Where's the Evidence for Evidence-based Knowledge in Ehealth Systems?

Consumers are increasingly turning to the Internet to gather information in making a wide variety of decisions - from the reliability of different brands of automobiles, to product costs. Similarly, many individuals are making use of online sources of information through the Internet and their employers to make health-related decisions - including options in health plans and personal assistance. But is the information that is available useful or, more importantly, accurate? Could online information even be harmful? A number of studies have looked at assessing the quality of online information available to consumers and concluded that much of the information, while perhaps not incorrect, is not well-founded. Several of these studies have pointed to the need to rely more on evidence-based approaches. In this paper we argue that evidence-based approaches are needed and that evidence must form the basis for the information provided to consumers. This raises a number of challenges in both how to embody evidence within eHealth systems as well as how to validate the effectiveness of such approaches. We identify these challenges and outline research directions for overcoming them.