Searching for Health Information Online: An Exploratory Study Jason Howell, Andrea Melnikas, Qian Gao, Shing Lai Cheng, Stan Kachnowski Healthcare Innovation & Technology Lab New York, NY Introduction
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Jason Howell, Andrea Melnikas, Qian Gao, Shing Lai Cheng, Stan Kachnowski
Healthcare Innovation & Technology Lab
New York, NY
A growing number of people search for health information on the Internet, independent of the traditional brick and mortar medical system. About 80 percent of Americans have searched for at least one health-related topic1 on the Internet using the more than 70,000 websites that provide this information2. Approximately 23 percent of those using the web for a major health issue felt that the web played an important role in their assessment of this issue3. This is specifically due to the perception that the web provides convenient access to reliable information about health3. Physicians have noted an increase in patient knowledge and expectation about their healthcare due to the convenient access to health information on the web5. As a result, health consumers who were previously passive receivers of medical and health information are now becoming more active consumers6. This development has triggered new research relating to e-patient search behaviors as well as providing challenging opportunities for system developers.
Searching for consumer health information online is still difficult for the average person. The quantity of health information on the web is voluminous and it requires no special skill or expertise to create. Those accessing that information also have varying backgrounds that affect their ability to comprehend the information provided, adequately for that information. Additionally, their actual mental and physical needs vary greatly. Therefore, building a better online health information system requires a holistic understanding of how e-health consumers interact with the web and the content the content that they find.
Thirty participants were recruited from the greater New York City area for an individual session. Each participant received one of two disease-based case studies (one well-known, one obscure) and was asked to search online for specific information about the disease. Website access was not restricted or directed by the study staff. Search behaviors were recorded using software that captured screen images, websites visited, and keywords searched. A post-search questionnaire was completed to analyze aspects of participant background and thought process. The recordings and questionnaire were reviewed and the data was coded for analysis. We sought to develop an understanding of search methodology and efficiency based on a review of individual searches. We speculated that sites visited, time spent on sites, and the interest in academic articles and clinical trials would illuminate this information.
We compared users by education and income levels and found that there were no significant differences in the average number of pages visited, or first page accessed. We found anecdotal evidence suggesting that users with the obscure disease condition were more apt to rely on search engines, instead of going directly to a known site. This may perhaps be due to a need to determine the disease definition. Our data did not suggest that subjects with higher education are more efficient at searching for health information or find better quality sites, but the data does suggest that higher income subjects may be more efficient.
RESULTS StudyFigure 1. Quality Ratings by 30 Users
RESULTS StudyFigure 2. Trust Ratings by 30 Users
Table 1: Top sites by their collective traffic
Table 2: Top sites (by time) for each user
RESULTS StudyTable 3: First Site entered by each user
We compared participants by education and income levels and were surprised to find no significant differences in the average number of pages visited or first page accessed. Subjects with a graduate degree or higher (n=9) did not differ from those with lower education (n=21) on total pages browsed (p=0.6), time spent on first non-search engine (p=0.4) or number of discrete pages within preferred website (p=0.9). The lack of significance may be due to limited sample size. This study serves as model for a larger project that will further examine education and income levels in online health search behavior.
Limitations and Future Research
1. Boase J, et al. The strength of Internet ties: the Internet and email aid users in maintaining their social networks and provide pathways to help when people face big decisions. Pew Internet and American Life Project.
2. Grandinetti D A. Doctors and the web: help your patients surf the net safely. Medical Economics 2000; April; 28–34.
3. Anderson J G. Consumers of e-health: patterns of use and barriers. Soc. Sci. Comp. Rev. 2004; 22 (2); 242–8.
4. Klein J D, Wilson K M. Delivering quality care: adolescents’ discussion of health risks with their providers. Journal of Adolescent Health 2002; 30 (3); 190–5.
5. Jadad A R, et al. Internet use among physicians, nurses, and their patients. Journal of the American Medical Association 2001; 286; 1451–2.
6. Anderson J G, Eysenbach G, Rainey M R. The impact of cyberhealthcare on the physician–patient relationship. JMS 2002; 27; 67–84.
This study was underwritten by Pfizer Inc.