title: E-health applications and services for patient empowerment: directions for best practices in The Netherlands.
abstract: OBJECTIVE
  E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-health that promotes patient empowerment.
  
  
  METHODS
  The concept of patient empowerment in the Dutch setting is discussed first. The prerequisites for patient empowerment are then described and translated into empowerment areas relevant to e-health.
  
  
  METHODS
  We reviewed Dutch e-health studies that provide insights into what works, and what does not, in e-health.
  
  
  RESULTS
  On the basis of the lessons learned from the studies, we propose directions for best practices to develop e-health that promotes patient empowerment. These directions cover various aspects, such as the design and implementation of e-health, its information content and usability, awareness, and acceptance. The studies also indicate the difficulty of establishing that e-health is really dedicated to patient empowerment.
  
  
  CONCLUSIONS
  Despite the body of knowledge about patient empowerment, as well as the technological visibility of e-health, evidence for best practices in general and for patient empowerment in particular is scarce. We call for a more systematic evaluation of e-health for patient empowerment and more reliable evidence. Beyond the organizational and technical issues involved in e-health, there is also a need to demonstrate its practical benefits to patients. The Netherlands is active in developing sustainable e-health. National initiatives are now in place to support the processes with the aim of establishing the required evidence-based best practices.
authors.affiliation: TNO Quality of Life, Prevention, and Care, Leiden, The Netherlands. laurence.alpay@tno.nl
authors.forename: Laurence L
authors.initials: LL
authors.lastname: Alpay
authors.forename: Olivier Blanson
authors.initials: OB
authors.lastname: Henkemans
authors.forename: Wilma
authors.initials: W
authors.lastname: Otten
authors.forename: Ton A J M
authors.initials: TA
authors.lastname: Rövekamp
authors.forename: Adrie C M
authors.initials: AC
authors.lastname: Dumay
mesh_terms: D022126:Access to Information; D019985:Benchmarking / Q000379:methods*; D006801:Humans; D009426:Netherlands; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods*; D011209:Power, Psychological