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Leveraging-Web-3.0-for-the-Next-Generation-Universal-Health-Care
Satyam Priyadarshy
Sunday, January 3, 2010
Web 1.0 and Web 2.0 are important transforming agents of health care and public health, their power and capabilities are limited to achieving universal health care. A significant proportion of the Internet health information available to consumers is confusing, misleading and often times even in disagreement with the professional recommendations of the health care service providers. Studies indicate that a certain population of patients failed to follow their physicians’ advice, after having performed web searches on the treatments they were recommended. This non-adherence arises due to the following two reasons: (a) the behavioral aspects (anxiety, decline health, etc.) of the patient, and (b) confusion created by fragmented information available via the web. The information itself is published with little co-ordination and co-operation between the various publishers (governmental agencies, non-governmental businesses, and other health care service organizations). The Web 2.0 revolution made it so easy to publish such information that no attention was paid to maintaining checks and balances on the information itself.

Universal health care also needs to account for the rising number of alternative providers of health care service. These providers are chiropractors, homeopaths, naturopaths, therapists, etc. Well, studies show that one in three persons in the U.S. seeks health care services concurrently from alternative providers and primary service providers. The care is, now, fragmented between the regular service providers and the alternative providers. A lack of communication develops into issues of critical importance for the patient, between the two providers. This fragmentation increases the complexity and the cost of treatment.

Web 3.0 and beyond, is poised to provide solutions for above challenges. Web 3.0 has many different meanings; but basically describes the evolution of the web usage and interaction among several paths. It transforms the web into a large database, makes content accessible through diverse devices and leverages the artificial intelligence, or the Semantic Web.

Heath care information is one of the prime candidates for leveraging Web 3.0 based on the issues discussed above. Web 3.0 technologies can enable a sustainable, efficient and reliable healthcare ecosystem. The health care ecosystem (HC Ecosystem) consists of the following: healthcare professionals, institutions that provide a range of clinical and non-clinical supporting services to the patients. The HC Ecosystem will flourish well, if the following topics are addressed well.

Health care systems collect large amounts of data, distributed across many applications and data stores. Health systems are upgraded as technology changes, however, the migration of legacy data remains a challenge. The standards for data transfer, sharing and communication between distributed sites are not well defined. There is an attempt to use HL7 data sharing standards for heath care data and web services.

Interoperability solutions of different levels are needed to solve the problem and those are: a) physical (network, systems, connectors, etc.), (b) data (schema designs, databases, etc.), (c) specification (framework), and (d) semantic. The development and adoption of the standards like HL7 and ANSI X12 can move semantic interoperability to specification level.

Semantic web technologies have shown early promises in the automatic diagnosis of diseases and clinical processes. Semantic web technologies provide more extensible and flexible data storage and interoperability options that helps in leveraging the distributed large data sets available in the electronic health care systems. The data can be easily associated with each other and using standard linking mechanisms.

The integration and increased usefulness of distributed data sets can also be addressed by using Web 3.0 technologies like OWL-S (the Ontology Web Language - based web services) and WSMO (Web service modeling ontology). These technologies are useful in the automatic and dynamic discovery of web services. Furthermore, role-based services can be defined using OWL-S and agent based modeling. Semantic ontology mapping from distributed health care systems could provide for interoperability between different members of the HC Ecosystem.

Another aspect of the Web 3.0 world is the availability of the natural, intelligent and multimodal user interface, through which patients will interact with the semantic web. The health care system needs to implement recognition of hand gestures, facial expressions, moods, voices and be able to react and respond in a multi-modal fashion. The response has to be intelligent and contextual.

As Web 3.0 technologies are used for creating interoperable and ubiquitous health care systems, one has to address various challenges that arise due to implementation of the Web 3.0 technologies. Some of these are known to use from the Web 2.0 world.

* Privacy, security and legal issues - The Web 2.0 world has provided us with a set of challenges related to privacy, security and legal issues. These issues are still being resolved. Implementation of Web 3.0 for health care systems will increase the complexity of these issues, due to the pervasive nature of the data on the web.

* Scalability and tractability - The large volumes of data that will be generated by monitoring devices for heart rate, blood pressure, glucose level, etc. and from a multitude of devices that are worn on the body, in the car, on the gym equipment, in the hospitals and clinics, therapists, etc., require that the backend systems are scalable and the data is track-able to a trusted source. The rogue devices could potentially harm the system, similar to the DDOS attacks in the current Web 1.0 and Web 2.0 worlds.

* The Semantic Web is, certainly, a comprehensive solution, but it poses implementation challenges on the timelines needed for it to work efficiently and completely. The user interface on a diverse set of devices requires a significant amount of work before they become useful.

* Social, Cultural and Ethical issues - The Web 2.0 world exhibits an increased reliance on technology platforms, and decrease in human-human interactions, overall. With Web 3.0, the presence of always-on network devices and a constant stream of information the patient may trust machines over human. This could lead to serious concerns about the health care service.

Future of healthcare systems, certainly look brighter, if Web 3.0 technologies are implemented. Interoperability, itself is projected to save about $86 billion per year for the health care systems in the U.S. alone. The next generation of health care systems could go beyond Web 3.0. The health care systems could learn from the interactions in the virtual world. The application of haptics in the virtual world could provide emotional assurance for the patients.

The author is Co-founder & Chief Knowledge Guru at RKR Group
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