Abstract
BackgroundPatient and consumer access to eHealth information is of crucial importance because of its role in patient-centered medicine and to improve knowledge about general aspects of health and medical topics.ObjectivesThe objectives were to analyze and compare eHealth search patterns in a private (United States) and a public (United Kingdom) health care market.MethodsA new taxonomy of eHealth websites is proposed to organize the largest eHealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data are used to accurately track and analyze detailed search behavior across 100 of the largest eHealth websites in the US and UK health care markets.ResultsThe health, medical, and lifestyle categories account for approximately 90% of online activity, and e-pharmacies, social media, and professional categories account for the remaining 10% of online activity. Overall search penetration of eHealth websites is significantly higher in the private (United States) than the public market (United Kingdom). Almost twice the number of eHealth users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than those in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both the markets. For all categories, the vast majority of eHealth users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on eHealth, that is, 3-7 minutes per website.ConclusionsThe proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring eHealth behavior. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per website in the health and lifestyle categories. Two explanations are offered: (1) the personal incentive of medical costs in the private market incentivizes users to conduct online search; and (2) health care information is more easily accessible through health care professionals in the United Kingdom compared with the United States. However, the use of medical websites is almost identical, suggesting that patients interested in a specific condition have a motivation to search and evaluate health information, irrespective of the health care market. The relatively low level of search in terms of the number of websites accessed and the average time per website raise important questions about the actual level of patient informedness in both the markets. Areas for future research are outlined.
Highlights
BackgroundThe Internet hosts over 100,000 health and medical-related websites, termed as eHealth websites in this study
The proposed taxonomy is based on the synthesis of individual categories identified in the literature, in particular, health [39], medical [15], lifestyle [40], e-pharmacy [41], social media [6], and professional [42]
The results show a medium effect size for health, lifestyle, and e-pharmacy, a large effect size for social media and a very weak effect size for medical
Summary
BackgroundThe Internet hosts over 100,000 health and medical-related websites, termed as eHealth websites in this study. The scale of health and medical-related online search and the importance of the outcomes in terms of informing and influencing patient behavior mean that it is important to gain a detailed understanding of the online search process [7,8]. The private health care system does appear to have an influence on eHealth search behavior in terms of search penetration and time spent per website in the health and lifestyle categories. Two explanations are offered: (1) the personal incentive of medical costs in the private market incentivizes users to conduct online search; and (2) health care information is more accessible through health care professionals in the United Kingdom compared with the United States. The use of medical websites is almost identical, suggesting that patients interested in a specific condition have a motivation to search and evaluate health information, irrespective of the health care market.
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