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Expanding the Reach and Impact of
Consumer e-Health Tools

June 2006

Office of Disease Prevention and Health Promotion logo

Table of Contents
Executive Summary (Stand-Alone)
Preface: A Vision of e-Health Benefits for All
Executive Summary
Chapter 1. Introduction
Chapter 2. Mapping Diversity to Understand Users’ Requirements for e-Health Tools
Chapter 3. Assessing the Evidence Base for e-Health Tools for Diverse Users
Chapter 4. Strategic Factors in Realizing the Potential of e-Health
Chapter 5. Partnerships for Meaningful Access
Appendix 1. Environmental Scan of 40 e-HealthTools
Appendix 2. Project Interviewees, Experts Consulted, and Reviewers
Appendix 3. Chapter 3 Literature Review Summary
Appendix 4. A Comparison of Internet Use and Health Status of Populations That Experience Health Disparities


Today, more and more decisionmakers are interested in e-health tools as critical components of personal health management and healthcare reform strategies. Decisionmakers are seeking viable approaches to reduce healthcare costs, improve the quality of care, and increase consumers’ ability to manage their own health. Conditions are favorable for a greater investment in consumer-oriented e-health tools. The technology marketplace is dynamic; the public is increasingly turning to information and communication technologies for a better life; healthcare organizations are adopting and offering health information technology; and Government policy is placing great emphasis on both health information technology and personal health management for consumers. Such activities are now part of everyday news.

Since this study began, the Federal Government has embarked on a major initiative to increase the use of health information technology by healthcare providers and consumers. The creation of the Office of the National Coordinator for Health Information Technology within HHS provides a strategic opportunity for the Federal Government to exercise the kind of leadership called for in this report. Improving population health and personalizing health care—key components of the vision underlying this study—are two of the four goals articulated in HHS’ Framework for Strategic Action for health information technology ( The vision and approaches proposed in the present study should be useful in realizing both the population and personal health goals.

The present study seeks to lay the foundation for a robust, population-wide, and consumer-centric e-health enterprise. It outlines a vision, identifies challenges and opportunities, and highlights strategies for using e-health tools to improve personal and population health. A central message is that no single tool or strategy will work for a national population with highly diverse interests, experiences, conditions, and capacities. This study found that, at present, the well-documented diversity in this country is not well matched by the diversity of strategies and responses in the e-health arena. This is the case for e-health tools themselves as well as the policies, funding, and program priorities that influence their development, evaluation, and dissemination.

Realizing the potential population health benefits of e-health tools requires not only a shift in thinking and strategies but also strong leadership to coordinate marketplace and policy momentum for maximum public benefit. Disparities in access to health information, health care, and technology make it highly unlikely that market forces and fragmented public-sector efforts alone will achieve desired public health goals. Consistent with other Government initiatives, public-sector engagement in partnerships that harness current consumer trends and align the multiple interests of stakeholders is crucial. The way forward for consumer e-health is to use these partnerships and interests to create and sustain a user-centered strategy that results in e-health tools being available on a much wider scale than is currently possible.

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