title: The new role of patients in future health settings.
abstract: Health is wide concept covering a person's physical, mental and social well-being. Traditionally, regulated healthcare has been the main source for curative and preventive service offered to patients. Healthcare is in transition, however. Paradigms such as patient empowerment and patient in the centre as well as in-home care service are changing processes and locations healthcare services are offered. Parallel to healthcare, new service models such as pHealth, ubiquitous healthcare, and digital medicine are developing. In the near future, technology enables the creation of a personal digital health dossier (e.g. digital patient and virtual patient model) for any individual. This dossier is stored and used in the unsecure information space. This all means that the traditional paternalistic patient model where patient is a passive object for regulated healthcare services will not work in future pHealth and digital health anymore. Instead, the new patient role (e.g. pHealth user or health consumer role) is dynamic, context-aware and participatory. The pHealth user can also have many roles at the same time, such as the role of informed chooser, decision maker, and personal health coordinator. This requires that the pHealth user can make information-based meaningful decisions before starting to use health services, and that he or she can trust on service providers by having evidence-based and reliable information about the quality and health impact of the services offered. A big challenge is that pHealth and digital health take place in unsecure information space where current healthcare specific laws, regulations, and medical ethics are insufficient to guarantee users' autonomy and privacy as well as the application of fair information and ethical principles when processing personal health information. A new ethical, legal and technical framework is needed. One of the prerequisites successful pHealth and digital health has to meet is the possibility to create information based on trustworthy relationship between service user and service providers. Furthermore, a trusted information platform is inevitable.
authors.affiliation: School of Information Sciences, University of Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Ruotsalainen
authors.affiliation: Medical Faculty, University of Regensburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Blobel
mesh_terms: D003199:Computer Systems; D034201:Computers, Handheld; D003219:Confidentiality / Q000331:legislation & jurisprudence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010358:Patient Participation; D018802:Patient-Centered Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D011209:Power, Psychological; D058998:Remote Sensing Technology; D017216:Telemedicine / Q000295:instrumentation / Q000331:legislation & jurisprudence / Q000458:organization & administration*