Hospital website rankings in the United States: expanding benchmarks and standards for effective consumer engagement

User Information Sharing and Hospital Website Privacy Policies

Importance

Hospital websites frequently use tracking technologies that transfer user information to third parties. It is not known whether hospital websites include privacy policies that disclose relevant details regarding tracking.

Objective

To determine whether hospital websites have accessible privacy policies and whether those policies contain key information related to third-party tracking.

Design, Setting, and Participants

In this cross-sectional content analysis of website privacy policies of a nationally representative sample of nonfederal acute care hospitals, hospital websites were first measured to determine whether they included tracking technologies that transferred user information to third parties. Hospital website privacy policies were then identified using standardized searches. Policies were assessed for length and readability. Policy content was analyzed using a data abstraction form. Tracking measurement and privacy policy retrieval and analysis took place from November 2023 to January 2024. The prevalence of privacy policy characteristics was analyzed using standard descriptive statistics.

Main Outcomes and Measures

The primary study outcome was the availability of a website privacy policy. Secondary outcomes were the length and readability of privacy policies and the inclusion of privacy policy content addressing user information collected by the website, potential uses of user information, third-party recipients of user information, and user rights regarding tracking and information collection.

Results

Of 100 hospital websites, 96 (96.0%; 95% CI, 90.1%-98.9%) transferred user information to third parties. Privacy policies were found on 71 websites (71.0%; 95% CI, 61.6%-79.4%). Policies were a mean length of 2527 words (95% CI, 2058-2997 words) and were written at a mean grade level of 13.7 (95% CI, 13.4-14.1). Among 71 privacy policies, 69 (97.2%; 95% CI, 91.4%-99.5%) addressed types of user information automatically collected by the website, 70 (98.6%; 95% CI, 93.8%-99.9%) addressed how collected information would be used, 66 (93.0%; 95% CI, 85.3%-97.5%) addressed categories of third-party recipients of user information, and 40 (56.3%; 95% CI, 44.5%-67.7%) named specific third-party companies or services receiving user information.

Conclusions and Relevance

In this cross-sectional study of hospital website privacy policies, a substantial number of hospital websites did not present users with adequate information about the privacy implications of website use, either because they lacked a privacy policy or had a privacy policy that contained limited content about third-party recipients of user information.

Web search to access health information by adults with intellectual disability

Purpose

This study explored the current and desired use of web-search, particularly for health information, by adults with intellectual disability.

Design/methodology/approach

The authors surveyed 39 participants who were in supported employment or attending day centers in Australia. The survey, delivered through structured interviews, increased participation with data in a form of the participants' narratives. The responses were analyzed through a form of thematic analysis.

Findings

This study's results present the participants' daily health information interests, approaches to finding information and expectations for self-sufficiency. Participants' interest was in information to stay healthy rather than purely clinical information. The participants were keen to use online information in, accessible as well as entertaining and engaging formats. Supporting others close to the participants was the prominent intention of participants' health information access. Participants showed aspirations for an autonomous life by wanting to learn how to search.

Research limitations/implications

The findings of this study provide some avenues for consumer health information access to be respectful and inclusive of users with intellectual disability, both from an accessible design perspective as well as from a learning and support standpoint.

Originality/value

This study complements other human–computer interaction (HCI) studies which observe how adults with intellectual disability can be supported to engage with web search; this study offers the adults' verbalized perspectives on how adults wish to interact with web searching for health information, nuanced by adults' existing abilities and support needs.

Website Usability Analysis of U.S. Military Residency Programs

INTRODUCTION

The Military Match is the residency matching system for medical students attending the Uniformed Services University of Health Sciences, and the students were funded by the Health Professions Scholarship Program through the U.S. Army, Air Force, and Navy. To evaluate and compare military residency programs, students use residency program websites. Often, the residency program's website serves as a key source, or the only point of reference, when considering residency options, especially during times when face-to-face interactions are limited.This report aims to provide a systematic evaluation of military residency programs and their websites.

MATERIALS AND METHODS

Utilizing a previously published website usability scoring system, military residency programs were categorized to objectively and quantitatively analyze their websites. Usability was divided into four categories for quantifiable analysis: accessibility, marketing, content quality, and technology. The methodology for this analysis was replicated from published reports that have examined healthcare website usability. Each website was analyzed and scored in four categories: accessibility, content quality, marketing, and technology. A "General Usability" score was calculated for each website using a composite of the key factors within the four categories. An overall score was generated utilizing the weighted percentage across all four categories. To address deficiencies of the original methodology, a secondary analysis was performed on the listed websites utilizing an automated methodology for website usability.

RESULTS

A comprehensive list of 125 Accreditation Council for Graduate Medical Education U.S. Military residency program websites was compiled. Of these, 96 programs and 106 websites were evaluated. The primary analysis employing usability methodology identified technology as the highest ranked category with a score of 0.749 (SD ± 0.039) (SE 0.005) (P < .05). Marketing and content quality were the lowest scoring categories with mean scores of 0.414 (SD ± 0.054) (SE 0.006) and 0.428 (SD ± 0.229) (SE 0.027), respectively (P < .05). There was no significant difference in overall usability rankings or scores among the 96 residency program websites across the three branches (P < .05).Secondary analysis with the new usability methodology demonstrated military residency websites to exhibit more external backlinking compared to internal backlinking (P < 0.05) and no social media backlinking to any of the 106 analyzed websites. When comparing the three services, the Army had significantly lower external backlinking ranking 43.4 (P < .05) and overall backlinking ranking 56.4 (P < 0.05) when compared to the Navy (mean 48.8 and 71.7, and 43.4). There were no other differences in backlinking rankings across the three branches.

CONCLUSIONS

Residency websites have become a primary way to communicate information to applicants. By assessing the overall usability of the various military residency websites, we determined the effectiveness of these websites to relay information to prospective students interested in applying for military residency. We predict that by improving website accessibility, residency programs increase their effectiveness at communicating information to potential applicants and increase interest in military residency programs.

Methodological Guidelines for Systematic Assessments of Health Care Websites Using Web Analytics: Tutorial

With the growing importance of communicating with the public via the web, many industries have used web analytics to provide information that organizations can use to better achieve their goals. Although the importance of health care websites has also grown, the health care industry has been slower to adopt the use of web analytics. Web analytics are the measurement, collection, analysis, and reporting of internet data used to measure direct user interaction. Our objective is to provide generalized methods for using web analytics as key performance metrics to evaluate websites and outline actionable recommendations for improvement. By deconstructing web analytic categories such as engagement, users, acquisition, content, and platform, we describe how web analytics are used to evaluate websites and how improvements can be made using this information. Engagement is how a user interacts with a website. It can be evaluated using the daily active users to monthly active users (DAU/MAU) ratio, bounce rate, pages viewed, and time on site. Poor engagement indicates potential problems with website usability. Users pertains to demographic information regarding the users interacting with a website. This data can help administrators understand who is engaging with their website. Acquisition refers to the overall website traffic and the method of traffic, which allows administrators to see how people are accessing their website. This information helps websites expand their methods of attracting users. Content refers to the overall relevancy, accuracy, and trustworthiness of a website’s content. If a website has poor content, it will likely experience difficulty with user engagement. Finally, platform refers to the technical aspects of how people access a website. It includes both the internet browsers and devices used. By providing detailed descriptions of these categories, we have identified how web administrators can use web analytics to systematically assess their websites. We have also provided generalized recommendations for actionable improvements. By introducing the potential of web analytics to augment usability and the conversion rate, we hope to assist health care organizations in better communicating with the public and therefore accomplishing the goals of their websites.

Website usability analysis of American anesthesiology residency programs: Original Paper (Preprint)

Background

The Association of American Medical Colleges has recently issued recommendations for the upcoming 2022-2023 application cycle that residency programs should conduct all interviews for this upcoming application cycle over the web. In light of these recommendations, many students will have limited exposure to anesthesiology programs and will rely on information gleaned digitally. This change means that the aspects of program websites used to provide information, such as size, structure, location, requirements, and contact information, will be crucial in helping prospective residents decide where and how to apply in the future. An evaluation of website usability, which includes initial appearance along with factors that influence its ease of navigation and convenience of use, can thus be applied to anesthesiology residency websites. Areas of need can be targeted to increase web presence and provide effective pathways to exhibit the different attributes of their programs to future applicants.

Objective

This study aimed to compile a list of US anesthesiology residency programs and their websites while objectively analyzing the websites using a formally published usability scoring system, as well as to identify positive and negative trends to offer areas of improvement among anesthesiology residency websites.

Methods

We included only 114 US anesthesiology residency program websites in our sample set, since some websites we analyzed showed errors or inconclusive. Website usability was separated into 4 distinct categories for analysis based on methodology outlined in previous literature on both health care website usability and residency website usability. The 4 categories were Accessibility, Marketing, Content Quality, and Technology. Each website was then analyzed and scored based on key components highlighted within the 4 categories. The multiple factors were then graded using a percentage system to create a comprehensive score for each program.

Results

The highest scoring category was Content Quality (mean 4.7, SD 2.48, SE 0.23). The lowest scoring category was Technology (mean 0.9, SD 0.38, SE 0.04).

Conclusions

Through the application of a health care website usability framework, multiple anesthesiology residency programs were analyzed and scored in the areas of Accessibility, Marketing, Content Quality, and Technology, which allowed us to determine the effectiveness of the usability of these websites to convey information to their end user. Websites must communicate vital information, with usability at the forefront, to continue to grow, especially as the United States faces challenges due to the COVID-19 pandemic. Our recommendation is that anesthesiology programs should strive to improve website usability to increase the ease by which applicants can collect vital information about anesthesiology programs. A few proposed solutions include making changes such as decreasing error pages on websites, migrating away from using in-line cascading style sheets, and improving web page loading speeds to improve the Technology category.

Physician Gender, Patient Risk, and Web-Based Reviews: Longitudinal Study of the Relationship Between Physicians' Gender and Their Web-Based Reviews

Background

Web-based reviews of physicians have become exceedingly popular among health care consumers since the early 2010s. A factor that can potentially influence these reviews is the gender of the physician, because the physician’s gender has been found to influence patient-physician communication. Our study is among the first to conduct a rigorous longitudinal analysis to study the effects of the gender of physicians on their reviews, after accounting for several important clinical factors, including patient risk, physician specialty, and temporal factors, using time fixed effects. In addition, this study is among the first to study the possible gender bias in web-based reviews using statewide data from Alabama, a predominantly rural state with high Medicaid and Medicare use.

Objective

This study conducts a longitudinal empirical investigation of the relationship between physician gender and their web-based reviews using data across the state of Alabama, after accounting for patient risk and temporal effects.

Methods

We created a unique data set by combining data from web-based physician reviews from the popular physician review website, RateMDs, and clinical data from the Center for Medicare and Medicaid Services for the state of Alabama. We used longitudinal econometric specifications to conduct an econometric analysis, while controlling for several important clinical and review characteristics across four rating dimensions (helpfulness, knowledge, staff, and punctuality). The overall rating and these four rating dimensions from RateMDs were used as the dependent variables, and physician gender was the key explanatory variable in our panel regression models.

Results

The panel used to conduct the main econometric analysis included 1093 physicians. After controlling for several clinical and review factors, the physician random effects specifications showed that male physicians receive better web-based ratings than female physicians. Coefficients and corresponding SEs and P values of the binary variable GenderFemale (1 for female physicians and 0 otherwise) with different rating variables as outcomes were as follows: OverallRating (coefficient –0.194, SE 0.060; P=.001), HelpfulnessRating (coefficient –0.221, SE 0.069; P=.001), KnowledgeRating (coefficient –0.230, SE 0.065; P<.001), StaffRating (coefficient –0.123, SE 0.062; P=.049), and PunctualityRating (coefficient –0.200, SE 0.067; P=.003). The negative coefficients indicate a bias toward male physicians versus female physicians for aforementioned rating variables.

Conclusions

This study found that female physicians receive lower web-based ratings than male physicians even after accounting for several clinical characteristics associated with the physicians and temporal effects. Although the magnitude of the coefficients of GenderFemale was relatively small, they were statistically significant. This study provides support to the findings on gender bias in the existing health care literature. We contribute to the existing literature by conducting a study using data across the state of Alabama and using a longitudinal econometric analysis, along with incorporating important clinical and review controls associated with the physicians.

Comparison of User-Oriented Information Services on the Websites of Large Hospitals in China and the United States: Cross-sectional Study

BACKGROUND

Many people use the internet to access health care information to support health care decisions, and hospital websites can be the first point of contact to provide health care information services for consumers. However, little is known about the current information services provided by the websites of large Chinese hospitals.

OBJECTIVE

The aim of this study is to evaluate and compare the information services of the websites of large hospitals in China and the United States. We hope that our findings will benefit hospital managers worldwide in providing service information on the web.

METHODS

This study adopted a cross-sectional analytical approach to evaluate the websites of large hospitals in China and the United States in 2020. A total of 300 large hospitals were randomly selected, of which half were in China and half were in the United States. Based on the 7Ps marketing mix, we identified 39 items that represent typical hospital website information services, covering the following seven dimensions: product, price, place, propagation, people, process, and physical evidence.

RESULTS

Most of the items (34/39, 87%) related to information services offered by hospital websites were less covered in China than in the United States; however, 5 items (appointments by a third-party platform, mobile payment, hospital value, hospital environment display, and physicians' profiles) had higher coverage in China. The average scores for hospital websites in China and the United States were 13.25 (SD 2.99) points and 23.16 (SD 2.76) points, respectively. Generally, high scores were given to the south areas of China and north areas of the United States.

CONCLUSIONS

Hospital websites in China lagged behind those in the United States with regard to information services offered. We recommend that hospital managers in China place more emphasis on the people, product, and propagation dimensions of the 7Ps marketing mix in the construction of information services on hospital websites. Through the comparison of the websites of large hospitals in China and the United States, our study findings can provide suggestions for forming standard hospital website construction guidelines worldwide.

An Analysis of US Academic Medical Center Websites: Usability Study

Background

Health care organizations are tasked with providing web-based health resources and information. Usability refers to the ease of user experience on a website. In this study, we conducted a usability analysis of academic medical centers in the United States, which, to the best of our knowledge, has not been previously carried out.

Objective

The primary aims of the study were to the following: (1) adapt a preexisting usability scoring methodology to academic medical centers; (2) apply and test this methodology on a sample set of academic medical center websites; and (3) make recommendations from these results on potential areas of improvements for our sample of academic medical center websites.

Methods

All website usability testing took place from June 1, 2020, to December 15, 2020. We replicated a methodology developed in previous literature and applied it to academic medical centers. Our sample included 73 US academic medical centers. Usability was split into four broad categories: accessibility (the ability of those with low levels of computer literacy to access and navigate the hospital’s website); marketing (the ability of websites to be found through search engines and the relevance of descriptions to the links provided); content quality (grammar, frequency of information updates, material relevancy, and readability); and technology (download speed, quality of the programming code, and website infrastructure). Using these tools, we scored each website in each category. The composite of key factors in each category contributed to an overall “general usability” score for each website. An overall score was then calculated by applying a weighted percentage across all factors and was used for the final “overall usability” ranking.

Results

The category with the highest average score was technology, with a 0.82 (SD 0.068, SE 0.008). The lowest-performing category was content quality, with an average of 0.22 (SD 0.069, SE 0.008). As these numbers reflect weighted percentages as an integer, the higher the score, the greater the overall usability in that category.

Conclusions

Our data suggest that technology, on average, was the highest-scored variable among academic medical center websites. Because website functionality is essential to a user’s experience, it is justified that academic medical centers invest in optimal website performance. The overall lowest-scored variable was content quality. A potential reason for this may be that academic medical center websites are usually larger in size, making it difficult to monitor the increased quantity of content. An easy way to improve this variable is to conduct more frequent website audits to assess readability, grammar, and relevance. Marketing is another area in which these organizations have potential for improvement. Our recommendation is that organizations utilize search engine optimization techniques to improve their online visibility and discoverability.

Patient-centered digital healthcare for patients undergoing breast surgery-A cross-sectional questionnaire study

INTRODUCTION

The potential of digital health services has become apparent in recent years, more so now following the coronavirus disease outbreak. However, despite majority of UK population integrating digital-based platforms into their everyday life, there is low engagement with NHS digital services, citing lack of patient-centered approaches to the design of such services. As such, this cross-sectional questionnaire aims to understand the patient perspective pertaining the utility of web-based information in aiding their breast cancer pathway at a large volume tertiary breast institute.

METHODS

Adult patients attending the outpatients' post-operative follow-up clinic for any breast-related surgery were included. Questionnaires were provided from 1 August 2019 to 31 December 2019, focusing on awareness of the website, usage and usefulness of information offered relating to their breast surgery journey, with opportunities for open feedback.

RESULTS

Of the 104 patients completed the questionnaire, 70% (n = 73) were unaware of the breast institute's website. Patients' wanted a wide range of information, including signposting to support groups and perioperative information such as patient experiences/journey on the operative day (n = 46, 44%/n = 60, 58%) and videos explaining procedures. The most frequent free text included requests for information regarding financial support and parking, and "signposting" to other support services.

DISCUSSION

Patients welcome the breast services' website, but we need to improve awareness of this resource and include more holistic information, relating not only to their diagnosis and treatment but also to practical/support services they can access to make their patient journey smoother.

Website usability analysis of United States emergency medicine residencies

OBJECTIVES

The Council of Residency Directors (CORD) in Emergency Medicine (EM) has recommended that all residency programs should conduct virtual interviews for the 2020 to 2021 application cycle due to the COVID-19 pandemic. While factors such as geographical region, city, program size, or hospital affiliation are not modifiable, EM residencies can bridge the information gap created by a lack of face-to-face interaction by representing themselves digitally. Measuring usability provides an objective method for EM residencies to improve their Web presence and effectively represent themselves to applicants.

METHODS

Our sample set included 55 U.S. EM residency program websites. Using methodology replicated from previous literature on health care website usability, we divided usability into four categories for quantifiable analysis: accessibility, marketing, content quality, and technology. Analysis was performed on each website and scored in all four categories. A "general usability" score was calculated for each website using a composite of the key factors within the four categories. Using a weighted percentage across all of the factors, an overall score was calculated.

RESULTS

Content quality was the overall highest scoring category (mean ± SD = 5.4, SE = 0.33). The overall lowest performing category was technology (mean ± SD = 0.8 ± 0.09, SE = 0.01).

CONCLUSIONS

Measuring usability can help EM residency programs identify ways to improve their Web presence. To effectively promote their programs, residencies need quality content that communicates their key features. Our recommendation is for all residency programs to periodically perform website audits and apply the usability measures outlined to improve their digital presence, especially during times when face-to-face interactions will be limited.

Applying Website Rankings to Digital Health Centers in the United States to Assess Public Engagement: Website Usability Study

Background

As the public increasingly uses the internet to search for resources and information regarding health and medicine, it is important that health care organizations provide adequate web resources. Website usability refers to the ease of user experience on a website. In this study, we conducted usability analyses on digital health center websites.

Objective

The primary aims of this study were to (1) replicate a preexisting usability scoring methodology for digital health centers; (2) apply and test this replicated usability scoring methodology on a sample set of digital health center websites; and (3) derive recommendations from the results on potential areas of improvements for our sample of digital health center websites.

Methods

Website usability testing was conducted from March 1, 2020, to March 15, 2020. We replicated a methodology and scoring system from previous literature and applied them to digital health center websites. Our sample included 67 digital health centers that were affiliated with US universities or hospital systems. Usability was split into the following four broad categories: accessibility, marketing, content quality, and technology. Usability tools were used to score websites in each of the four categories. The composite of the key factors of each category was used to generate a general usability and overall usability score for each website.

Results

The category with the highest average score (6.3) was content quality. The content quality score also had the highest SD (2.18) and an SE of 0.27. The lowest performing category was technology, which had an average score of 0.9. The technology score also had the smallest SD (0.07) and an SE of 0.01.

Conclusions

Our data suggest that content quality, on average, was the highest scoring variable among digital health center websites. As content is crucial to digital health knowledge, it is justified that digital health centers invest more resources into creating quality content. The overall lowest scoring variable was technology. Potential reasons for this finding include designated funding for servers, a lack of regulatory frameworks for social media presence and liability, and infrequent website audits. An easy approach for improving this variable is increasing website speed. Accessibility is another area that organizations can potentially improve. We recommend that these organizations perform periodic audits of their web presence with usability tools.

The Quality of Infectious Disease Hospital Websites in Poland in Light of the COVID-19 Pandemic

The quality of healthcare service websites gains particular importance in the time of the pandemic, asthe popularity of electronic services grows. This applies to infectious disease hospitals as well, often on the front line of the effort against COVID-19. The paper aims to assess the quality of infectious disease hospital websites in Poland in light of the COVID-19 pandemic. The research covered 91 websites. The first stage was an analysis of selected technical attributes of the websites (including website performance, SEO quality, website availability, and mobile-friendliness) with selected online tools, such as Google PageSpeed Insights, Blink Audit Tool, Backlink Checker, andwebsite accessibility evaluation tool (WAVE). The data were then analyzed with statistical methods. The next step was to analyze the content of the websites. The research has shown that most of the websites were of satisfactory quality, apart from those that were not mobile-ready. The following keywords were found most often on the hospital websites: SARS-CoV-2, COVID-19, smear, specialist care clinic, isolation, telephone consultations, sample collection center, support, coronavirus, recommendations, patient registration, signs of disease. The research suggests that the quality of infectious disease hospital websites in Poland is significantly diversified in search engine optimization, mobile-friendliness, and needs of people at risk of digital exclusion.

An Alternate Unsupervised Technique Based on Distance Correlation and Shannon Entropy to Estimate λ0-Fuzzy Measure

λ0-measure is a special type of fuzzy measure. In the context of multi-attribute decision making (MADM), the measure can be used together with Choquet integral to model the interdependencies that usually present between the decision attributes. Unfortunately, the range of techniques available to estimate λ0-measure values is too limited i.e., only four techniques are available to this date. Besides, the review on literature shows that each of these existing techniques either requires some initial data from the decision-makers or misrepresents the actual interdependencies held by the attributes. Thus, an alternate unsupervised technique is needed for the estimation of λ0-measure values. This study has developed such a technique by integrating the idea of distance correlation and Shannon entropy. In this technique, the two inputs required to estimate λ0-measure values, namely, the interdependence degrees and fuzzy densities are determined by utilizing the distance correlation measures and entropy weights, respectively. An evaluation to rank the websites owned by five different hospitals located in Sabah, Malaysia, was conducted to illustrate the usage of the technique. A similar evaluation was also performed with a few selected MADM techniques for comparison purposes, where the proposed technique is found to have produced the most consistent ranking. From the literature perspective, this study has contributed an alternate unsupervised technique that can estimate λ0-measure values without necessitating any additional data from the decision-makers, and at the same time can better capture the interdependencies held by the attributes.

Analysis of user behavior on the website of a university eye hospital in Germany

Medical information websites are usually targeted toward patients, physicians, and medical students. Most of the latest studies researched the usability of such websites. However, reports on user numbers and behavior are rare.The goal of our study is to analyze the utility of a website of a large tertiary referral center in ophthalmology in terms of various target audiences (patients, applicants, medical students, referring ophthalmologists).The web access data from our institutional website was assessed with Google Analytics. Data collection started in 2016.From 2016 to 2018, we counted a total of 763,942 page views. The overall number of users dropped from 81,572 to 67,740. This drop's onset correlates with a change in the website structure. All target audience pages received constant traffic from 2016 to 2019, with the patients' and doctors' sites attracting the most traffic. The pages for medical students and job applicants, although not viewed often, revealed a long session duration.Our website is used by all our target audiences. The behavior and the user numbers of each target group differ. Changes to a website's structure can influence the number of users and their behavior. It is not possible to make a direct comparison to other institutions' websites as there are so few similar reports available. By adding more parameters to the analytics profile in a prospective setting, more detailed analyses of user behavior may be possible in the future.

Predictors of online accountability practices in US hospitals: An exploratory investigation

The purpose of this research paper is to explore variations in online accountability practices in US hospitals and determine the factors that are associated with higher levels of online accountability practices. This project employed a quantitative content analysis of 240 US hospital websites. Additionally, secondary data were obtained from the American Hospital Association and the American Hospital Directory. The results show that the external environment somewhat impacted hospitals' online accountability practices, with hospital volume (measured through the number of annual admissions) as an unquestionable predictor. Another key finding is that some of the governance forms impacted online accountability practices. Particularly, hospitals with private ownership structures tended to disclose less accountability information in an online environment, compared with their public and nonprofit counterparts. The financial situation of hospitals did not have any significant impact on overall online accountability practices but was influencing performance disclosure practices. Online accountability studies have not been conducted in a health care setting. This research theoretically relates online accountability practices to organizational characteristics (such as size, volume, financial performance, system affiliation, ownership, and rurality). Knowledge of the online accountability landscape might benefit future policy decisions on accountability models.

Evaluating hospital websites in Kuwait to improve consumer engagement and access to health information: a cross-sectional analytical study

BACKGROUND

Current advances in information and communication technology have made accessing and obtaining health-related information easier than ever before. Today, many hospital websites use a patient-centric approach to promote engagement and encourage learning for better health-related decision making. However, little is known about the current state of hospital websites in the State of Kuwait. This study aims to evaluate hospital websites in Kuwait and offer recommendations to improve patient engagement and access to health information.

METHODS

This study employs a cross-sectional analytical approach to evaluate hospital websites in Kuwait in 2017. The websites of hospitals that provide in-patient services were identified through a structured search. Only active websites that were available in either English or Arabic were considered. The evaluation of the websites involved a combination of automated and expert- based evaluation methods and was performed across four dimensions: Accessibility, Usability, Presence, and Content.

RESULTS

Nine hospitals met the inclusion criteria. Most of the websites fell short in all four dimensions. None of the websites passed the accessibility guidelines. The usability of websites varied between hospitals. Overall, the majority of hospitals in Kuwait have rudimentary online presence and their websites require careful reassessment with respect to design, content, and user experience. The websites focus primarily on promoting services provided by the hospital rather than engaging and communicating with patients or providing evidence-based information.

CONCLUSIONS

Healthcare organization and website developers should follow best-practices to improve their websites taking into consideration the quality, readability, objectivity, coverage and currency of the information as well as the design of their websites. Hospitals should leverage social media to gain outreach and better engagement with consumers. The websites should be offered in additional languages commonly spoken by people living in Kuwait. Efforts should be made to ensure that health information on hospital websites are evidence-based and checked by healthcare professionals.

A content analysis of Clinical and Translational Science Award (CTSA) strategies for communicating about clinical research participation online

Introduction

There is a dearth of literature providing guidance on how to effectively communicate about clinical research (CR).

Methods

Using the transactional model of communication, a content analysis of the investigator (n=62) and participant (n=18) Web sites of institutions funded through the National Institutes of Health Clinical and Translational Science Award (CTSA) was conducted to identify their strategies (e.g., messages) for communicating about CR participation.

Results

CTSAs targeted investigators with CR participation content across the main Web sites, although most CTSAs (n=55; 88.7%) also included CR participation content for participants. In total, 18 CTSAs (29%) hosted participant Web sites. Participant sites included 13 message types about CR participation (e.g., registry enrollment) and 5 additional channels (e.g., email, phone number) to communicate about CR. However, many CTSA participant Web sites excluded information explaining the CR process and offered CR content exclusively in English.

Conclusion

CTSAs should identify their target audience and design strategies (e.g., messages, channels) accordingly.

The effect of social media (#SoMe) on journal impact factor and parental awareness in paediatric urology

BACKGROUND

Social media (SoMe) comprises a number of internet-based applications that have the capability to disseminate multimodal media and allow for unprecedented inter-user connectivity. The role of Twitter has been studied in conferences and education; moreover, there is increasing evidence that patients are more likely to use social media for their own health education.

OBJECTIVE

The aim of this study was to assess the impact of social media platforms on the impact factor of both urological and paediatric journals that publish on paediatric urology, and to assess parental awareness of social media in paediatric urology.

STUDY DESIGN

A filtered Journal of Citation Reports (JCR) search was performed for the period 2012-16 for journals that published articles on paediatric urology. Journals were ranked according to impact factor, and each individual journal website was accessed to assess for the presence of social media. Parents in paediatric urology clinics and non-paediatric urology patients also filled out a questionnaire to assess for awareness and attitudes to social media. All statistical analysis was performed using Prism 6 software (Prism 6, GraphPad Software, California, USA).

RESULTS

Overall, there were 50 urological journals and 39 paediatric journals with a mean impact factor of 2.303 and 1.766, respectively. There was an overall average increase in impact factor across all urological journals between 2012 and 16. The presence of a Twitter feed was statistically significant for a rise in impact factor over the 4 years (P = 0.017). The cohort of parents was statistically more likely to have completed post-secondary education, to have and access to a social media profile, use it for health education, and use it to access journal/physician/hospital social media accounts.

DISCUSSION

This study examined, for the first time, the role of social media in paediatric urology, and demonstrated that SoMe use is associated with a positive influence in impact factor, but also a parental appetite for it. Limitations included a non-externally validated questionnaire. There may also have been bias in larger journals that generate and maintain social media platforms such as Twitter, which may then in turn have an influence on impact factor.

CONCLUSIONS

Social media use within paediatric urology was associated with a higher impact factor, which remained significant after 4 years of analysis. Parents were more likely to use a wide variety of social media to search for conditions and physicians/healthcare providers; therefore, journals and institutions need to embrace and endorse SoMe as a potential source of important clinical information.

Cancer Center Website Rankings in the USA: Expanding Benchmarks and Standards for Effective Public Outreach and Education

The 68 National Cancer Institute (NCI)-designated comprehensive and cancer centers have been tasked with leading the campaign in the fight against cancer, as well as providing education and outreach to the public. Therefore, it is important for these organizations to have an effective online presence to disseminate information and engage patients. The purpose of this study was to assess both the functionality and usability of cancer centers' websites. The 68 center web domains were evaluated using two separate but complementary approaches. First, a webcrawler was used to score each website on five dimensions: accessibility, content, marketing, technology, and usability. Rankings on each dimension and an average ranking were calculated for all 68 centers. Second, a three-reader system was used to determine a list of all functionalities present on the websites. Both webcrawler scores and functionality prevalence were compared across center type. No differences were observed in webcrawler scores between comprehensive and cancer centers. Mean scores on all dimensions ranged between 5.47 and 7.09. For the functionality assessment, 64 unique functions were determined and categorized into 12 domains, with the average center possessing less than 50 % of the functions. This census assessment of NCI centers' websites suggests the need for improvement to capitalize on new dissemination platforms available online. Progress in development of this technology can help achieve the goals of public education and outreach to a broad audience. This paper presents performance guidelines evaluated against best-demonstrated practice to facilitate social media use improvement.

An Evaluation and Ranking of Children's Hospital Websites in the United States

Background

Children’s hospitals are faced with the rising need for technological innovation. Their prospective health care consumers, who increasingly depend on the Web and social media for communication and consumer engagement, drive this need. As patients and family members navigate the Web presence of hospitals, it is important for these specialized organizations to present themselves and their services efficiently.

Objective

The purpose of this study was to evaluate the website content of children’s hospitals in order to identify opportunities to improve website design and create benchmarks to judge improvement.

Methods

All websites associated with a children’s hospital were identified using a census list of all children’s hospitals in the United States. In March of 2014, each website and its social media were evaluated using a Web crawler that provided a 5-dimensional assessment that included website accessibility, marketing, content, technology, and usability. The 5-dimensional assessment was scored on a scale ranging from 0 to 10 with positive findings rated higher on the scale. Websites were ranked by individual dimensions as well as according to their average ranking across all dimensions.

Results

Mean scores of 153 websites ranged from 5.05 to 8.23 across all 5 dimensions. Results revealed that no website scored a perfect 10 on any dimension and that room exists for meaningful improvement.

Conclusions

Study findings allow for the establishment of baseline benchmarks for tracking future website and social media improvements and display the need for enhanced Web-based consumer engagement for children’s hospitals.

Quality of Public Hospitals Websites: A Cross-Sectional Analytical Study in Iran

Introduction:

Nowadays, hospitals have turned increasingly towards the Internet and develop their own web presence. Hospital Websites could be operating as effective web resources of information and interactive communication mediums to enhance hospital services to the public.

Aim:

Therefore, the aim of this study was to assess the quality of websites in Tehran’s public hospitals.

Material and methods:

This cross-sectional analysis involved all public hospitals in Iran’s capital city, Tehran, with a working website or subsites between April and June, 2014 (N=59). The websites were evaluated using three validated instruments: a localized checklist, Google page rank, and the Alexa traffic ranking. The mentioned checklist consisted of 112 items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. Data were analyzed using descriptive and analytical statistics.

Results:

The mean website evaluation score was 45.7 out of 224 for selected public hospitals. All the studied websites were in the weak category based on the earned quality scores. There was no statistically significant association between the website evaluation score with Google page rank (P=0.092), Alexa global traffic rank and Alexa traffic rank in Iran (P>0.05). The hospital websites had a lower quality score in the interactive online services and external activities criteria in comparing to other criteria. Due to the low quality level of the studied websites and the importance of hospital portals in providing information and services on the Internet, the authorities should do precise planning for the appreciable improvement in the quality of hospital websites.

An Effective Web Presence for Substance Abuse Treatment Facilities

BACKGROUND

Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page.

OBJECTIVES

The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry.

METHODS

This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score.

RESULTS

The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites.

CONCLUSIONS

The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.

The evolving identity, capacity, and capability of the future surgeon

Technology has transformed surgery more within the last 30 years than the previous 2000 years of human history combined. These innovations have changed not only how the surgeon practices but have also altered the very essence of what it is to be a surgeon in the modern era. Beyond the industrial revolution, today's information revolution allows patients access to an abundance of easily accessible, unfiltered information which they can use to evaluate their surgical treatment, and truly participate in their personal care. We are entering yet another revolution specifically affecting surgeons, where the traditional surgical tools of our craft are becoming "smart." Intelligence in surgical tools and connectivity based on sensory data, processing, and analysis are enabling and enhancing a surgeon's capacity and capability. Given the tempo of change, within one generation the traditional role and identity of a surgeon will be fully transformed. In this article, the impact of the information revolution, technological advances combined with smart connectivity on the changing role of surgery will be considered.

Do cancer patients tweet? Examining the twitter use of cancer patients in Japan

BACKGROUND

Twitter is an interactive, real-time media that could prove useful in health care. Tweets from cancer patients could offer insight into the needs of cancer patients.

OBJECTIVE

The objective of this study was to understand cancer patients' social media usage and gain insight into patient needs.

METHODS

A search was conducted of every publicly available user profile on Twitter in Japan for references to the following: breast cancer, leukemia, colon cancer, rectal cancer, colorectal cancer, uterine cancer, cervical cancer, stomach cancer, lung cancer, and ovarian cancer. We then used an application programming interface and a data mining method to conduct a detailed analysis of the tweets from cancer patients.

RESULTS

Twitter user profiles included references to breast cancer (n=313), leukemia (n=158), uterine or cervical cancer (n=134), lung cancer (n=87), colon cancer (n=64), and stomach cancer (n=44). A co-occurrence network is seen for all of these cancers, and each cancer has a unique network conformation. Keywords included words about diagnosis, symptoms, and treatments for almost all cancers. Words related to social activities were extracted for breast cancer. Words related to vaccination and support from public insurance were extracted for uterine or cervical cancer.

CONCLUSIONS

This study demonstrates that cancer patients share information about their underlying disease, including diagnosis, symptoms, and treatments, via Twitter. This information could prove useful to health care providers.