[The internet. Chances, risks and prospects for the surgical patient]

The World Wide Web (WWW) serves consumers with an abundance of health information and services. This factor sets new accents in the health care system. The Internet can help to create an informed patient, who is actively involved in clinical decision-making processes ("shared decision making"). This has effects on the physician patient relationship. An informed patient demands better performance. The increased transparency and comparability of provider performance in patient care leads to an enhanced competition between providers. On the other hand, the Internet also bears certain risks: The quality of health information on the Internet is frequently described as unsatisfactory and patients rarely pay attention to quality markers of the information provided. It is necessary to encourage an active quality management for health information and services on the web. The Internet is not only a passive information resource but, above, all, an interaction medium. It can be harnessed to facilitate quality management. Intelligent technologies will gain increasing significance in the future, when the WWW develops towards a "semantic web". In particular, consumers will use intelligent computer programs, so-called "agents", to gather information or to evaluate the trustworthiness of health information providers.