National concern over the spread of swine flu led the UK National Health Service to set up a telephone hotline, but also an Internet Website. The site provides a set of tick boxes – a questionnaire – that is self-administered. The answers permit individuals to make a more informed judgment of whether they do, or do not, have swine flu, or a more serious problem, and whether and how they can obtain antivirals. The traffic to this site has been phenomenal — literally crashing the site and forcing the service to add more capacity to deal with the volume of hits. Clearly, it has helped many people gain some personalized information about their own condition. To me, this is more evidence that the Internet has passed a tipping point at which it has become an essential aspect of everyday life and work.
Related journalistic coverage has illustrated that individuals who have been quarantined due to the swine flu have been able to keep in touch over the Internet. E-mail, Skype, and other tools are helping individuals to stay isolated and still get help as needed from friends and family. Preparations are already underway for how the Internet could help students keep up with their studies if they must remain home during the coming months, when the flu epidemic is expected to spike.
That said, the major media stories have been critical of the services – both the telephone hot line and the Website. One criticism is that the users are not speaking directly to a qualified physician. One editorial claimed that the operator on the hot line had mispronounced several medical terms. Another concern was that users would fabricate their answers in taking the online self-assessment to obtain inappropriate access to antiviral drugs. It stikes me that the whole point of these electronic service options has been to address the impossibility of physicians dealing directly with a flood of individuals calling at their offices or coming into their doctor’s offices or hospitals with the added risk of spreading the virus to others. Doctors have designed the questionnaires and real people are manning the phones, so I would be happy to defend these approaches in comparison with the alternatives — no service or overwhelming demands on health facilities.
This case will be remembered as a real turning point in recognition for what the Internet can contribute in the healthcare arena. Many seniors (70% of whom do not have access to the Internet in the UK), who often believe that the Internet has nothing of relevance for them might learn from this experience. Fortunately, the elderly are less at risk from swine flu, but other flu epidemics and communicable diseases do put senior citizens, or other demographic groups, at risk. Being able to obtain information directly from one’s household is of great importance, as illustrated by this pandemic. The advocates of e-Health have hit a home run in having the courage to establish this Internet service, knowing it would be a target of criticism, and demonstrating that the Internet can provide a response to contagious disease or the risk of spreading a flu virus.
Soon we should be learning something from the patterns of use of this Website. It should be possible to have more information to map the incidence and spread of swine flu by tracking access to this and other Websites focused on this flu. In such ways, services such as this can help generate additional information that will help address public concerns.
William H. Dutton (B.A. University of Missouri; M.A., PhD. SUNYBuffalo, 1974) is Professor of Internet Studies, Oxford Internet Institute, University of Oxford, and Fellow of Balliol College.