2008 United States Presidential Elections, 2009 Iranian elections, 2010 G20 Toronto.
Nursing Education
Nursing education currently uses this word – until recently, rather reluctantly within education I’ve never heard ‘eHealth’ used commonly in any Canadian nursing syllabus. Informatics still seems to be the preferred term Some researchers jumped aboard early with Web 2.0 like podcasts and blogs. Limited penetration Becoming more of a popular topic due to ubiquity within specific demographics and highlighted recently with political (e.g., G20) and advertising events (e.g., OldSpice commercials)Regardless. ‘social media’ doesn’t seem to have caught on in any systematic fashion in the education vernacular (yet?).
Why I choose to use the term
I usually use this word to outline something that has an IT/information systems focus, or, something that also has been historically fixed within healthcare and involves more focus on information networks controlled and run by healthcare organizations with limited consumer involvement I use this term to as a broader word than informatics, or when speaking to lay audiences.That said, quickly, I have found that the term eHealth is not needed in many instances as what used to be “eHealth” is now “just the way of doing things”. The innovation has been absorbed into the fabric of practice and daily life. Therefore, I’ve gone back to using the word ‘innovation’ or ‘health technology’ as my crutch. Usually in passing to introduce social media. I generally save this word for consumer-driven technology in healthcare underpinned by the Internet, whether or not they have an eHealth or informatics flare to the innovation. If it is consumer driven and uses the Internet, I generally label it ‘social media’.
Cross-sectional news media usage
Has not really cracked the news feed for popular media.
Currently 597 news items on Google News*
Limited use – generally not ‘big’ stories.
225 news items on Google *
Popular in the mid 2000s – has subsequently fallen from popular use with only
5,594 times used on Google News*
Currently in popular use. Over
27,557 hits on Google News*

So, as you can see through my concept listing, the blurring of the terms exists at many entangled socio-political-technological levels. The ability tease apart the differences are rather difficult at the best of times and sometimes a moot endeavor. Context is probably the best predictor of what term to use, but even that rule of thumb can be flawed. In my short time (respectively) within the profession, I’ve had the opportunity to see terminology come, go, evolve, die, and be replaced with an entirely new cross-section of lexicon. Sadly, I doubt the future will bring any clarity to this issue.

I guess my take away point is to examine how you use certain terminology when describing innovation in healthcare. Neologisms are time limited and sometimes do not gain traction in the literature or practice language. It is probably wise to not fully align one’s self with a term that might only have a useful half-life of 3-4 years. I encourage you to attempt the reflective exercise I’ve tried above and let me know if any of your conceptualizations differ from mine – I’m interested to see how others conceptualize this mashup of terminologies used in describing the informatics discipline.

Image from TedEytan

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