Now that seemingly everybody, from young to old, has embraced the revolution in electronics gadgets, researchers at Johns Hopkins Bloomberg School of Public Health decided to find out whether electronic tools and technology applications are really helping improve the health care process. What they found was that electronic gadgets, health software applications and online health-oriented Websites—what they call consumer health informatics—do indeed improve the health care process, especially regarding adherence to medication regimes and to ensure success in tough-to-achieve clinical outcomes like smoking cessation.

Rather than do yet another primary research program to investigate a particular medical application, Johns Hopkins researchers instead analyzed the published results of 146 studies that focused on patient use of electronic tools. Their question was this: Does health information technology (health IT) benefit from this electronics revolution?

The study was performed by Johns Hopkins' Evidence-based Practice Center with support from the government's Agency for Healthcare Research and Quality (AHRQ). The resulting 549-page report offers the first comprehensive survey of health informatics as it applies to consumers directly interacting with e-health applications.

For the purposes of the study, health informatics was defined as the use of an electronic tool that provides interactive medial information that is personalized to the patient's history and that helps the patient better manage his or her health or health care. Examples of e-health included in the study were online health "calculators," decision support software that aids in making treatment choices, and both e-mail and text messaging services that are now available for a variety of maladies, including smoking, diabetes, cancer, exercise and mental health disorders.

The report goes into detail about each of the maladies being addressed by consumer health informatics, asking the same key questions regarding whether consumer health informatics contributed to a positive clinical outcome (whether it helped or not), whether there was evidence of misinformation that harmed consumers and whether there was a positive economic impact (reduced costs to the consumer).

Overall, the report concludes that there was significant positive impact demonstrated for smoking, diabetes, cancer, diet, exercise, physical activity and mental health maladies. None of the 146 studies found any evidence of harm coming to patients as a result of misinformation or other negative effects. Regarding economic impact, however, the jury is still out, since not enough evidence was found to support a conclusion one way or the other.

The grand conclusion of the 549-page report regarding consumer health informatics (CHI) was that "despite study heterogeneity, quality variability, and some data paucity, available literature suggests that select CHI applications may effectively engage consumers, enhance traditional clinical interventions, and improve both intermediate and clinical health outcomes."