We are in the midst of an information revolution in modern society that is transforming the ways that we communicate and organize information. Nowhere is the adoption of new information technologies more evident than in the delivery of care and the promotion of health (Kreps and Neuhauser 2010; Neuhauser and Kreps 2010). There has been a rapid growth in the development and use of new health information technologies, such as electronic medical records, online support groups, and the omnipresent availability of health information via specialized web sites. This growing use of health information technologies has become known as e-health, which Eng defines as “the use of emerging information and communication technology, especially the Internet, to improve or enable health and health care” (2001, p. 1). E-health encompasses a range of overlapping disciplines that relate to the application of information, computer and communication technology to the delivery of health care and the promotion of health.

E-health communication strategies include, but are not limited to, health information on the Internet, computer assisted learning, online support groups, online collaborative communities, information tailored by computer technologies, computer-controlled in-home telephone counseling, biometric assessment and transmission, and patient–provider e-mail contact. Each of these e-health technologies has the potential for helping to promote pain management to the extent that they can provide consumers with relevant information to increase understanding of their pain experience, help consumers explore different strategies for reducing their experience of pain, coordinate the delivery of effective and timely palliative care, and provide consumers with needed social support. Question: what about liability issues? How have these been addressed?

E-health communication technologies can work in concert with other channels of communication. For example, it is advantageous for physicians to talk with their patients about health information that patients may have gathered from the Internet to help explain the information to the patients and its relevance to their health conditions. Similarly, in pain management, computerized information systems, such as web sites, the use of e-mail, and electronic patient records, can effectively supplement interpersonal communication between patients and their healthcare providers. Use of these electronic communication channels can extend the reach of interpersonal channels by providing communication access at any time day or night for feedback about the pain management needs, additional information about pain management strategies, and reinforcement for pain management requests and strategies that have been shared (Hesse et al. 2005).

There have been several promising new e-health interventions developed for promoting effective pain management. Some of these interventions are designed to provide pain sufferers with more information about the pain experience and strategies for coping with pain. For example, there are now a broad range of web sites dedicated to providing both consumers and healthcare providers with education and support about pain and pain management. Some of these web sites include:

However, there is little external oversight over the accuracy, currency, completeness, and accessibility of the information provided on these web sites. Consumers must make good decisions about whether the pain management information they find on these web sites is appropriate for them and what the best strategies are for implementing these pain management recommendations. This is an ideal opportunity for supplementing web surfing with more direct communication with healthcare professionals. Doctors, nurse, pharmacists, and other health professionals can also help consumers make sense of and apply pain management information gathered on the web (Manzanec et al. 2002). Some healthcare providers and healthcare systems enable patients to consult with their providers online, making it relatively quick and easy to get help interpreting web-based information about pain management. There are also online pain consultation services and ask-a-doctor sites available such as:

The best strategy for consumers to ensure they understand and use properly the pain management information they gather online is to discuss the information with their healthcare providers (Hesse et al. 2005). A trusted healthcare professional can help them about making sense of the pain management information and advise them about the best strategies for utilizing the information for managing pain (Berry et al. 2003; Detmar et al. 2000).

A number of promising e-health interventions are designed to promote awareness and coordination in facilitating prompt response to pain incidents. For example, Wilkie et al. (2003) have introduced a computerized format for self-reporting pain assessment, PAINReportIt, that has been shown to help patients gain personal control over pain management and share real-time information about pain incidence and treatment with their providers. Computerized self-report systems like this one can promote coordination of efforts in responding quickly to severe pain incidents (Detmar et al. 2001; Huang et al. 2003).

There has been a lot of promising work on the development of online diaries for tracking pain incidence and management (Jamison et al. 2001; Peters et al. 2000; Stone et al. 2003). These electronic diary systems help patients and providers identify the unique patterns each patient experiences in pain incidence and management, as well as to report these incidents in real time. This diary data can help patients and providers predict when pain incidents are likely to occur and plan advance strategies for quick and decisive pain management interventions. Evidence suggests that these diaries are particularly useful for empowering patients (and providers) to better understand unique patterns of pain incidence and severity, as well as to develop good prevention and intervention plans to minimize pain (Marceau et al. 2007).

Other work has focused on the development of computerized assessment programs for measuring pain (Cook et al. 2004; Jamison et al. 2002). Electronic pain questionnaires have been shown to be just as accurate as paper and pencil measurement tools, yet they are more adaptive to tracking, storing, and sharing this pain information with healthcare providers who can use this information for managing pain (Jamison et al. 2006; Junker et al. 2008). The use of handheld devices has made the collection of pain information portable for consumers who experience pain at different times and different places (Newman et al. 1999; VanDenKerkhof et al. 2003). It enables efficient storage and processing of pain information, as well as the ability to share this information electronically with others.

There is a long history of using peer support groups to help people cope with serious health problems (Kreps 2001; see also Cowan 2011). The advent of online social support groups has made it easier for people to connect with others over long distances, especially when support group members may find it difficult to travel, as is the case for many people with serious health problems (Eng 2001; Ferguson 1996; Kreps and Neuhauser 2010). Several online support groups have been developed for pain sufferers, their caregivers, and their healthcare providers. For example, see:

These online support groups allow pain sufferers (and their caregivers) to connect with others who are experiencing similar pain issues and to share relevant information and develop strategies for managing pain. The asynchronous nature of these online support groups means that group members can post messages whenever they need support or information, and do not need to wait for specific group meeting times. Evidence has suggested that the information provided on these online support groups is of very high quality and group participation provides many benefits to users (Ferguson 1996; Lindsay et al. 2009).

Telehealth information systems also have a long history of use to provide health professional advice and care to consumers in remote areas where there may be limited health services available (Kreps and Neuhauser 2010). These telehealth systems have also been used effectively to deliver pain management interventions (Appel et al. 2002; Peng et al. 2006; Pronovost et al. 2009). Research has shown that telehealth management interventions have resulted in significant improvements in both pain and depression for consumers who may not have had access to in-person care by enhancing health communication and the coordination of care (Chumbler et al. 2007; Harris et al. 2007; Peng et al. 2006).

While current e-health developments for the management of pain have been very promising, we are just at the very beginning of designing and implementing powerful computer-based intervention programs. The future is very promising for the development of smart, interactive, and comprehensive health information systems that will travel with consumers wherever they go (mobile health), ­automatically monitor consumer health status (real-time data capture), share relevant health information with all members of the pain management team (inter-professional coordination), and deliver pain management support to consumers when and where they need it. The integration of artificial intelligence into the design of health information systems will allow e-health programs to interact meaningfully with consumers about their pain management needs and concerns. These new smart systems e-health information systems can be tailored to provide personalized information to consumers based upon the consumers’ unique experiences and information needs.

New embedded information technologies that are either worn on consumers’ clothing or implanted within their bodies have the potential for continuously collecting physiological information that will enable proactive prediction of pain events and will allow early response interventions to prevent pain incidents. These imbedded information systems could be designed to deliver relevant health information to consumers, stimulate their neural pathways to minimize pain, and perhaps even administer needed pain medications to pain sufferers. The growth of nanotechnology is making smaller and less invasive embedded information technologies increasingly feasible for use as embedded health information systems to support pain management.

The development and implementation of online palliative care training systems can make help healthcare providers and consumers develop the communication competencies needed to support effective pain management. Similar health communication education programs have already been designed and implemented to train healthcare providers to communicate effectively with culturally diverse, low health literacy, and low English proficiency consumers (see http://​ftp://​ftp.​hrsa.​gov/​healthliteracy/​training.​pdf). E-health systems that support the development and use of sensitive and strategic health communication practices to support pain management can increase both the quality of care for pain and enhance self-management of pain. Particular attention must be taken to make sure that pain management support technologies are made available and accessible to vulnerable and hard to reach populations (see Kreps et al. 2007 for an examination of strategies for making e-health applications work for under-served and vulnerable groups).