Apomediation and Apomediary in Healthcare

A man doing research on a computer.
A man doing research on a computer. Nick David/Getty Images

Apomediation is a term used to describe using a person who facilitates your pursuit of information on the Internet. You are assisted in getting and understanding the information, but you are not required to go to a gatekeeper to get the information.

The prefix apo comes from the Latin for "to stand by." Mediation comes from the Latin mediare to "be in the middle." Put together, it is someone who stands by your side rather than someone who is standing between you and something as an intermediary would.

Disintermediation is the term used for cutting out this middleman. Apomediation provides an expert who helps you when you directly access information.

Medicine 2.0 and Health 2.0 are terms used to describe the fact that everyone, professionals, and patients alike can share information on the Internet about health and medical information. Apomediation describes the fact that when you access information on the Internet, you cut out the gatekeepers or any middlemen, which before would have included your own doctor or an insurance salesman. You would have had to go to them to get medical information.

Now, apomediation allows you to go directly to the source of information, even if it is not a (previously considered) "expert" source. The expert presenting the information "stands by" you. The information may come from a professional, or it may come from someone considered to be more of a peer.

What Is an Apomediary?

The expert source is an apomediary (or apomediator), which is someone who stands by, offering you the Internet medical information you seek.

You are probably more familiar with an intermediary, who is someone who would generally go to an information source, get the answers and then relay them to you.

These apomediaries may have developed an expertise that is not formally credentialed in any particular way but can be valuable. For instance, a patient who has developed an incredible amount of knowledge about one particular disease, symptom or treatment because she has suffered from it herself, or has been a caregiver for someone who has that disease, and shares that expertise online, is an apomediary.

A good example of this person is thyroid disease expert Mary Shomon, who is known globally for her expertise in thyroid-related problems. Mary is an apomediary (or apomediator) for thyroid information.

You can use this information to help you understand your own medical challenges. However, make sure you confirm the credibility of information provided by apomediaries just as you would for any information you find on the Internet.


The term apomediation was created by Dr. Gunther Eysenbach. He is a professor of Health Policy and eHealth at the University of Toronto. He analyzed what was happening as people had direct access to medical information on the internet. He saw that the middlemen were being eliminated, but this can leave a gap in what information sources they can trust. He has written scholarly papers on the subject, first describing it in 2007 and further in 2008 in two journals.


Eysenbach, G. "From intermediation to disintermediation and apomediation: new models for consumers to access and assess the credibility of health information in the age of Web2.0." Stud Health Technol Inform. 2007;129(Pt 1):162-6.

"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

Eysenbach G. "Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness." J Med Internet Res 2008;10(3):e22.