e(un)Health

Every time I sit down at my computer I find myself in awe at the power in my hands. I was listening to a podcast on a plane yesterday (just think of that: listening to a radio show, downloaded via the Internet for free to listen whenever I want, on a device that fits in my pocket, and lets me tune in at 34,000 feet over the Caribbean Sea). The podcast was on the Great Library 2.0: Google’s efforts to digitize nearly every book in the world and make it searchable. I find all of this amazing, and unlike some I am happy with how amazing things are in terms of technology.

Yet as Marshall McLuhan so astutely noted, technology first serves as an appendage that serves and then as a master.

Looking at the score between appendage and master I’d say we’re about tied when it comes to how technology affects health. And that’s not necessarily a good thing.

Email Overload

Consider the concept of time poverty. Take the United States, arguably one of the most technologically sophisticated societies, yet also among the most time poor. One poll looking at U.S. vacation time suggests that only 14% of Americans will get a vacation of two weeks or longer this year. That is despite having all of the tools to reduce work time, maximize efficiency, and engage in leisure activities in a way that was once unfathomable. Yet, time poverty is certainly something that I live with despite having the ability to do far more in less time thanks to technology. The problem is the ‘far more’ part of that statement.

When I look at my life and that of others working with eHealth (or academia — or just about every knowledge-based profession), the same storyline come up: too much communication and not enough time to process or participate in it fully. I don’t know of a colleague who doesn’t feel that their email is difficult to manage. I appreciate being able to communicate with colleagues easily (McLuhan’s extension argument), but when I get back from a couple days offline to find hundreds of email, dozens of phone calls, tweets, blog updates, Blackberry messages, and Skype calls waiting for me, I feel very time poor indeed. So ironically, these tools that enable me to do so much so fast contribute vastly to time poverty and stress.

This can’t continue for long – -can it? So far, there is no sign of it stopping with 3G communications and the mobile web. But there are things we can do to change ourselves relative to the technology and avoid becoming the slave to its master. I recently read John Freeman’s Manifesto for Slow Communication and think he might be on to something. He writes:

“In the past two decades, we have witnessed one of the greatest breakdowns of the barrier between our work and per sonal lives since the notion of leisure time emerged in Victorian Britain as a result of the Industrial Age. It has put us under great physical and mental strain, altering our brain chemistry and daily needs. It has isolated us from the people with whom we live, siphoning us away from real-world places where we gather. It has encouraged flotillas of unnecessary jabbering, making it difficult to tell signal from noise. It has made it more difficult to read slowly and enjoy it, hastening the already declining rates of literacy. It has made it harder to listen and mean it, to be idle and not fidget.”

This fits with a recent study in the Proceedings of the National Academy of Sciences by two psychologists who looked at multitasking and cognitive performance and,” in every test, students who spent less time simultaneously reading e-mail, surfing the web, talking on the phone and watching TV performed best.

Is the ‘e’ part of eHealth becoming a source of illness rather than wellbeing? As Freeman states:

“This is not a sustainable way to live. This lifestyle of being constantly on causes emotional and physical burnout, work place meltdowns, and unhappiness. How many of our most joyful memories have been created in front of a screen?”

Indeed.

The system in which we utilize these tools best determines their ultimate impact on health and wellbeing. I use all types of media to learn about them and their potential and find it fascinating. But we have no users guide to healthful communicating and frankly, things are happening so quickly I question whether we can even come up with a good one that is timely and relevant. But the question about how eHealth communications and the speed and volume at which this takes place is one that warrants serious attention for us as researchers, teachers, health professionals and citizens. Otherwise, eHealth risks becoming a 21st century version of bloodletting.

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