Not every site needs a wiki: A conceptual framework for health Websites

Medicine 2.0

Introduction In the early days of the World Wide Web, a Website was a Website was a Website. Sites facilitated information exchange in the form of text, images and hyperlinks and, for the most part, differed from each other only in content and aesthetic design features [1]. As the Web and its associated technology evolved, exchanges became more complex, incorporating new functions such as commerce, which enabled users to purchase items or services via the Web, and new features such as guest books, which allowed readers to comment directly on Websites authored by others. This increase in interactivity continued, and there are now many different classes of Web-based applications, each with its own focus and key functions. Choosing which applications and technologies to incorporate in health Websites requires an understanding of one's goals and of how different Web-based tools might help achieve such goals. Similarly, analyzing existing Websites requires an understanding of fundamental differences in focus between different applications [2]. Methods In this work, we drew on literature from Human-Computer Interaction, Sociology, Human Behaviour and eHealth to develop a conceptual framework for Web-based applications and technologies within which to consider and balance potentially competing goals and priorities. We explore these concepts through a framework with two pillars: 1) Community and 2) Information (Re)Organization that shape a structure of attributes, each with technical, design, social and human aspects. Results 1) Community: a) Individuals and Identity: What are the characteristics and roles of individuals in the community? How is identity constructed? What options are available for depicting identity? b) Connections: What role do connections between individuals have in the application? How are connections made and represented? c) Authorship: Who authors information in this application? How is authorship depicted? d) Authority: What are the formal and informal structures of authority in the community? How do these reflect, reproduce, support, or provide alternatives to existing power structures? e) Dialogue and Dissent: How is dialogue represented in the application? (How) is dissent addressed? f) Collaboration: How does the application support collaboration amongst community members? 2) Information (Re)Organization a) Information (Input): What are the characteristics of the content input to this application? E.g. Is the content textual or numerical? Scientific or lay? Does it convey specific experiential knowledge or generalized knowledge? Is it detailed or vague? b) Organization (Presentation): How is the content of this application presented? E.g. Are there tables or graphs? Images, audio, or video? What is the general layout? Is it multi-platform? c) Reorganization (Output): What are the characteristics of the content output from this application? E.g. Is it aggregated or mashed up from a variety of sources? Discussion We propose a theoretical model describing the relationships between the attributes, situate existing and upcoming Web-based eHealth applications within the framework, and highlight the implications of this framework for eHealth researchers and health Website designers. References 1. Berners-Lee T. Weaving the Web: The Original Design and Ultimate Destiny of the World Wide Web. New York, NY: Harper Collins; 2000. 2. Weiss JB, Campion TR. Blogs, Wikis, and Discussion Forums: Attributes and Implications for Clinical Information Systems. MEDINFO 2007 - Proceedings of the 12th World Congress on Health (Medical) Informatics: Building Sustainable Health Systems. Brisbane, Australia: IOS Press; 2007;12(Pt 1):157-161.