PREFACE In some ways, this book is an academic version of the classic movie, "King Kong meets Godzilla." King-Kong is played by the health care sector. Central casting’s choice is sound; the national health care sector can easily play the proverbial 800-pound gorilla that must not be ignored when he occupies a seat at important policy discussion tables. In the U.S. alone, health expenditures tip the scales at 1.3 trillion dollars and is projected to balloon to a yet more impressive 2 trillion dollars before the decade is out (U.S. Census Bureau, 1999). In fact, it is the largest sector in the U.S. economy. And the importance of health to Americans is not something that can be measured by money alone. It is a high priority to all Americans; simply, we cannot live without it.
In the other corner is the Godzilla-like Internet. We could easily venture that the Internet is the first new mass medium in a half-century. But we go further. We propose that it, like Godzilla, is unprecedented. Godzilla, the reader may recall, is a not entirely seamless amalgamation of pre-existing creatures, but is also endowed with a generous mixture of unprecedented and, one might add, common-sense-defying, powers. The Internet too is something that has been both been seen before but also has unexpected and common-sense-defying powers. In a few short years, the Internet has sprouted from a handful of kluged computer networks to a frenetic monster that embraces half the U.S. population. As such, it is sui generis, the first "many-to-many" medium, as opposed to “one-to-many” media (such as TV) or “one-to-one” (such as the telephone).
The focus of our book, to continue the movie analogy, is the “meeting” of these two colossal beasts. As they embrace, the stakes are enormous, and are ones in which we are all vested. Given the magnitude of the event, we have necessarily taken only a narrow perspective on the interaction of these two powerhouses: that of communication issues.
This is not a "how to" book nor a book offering practical advice to the public or physicians about finding and using a medical information on the Internet. It is, instead, an attempt by academics for academics, students, researchers and health professionals to explore the communication issues related to the consequences the Internet is having on healthcare as well as the way the exigencies of healthcare are affecting the use of the Internet.
The gap we see in the literature on this area is an analysis of the way people actually use the Internet in pursuit of health care, with what consequences and implications. That is, few have probed what can be learned about human communication behavior when we look at the practice of medicine and the pursuit of health on the Internet. At this point, we know little about how traditional modes of human behavior are changing, and what might remain the same, as considerable personal and economic resources are shifted from traditional to electronic sites of health care delivery. Will the previously successful appeals to change behavior aimed at promoting good health be as effective in cyberspace? What new appeals will succeed? What policy questions need to be resolved so that the fruits of Internet health care can be harvested while avoiding further tragedies and abuse? How can social science theory enlighten us about communication issues in this brave new environment? By drawing on dispassionate and rigorous analysis experiences to date, we will better know what to expect for the future.
A unique aspect of the book is that we look at a variety of settings and groups to grasp the diverse nature and impact of the Internet's use for health care. As a result, we believe our volume should help cross boundaries that have heretofore prevented greater progress both in understanding human communication behavior, and in turning that understanding to the benefit of the public’s health.
This book is one of the first to apply systematic empirical tools to analyze the dramatic changes in health care associated with the Internet. Rather than being based primarily on ad hoc analyses or speculation, the authors have sought to ground the volume firmly in research. The book covers the gamut of activities from social interaction to e-commerce, and from regulatory regimes to web site development and evaluation.
Some courses will use this book as their primary text. These include college and graduate school courses that examine the Internet and electronic commerce, telecommunications, health communication, and communication campaigns. Nearly all research-caliber-university libraries would want to acquire a copy. We would also expect strong interest from professional audiences including health care and hospital administrators, federal and local policymakers, health care-oriented business people, and entrepreneurs interested in offering services. Finally, it seems quite likely that many physicians, social science researchers and communication professionals would want to read this book to develop a broader understanding of the many relationships between the Internet and health communication.
Thus, what we have to say should be of both practical and conceptual significance to the provider community, the interested general reader, the health care entrepreneur and policymaker, the researcher, the teacher, and the student.