tion will be met in this way in practice is the hard question. It is likely to vary sharply by domain and by audience characteristics. If only a small proportion of the need for a particular domain for a given audience is actually met through active Internet use, this may create a worrisome tension. Although physicians report few negative experiences with patients’ use of the Internet, they do report some negative sequelae (Potts and Wyatt, 2001). Moreover, we are still at an early point in studying how the Internet affects patients’ health behaviors and their communication with health professionals. It is possible that institutions could reduce their outreach efforts after confusing the extraordinary availability of Internet information with the actual limited use of that information by the audience. They may believe the Internet has solved the problem when it has not.

Interactive Health Communication

Interactive Health Communication is defined as the interaction of an individual—consumer, patient, caregiver, or professional—with or through an electronic device or communication technology to access or transmit health information or to receive guidance and support on a health-related issue (Patrick et al., 1999). Many of the early applications demonstrated increases in users’ knowledge and acceptability of the systems (Kumar et al., 1993). Most applications now are Internet based or will be in the future. IHC includes computer health enhancement systems, interactive computer games, and Web-based applications, including the Internet. IHC services can range from simple applications, such as a single article or a discussion group, to online support groups and programs that offer many services, including information, communication, analysis, and a personalized Web page or a computer-based game intended to promote a certain behavior change (see Bental, Cawsey, and Jones, 1999, for an excellent overview of computer-mediated patient education techniques). Telemedicine and telecomputing offer a host of new communication opportunities, including electronic house calls (Ostbye and Hurlen, 1997).



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