Harvard Takes Health On-line

In a move that takes Harvard's educational mission to a general audience, the University has made available the expertise of faculty members from Harvard Medical School (HMS) and the Harvard School of Public Health (HSPH) through two websites devoted to personal health. These nascent efforts by the University to disseminate medical knowledge have been enabled by new information technologies and are a likely harbinger of additional outreach efforts in other fields (see "Distance [email protected]", July-August, page 75).

Personal health is the focus of Intelihealth.com, a website owned by insurance company Aetna U.S. Healthcare. Harvard Medical School has agreed to review and provide content for the site.

Personal health is the focus of Intelihealth.com, a website owned by insurance company Aetna U.S. Healthcare. Harvard Medical School has agreed to review and provide content for the site.

The Harvard School of Public Health created Yourcancerrisk.harvard.edu, which provides personalized cancer risk-reduction strategies.

The Harvard School of Public Health created Yourcancerrisk.harvard.edu, which provides personalized cancer risk-reduction strategies.


Your Cancer Risk (www.yourcancerrisk.harvard.edu), a project of the Harvard Center for Cancer Prevention at HSPH, estimates your risk of developing 12 common cancers--breast, prostate, lung, colon, bladder, melanoma, uterine, kidney, pancreatic, ovarian, cervical, and stomach--based on answers to a simple on-line questionnaire. The site also provides suggestions, based on an individual's circumstances, for lowering that risk.

The consequences of following the advice found on the site could be dramatic. According to the center, 50 percent of all cancers in the United States can be prevented when people take basic steps to reduce their risk. Your Cancer Risk personalizes risk-reduction strategies for each visitor to the site. "Your Cancer Risk is unique because it offers people a road map, showing them which steps have the biggest impact, given their lifestyle and background," says Graham Colditz, M.D., Ph.D., director of education at the center and professor of epidemiology at HSPH.

The risk estimates were developed by a team of experts from the center, who spent two years reviewing the scientific evidence before determining which factors have the strongest proven association with cancer. "People get conflicting health advice all the time," says center director David Hunter, M.D., Sc.D., a member of the team. "Your Cancer Risk offers reliable, consistent information that we all agree can help lower an individual's risk of cancer"--for example, eating more vegetables, taking a daily multivitamin, giving up smoking. (Major funding for the development of the site, which is run solely as a public service, was provided by Canyon Ranch Health Resorts.)

Harvard's role in the other site, which addresses a broad range of health issues, is as a content provider. Intelihealth.com is insurance giant Aetna U.S. Healthcare's on-line health-information subsidiary. In July, the medical school and Aetna announced that they had entered into an agreement under which Harvard would provide editorial content for Intelihealth, a commercial website, in exchange for an undisclosed sum. (Johns Hopkins University School of Medicine previously provided the content.) HMS spokesman Donald Gibbons says the school will receive a "regular payment to cover the cost of Harvard's development and review of the editorial content, as well as a separate, additional payment to be spent at the dean's discretion in support of the school's mission." Gibbons says the school anticipates that 50 to 75 percent of some professors' time will be spent working on the site's content, and the payment is "what we thought we could feel comfortable with in order to devote the necessary time to reviewing the material."

The benefits to Aetna are obvious: partnering with Harvard Medical School, they associate themselves with a well-known and trusted "brand" in medicine, and can count on obtaining reliable and up-to-date medical information for the website's visitors. Also clear is the potential for damage to the medical school's reputation from working with a commercial site--through conflicts of interest if advertisements for drugs or health services were to run near related editorial content, for example--and the agreement therefore gives Harvard full editorial independence, as well as a say over the placement of advertising.

HMS dean Joseph B. Martin says that the Web "has become an integral part of our healthcare system, so it is important for Harvard Medical School to take this step to enhance the quality of the health information available to consumers on-line." More than 70 HMS faculty members--with expertise ranging from pediatrics to geriatrics--will reportedly develop and review editorial content for the site, and help in developing software that will give consumers rapid, thorough, and credible answers to their specific questions.

The new editorial team intends to bring increased attention to the health issues facing underserved populations, says professor of medicine Anthony L. Komaroff, M.D., who has overall editorial responsibility for the medical school's print and electronic publishing for the general public. The hope, he explains, is to reach "vast populations that currently have no access to information about health" as Internet technologies become less expensive and easier to use.

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