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Introduction

This year World Usability Day is focused on healthcare. This is a great focus for this event. Medical instrument design is one of those areas where usability really can make a life-or-death difference. And there is lots of room to improve the patient experience. Starting with "Why does the exam room have to be so cold?"

Evolving and improving technology can improve health and healthcare in a myriad of ways. Equipment that is designed with the user, task, and environment in mind will reduce errors and improve outcomes. New designs make it possible for patients to do things for themselves that previously only doctors could.

The impact of usability on health isn't limited to equipment. The emergence of the Web as a source of health information has changed the way many patients manage their own health. Better informed patients are more confident and proactive. Overall responsibility for health management and improvement is shifting from the purview of the physician to that of the new health consumer.

I'm not a doctor, but I play one on the Web...

The doctor knows best, but today's patient is likely to confirm it on the Web. As early as 2002, self-report studies indicated that more than 80% of adult Internet users in the US and more than two-thirds of European users had looked to the Internet for health information. (Pew, 2002, Taylor and Leitman, 2002). That number continues to rise. Private and government organizations are doing their best to keep up with the new, demanding health consumers.

But anybody can put up a Web site. How do consumers decide if a site is trustworthy or will be helpful? Are health consumers becoming more savvy?

Early reports indicated that lay health information seekers attributed credibility and trustworthiness to sites based on site look-and-feel and information design (Fogg 2002). Over the years, health consumers have become more savvy. More recent research suggests that health consumers have become more sophisticated, more proficient at searching for information and more demanding.

Sillence, Briggs, Harris and Fishwick (2006) compare the results from two large-scale, online questionnaire studies undertaken in 2000 and 2005 that looked at the behavior of consumers seeking heath information. The 2005 study recruited 1480 participants world wide through a UN hunger relief site, Yahoo and local print media.

75% of the nearly 1500 participants in the 2005 study reported that they had turned to the Web for health information. Those who hadn't used the Web for health information, didn't have particular concerns about getting health information from the Web. They just didn't need it. Most will go to the Web when they do.

In 2000, about half of the people looking for health information on the Web were helping others. The other half were looking for themselves. By 2005, most people were looking for their own info: 66% were seeking information for themselves, 15% were helping someone else and abut 20% were doing both.

WebMD was the favorite individual site mentioned in both 2000 and 2005 by a substantial margin. However for both years, a substantial proportion of the respondents looked directly to topic-specific sites. They mostly started at search engines (66%) rather than a personal recommendation (12%). The biggest increase from 2000 to 2005 in the type of Web site that people looked to for health information was in the category of "personal/individual/on behalf of support group". This trend predicts the increased use of social networking for those seeking health information.

Health information seekers report that they both trust the information they are finding and are prepared to act on it. Important trust factors evolved slightly from 2000 to 2005.

In 2000, health seekers looked for

  1. Information from like-minded people
  2. Advice from a knowledgeable source
  3. A feeling of involvement in finding the right advice / answers
  4. Ease of use
  5. Impartial and independent information.

In 2005, they looked for

  1. Ease of use
  2. Advice from a knowledgeable source
  3. Advice from an expert
  4. Impartial and independent information
  5. Clear and understandable reasoning to support the information

Sillence and colleagues do not believe the emerging focus on expertise means that people want to hear from only health care professionals. They suggest that the focus on expertise in conjunction with the popularity of Personal / Individual site developers indicates that the notion of "expertise" may be becoming broader. Health care seekers are looking for traditional expertise. But they may also be increasingly accepting first hand experience with a health condition as an form of expertise. This shift is consistent with the increasing use of the Web as a channel for social networking.

Prognosis: smarter patients

Overall, Sillence and colleagues found that people are looking for more health information on the Web. Although baseline trustfulness has not changed, health information consumers are becoming more savvy: They are looking to more sites from more varied providers. They are using the Web to research alternatives. And, critically, they are using the Web in conjunction with other, offline sources. The Web is not replacing doctors. It's creating smarter patients.

Are your on-line health seeking behaviors in the normal range?

References

Fogg, B. J., Kameda, T., Boyd, J., Marchall, J., Sethi, R., Sockol, M. and Trowbridge, T., (2002). Stanford-Makovsky Web Credibiltiy Study: Investigating what makes Web sites credible today, A Research Report by the Stanford Persuasive Technology Lab.

Pew Internet Research, (2002). Vital decisions: How Internet users decide what information to trust when they or their loved ones are sick.

Pew Internet Research, (2005). Health information online.

Pew Internet Research, (2005). How women and men use the Internet.

Sillence, E., Briggs, P., Harris, P., Fishwick, L. (2006). Going online for health advice: Changes and usage and trust practices over the last five years. Interacting with Computers..

Taylor, H., Leitman, R., (2002). The future use of the Internet in four countries in relation to prescriptions, physician communication and health information. Health Care News 2:13.

Message from the CEO, Dr. Eric Schaffer — The Pragmatic Ergonomist

Leave a comment here

Reader comments

Jennifer Blake
Sutter Health

Great article on health care online. Very timely for a large project that we are doing right now. Thank you!

Hector Fernandes
Premera Blue Cross

Good article. This confirms trends observed by other research on the same topic. The Mayo Clinic is another source used by consumers seeking health information from a neutral third party.

Subhrajit Majumder
Web18 Software Services Ltd

The information was useful & I quite agree on the shift in trend from 2000 to 2005.

Don Child, Health is Your Destiny

I think it's debatable as to whether the doctor really does know best. If you are talking about an allopathic paradigm, yes. But is that the best paradigm? For many people, the answer is no. A more holistic medical practice recognizes that treating symptoms through surgery or pharmaceuticals is often not the treatment of choice... educating the clients to change their lifestyle is far more effective in the long term.

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