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Contents

6.D.1. The Problem
6.D.2. The Intervention
6.D.3. Benefits of This Intervention
6.D.4. Constraints on This Intervention
6.D.5. Examples
References

Download Strategy 6D:
Internet Access for Health Information and Advice
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6.D.1. The Problem

Many health care consumers seek information about specific complaints, conditions or diseases, drugs, nutrition, and fitness.¹ For these people, getting information quickly is a large component of "getting care quickly."

In the past, patients and their families had to depend primarily on their physicians for this kind of information. In the last two decades, of course, the Internet has evolved into an amazing resource for those seeking health-related information. Studies disagree on the number of Americans using the Internet for this purpose. But there is little question that a large number of people are looking for information and advice on the Internet, and that the number is growing rapidly. A Harris Poll in 2011 estimates that three-quarters of all adults have looked for health information online.² According to a 2012 poll by the Pew Research Center's Internet and American Life Project, over a third of adults have used the Internet to diagnose themselves or someone else.³

However, the sheer volume often makes information on the Internet overwhelming, hard to navigate, and hard to validate. A search for health information can bring up thousands of sites. It is also hard for people to know whether a source of information is trustworthy. A Pew survey found that many seekers of health information on the Internet do not follow recommended guidelines for checking the reliability and timeliness of information: half reported that they check the date and source of information only occasionally, hardly ever, or never.⁴

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6.D.2. The Intervention

A number of health plans and medical groups have been exploring ways to channel consumers and patients to useful and reliable sources of information on the Internet. This strategy is meant to help address the demand for immediate information and to build on and reinforce the relationship of trust that health care organizations have with patients and members. While information on the Internet should not be a substitute for direct communication with personal care providers, it is a useful way to augment information sources for patients, especially when direct access to clinicians is not available.

One way to do this is to expand your own Web site to include health information and relevant tools as well as links to related information. Another simpler approach is to tell patients or members about external sites that are reliable and could be helpful; this information could be provided during office visits, in printed materials, through patient portals, or in emails (which allow you to provide the address [URL] for the site).

There are literally thousands of sites on the Web that may be helpful to your members and patients, including patient-support networks (such as bulletin boards and patient chat rooms) and disease-specific sites sponsored by medical associations, patient groups, government agencies (such as NIH), and others. You can do your members and patients a huge favor by sifting through some of these sites for them and recommending only those that offer timely, reliable, and objective information.

You may also want to provide links to the following sites, which enable users to conduct their own research:

• This site allows users to search , the bibliographic database of the National Library of Medicine (NLM).
• offers access to the NLM’s digital archive of life sciences journals.
• offers direct access to health-related information. It is sponsored by NLM and the National Institutes of Health (NIH).
• provides free information on cancer to the public. It is sponsored by the Abramson Cancer Center of the University of Pennsylvania.
• offers general information on health and wellness topics as well as a variety of message boards.

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6.D.3. Benefits of This Intervention

The benefits of Internet access to health information and advice include improved quality of care, timeliness (i.e., 24-hour access), and efficiency. At least one study has found shorter duration of office visits, more phone consultations, and fewer and shorter hospitalizations due to an interactive, disease-specific networked computer system.⁵ In addition, consumers may benefit from quality of life gains, including improved psychosocial support, improved information-seeking ability, and reduced emotional distress.⁶

For example, in a small pilot study where a family practice provided access to patient education Web sites during the office visit, researchers reported the following results after just one month:⁷

• 90 percent were more satisfied with their visit because of the availability of the information.
• 94 percent of users found the information helpful.
• 77 percent felt the information would make them change their health behavior.
• 90 percent said they would use the clinic's Internet access again.

6.D.4. Constraints on This Intervention

While increasing numbers of health care organizations are embracing the use of the Internet to provide access to health information, some have expressed concerns about confidentiality, legal and liability issues, and reimbursement. Others are waiting for stronger evidence that these applications improve clinician efficiency, satisfaction, or quality of care.⁸ Moreover, health care organizations may be reluctant to invest in this kind of functionality because they are not sure how to evaluate the information technology needed to implement it or how to integrate it into existing information systems.

A final obstacle for some organizations is that they are not certain that this strategy makes sense for the populations they serve. One common concern is that members or patients may not have access to the Internet. While disparities in Internet access (often referred to as the "digital divide") have decreased in recent years, there are still some populations with limited or no experience with or access to the Internet—including seniors, people without a college education, people living in rural areas, people with disabilities, and people who prefer languages other than English.⁹ To help overcome these constraints, some health care organizations are taking explicit steps to educate members and patients on ways to get access to information on the Internet (e.g., through smart phones; through computers available in libraries and schools; or through family, caregivers, and intermediaries with direct access). A few are even providing access to Internet-based resources at their site (e.g., by installing devices in clinic waiting rooms). A related concern is that providing better access only addresses part of the problem. The other part relates to Web literacy: the inability of some people with Internet access to navigate the Web efficiently or process all the information it offers.

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6.D.5. Examples

A Web search would yield many examples of health plans and medical groups directly providing health information and serving as portals to other sites. One example is Kaiser Permanente, where members who sign in have access to in-depth health information and can refill prescriptions, make appointments, learn about health classes, and get personalized health advice from a clinician. They can also research health conditions, take personal health assessments (e.g., disease risks, healthy lifestyle) and join online health discussions.¹⁰

Other examples include the websites for  and the . These sites are excellent examples of providing specific information about the health care organizations—practices, hours, policies about appointment waiting times, access to medical records—as well as health information and condition-specific resources

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>References

1. Kassirer JP. Patients, physicians, and the Internet. Health Aff (Millwood) 2000;19(6):115-23.
2. The Harris Poll #98. Harris Interactive September 15, 2011. Available at: harrisinteractive.com/NewsRoom/HarrisPolls/tabid/447/ctl/ReadCustom%20Default/mid/1508/ArticleId/863/Default.aspx. Accessed July 28, 2015.
3. Fox S, Duggan M. Health Online 2013. Pew Research Center, Internet and American Life Project. January 15, 2013. Available at . Accessed July 28, 2015.
4. Fox S, Rainie L. Vital decisions: How internet users decide what information to trust when they or their loved ones are sick 2002; Washington, DC, Pew Internet & American Life Project.
5. Gustafson DH, Hawkins R, Boberg E, et al. Impact of a patient-centered, computer-based health information/support system. Am J Prev Med 1999;16(1):1-9.
6. Gustafson DH, Hawkins R, Pingree S, et al. Effect of computer support on younger women with breast cancer. J Gen Intern Med 2001; 16(7):435-45.
7. Helwig AL, Lovelle A, Guse C, et al. An office-based Internet patient education system: A pilot study. J Fam Pract 1999;48(2):123 7.
8. Eng TR. The eHealth Landscape: A Terrain Map of Emerging Information and Communication Technologies in Health and Health Care. Princeton, NJ, The Robert Wood Johnson Foundation, 2001.
9. Rainie L. The State of Digital Divides. Presentation on Washington Post Live: "Bridging the Digital Divides." November 5, 2013. Available at . Accessed July 28, 2015.
10. Kaiser Permanente. Kaiser Permanente Online. . Accessed July 7, 2017

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