Apomediation

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= apomediation means that there are agents (people, tools) which “stand by”

Description

The term apomediation was coined by Dr. Gunther Eysenbach, a Health Policy and eHealth professor at the University of Toronto [1]:

"Apomediation is a new scholarly socio-technological term that characterizes the process of disintermediation (intermediaries are middlemen or “gatekeeper”, e.g. health professionals giving “relevant” information to a patient, and disintermediation means to bypass them), whereby the former intermediaries are functionally replaced by apomediaries, i.e. network/group/collaborative filtering processes [Eysenbach, 2008 [WebCite] and 2007b]. The difference between an intermediary and an apomediary is that an intermediary stands “in between” (latin: inter- means “in between”) the consumer and information/service, i.e. is absolutely necessary to get a specific information/service. In contrast, apomediation means that there are agents (people, tools) which “stand by” (latin: apo- means separate, detached, away from) to guide a consumer to high quality information/services/experiences, without being a prerequisite to obtain that information/service in the first place. The switch from an intermediation model to an apomediation model has broadimplications for example for the way people judge credibility, as hypothesized and elaborated in more detail elsewhere [Eysenbach 2008]." (http://gunther-eysenbach.blogspot.com/2008/03/medicine-20-congress-website-launched.html), see also [2]

Example: Healthcare

Dr. Gunther Eysenbach in a presentation of the five characteristics of Medicine 2.0:


"In the health context, disintermediation (cutting out the middleman) means a more direct access of consumer to their personal data (e.g. in web accessible EHRs – left circle of the diagram) and general medical information (on the web – right circle of the diagram) with all its advantages and hazards. The main problem of cutting out the gatekeeper is that the traditional role of the middleman is to guide consumers to relevant and credible information (the intersection of both circles in the center of the diagram) and that by bypassing the middleman consumers/users may “get lost” in the vast amount of information. Apomediation theory conceptualizes that “apomediaries” (which includes Web 2.0 approaches) can partly take over the role of the intermediary and “push” or “guide” users to relevant and accurate information. The Web 2.0 environment is essentially an “apomediated environment”, with all the issues affecting related to apomediation phenomeon, raised by [Eysenbach 2008a] [1]. and summarized in Table 1. Apomediation vs Intermediation Environment.


Apomediation theory further argues that apomediaries, such as users and friends in the case of Digg, can help users navigate through the onslaught of information afforded by networked digital media, giving additional credibility cues and supplying further metainformation. Other examples of apomediaries and apomediation tools include consumer ratings on amazon.com or epinions.com; technologies like PICS or MedPICS labels and its RDF successors that enable machine-processable dissemination and interpretation of user ratings (Eysenbach, Yihune, Lampe, Cross, & Brickley, 2000; Eysenbach & Diepgen, 1999a); collaborative filtering and recommender systems as exemplified by StumbleUpon.com; and other second generation Internet-based services and tools that let people collaborate on a massive scale and share information online in new ways, including social networking sites, social bookmarking, blogs, wikis, communication tools, and folksonomies (Wikipedia, 2007b; Wikipedia, 2007c).

The Dynamic Intermediation-Disintermiation-Apomediation model (DIDA) (illustrated in the Figure below) argues that whether or not consumers prefer an apomediation or intermediation environment is highly situation-specific, and key variables in determining consumer preference are autonomy, self-efficacy, and knowledge in a specific area for which information or support is sought. For example, a cancer patient may initially prefer an intermediary, but with growing autonomy, self-efficacy, and knowledge prefer Web 2.0 approaches to guide him/her to information deemed trustworthy.[1]


Apomediation is not only important with the consumer as end-user and the health professional as intermediary in mind. As mentioned in a previous blog post, we also witness an apomediation process in science, with the former intermediaries such as journals becoming partly (and increasingly) obsolete, with much of the communication between scientists taking place on the Web before an article is actually published, necessitating scientists to use "apomediaries" to guide them to the relevant information on the Web (in fact, the only reason why we appear to still need journals is to make online information "citable", which in itself is absurd - as mentioned in a previous post - and could be overcome by archiving tools such as WebCite). Also, health professionals now partly bypass traditional intermediaries such as information brokers or librarians. I remember that when I was in medical school I had a summer job as information broker, where health professionals or scientists would call or see me and I would do an online Medline search for them. Today, people obviously use PubMed and other Internet tools directly, and search the web and/or the library for relevant information. But what is "relevant", and how can we deal with the onslaught of information? The "apomediaries" here are shared bookmarking tools such as CiteULike or Connotea, where people receive pointers to recently published relevant literature based on what others with a similar citation/bookmarking behavior have cited/bookmarked." (http://gunther-eysenbach.blogspot.com/2008/03/medicine-20-congress-website-launched.html) [2]

References

1. Eysenbach G. Credibility of health information and digital media: new perspectives and implications for youth. In: Metzger MJ, Flanagin AJ, editors. Digital Media, Youth, and Credibility. The John D and Catherine T MacArthur Foundation Series on Digital Media and Learning. Cambridge, MA: MIT Press; 2008. URL: http://www.mitpressjournals.org/doi/pdf/10.1162/dmal.9780262562324.123

2. Eysenbach G. Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness. J Med Internet Res 2008;10(3):e22 URL: http://www.jmir.org/2008/3/e22/ doi:10.2196/jmir.1030