for the Study of
Healthcare Organizations & Transactions
A presentation based on this research was given at the annual meeting of the Association for Health Services Research in Los Angeles, California, June 26, 2000. An article based on this presentation was published in Managed Care Interface, May, 2001, pages 64-68.
The abstract is first, followed by the slide presentation.
Conclusions Implications for Policy, Delivery or Practice The PowerPoint Presentation
The Internet has made substantial inroads into the delivery, administration, and reimbursement of health care services, as well as into consumer health information. In the 21st century, the Internet will increasingly serve as a low-cost, rapid method for disseminating health information. However, while there is a wealth of information available on the Internet, there is little agreement about how the quality and content should be evaluated. This exploratory analysis examines the information that is disseminated on the Internet by PBMs by using components of several existing evaluation tools.
The conceptual framework for this work derives from specific theories of information in which information is considered both a resource AND a commodity. Three broad groups of variables were used to assess the information on the PBM Web sites. The first group addresses features of interactive marketing: target audience, niche marketing, brand recognition and identity, and information gathering (the use of "cookies" to profile visitors to Web sites). The second group evaluates the technology that is used in the design and operation of the site. The final set focuses on the reliability and credibility of the content on the site. The variables for this set were obtained from the work conducted by the international not-for-profit organization, Health On the Net (HON) Foundation, and from the AHCPR-funded White Paper on the Quality of Health Information on the Internet.
The URLs for PBM Web sites were obtained from a commercial directory of health care management companies published in 1999. The directory included 103 PBMs; however, URLs were available for only 89 of the firms. Of those 89 firms, 74 had sites that were working; 3 firms had URLs that were identical with other firms (the parent company) and thus were eliminated from this study. As a result, seventy-one (70%) of all PBMs were included in this study.
Marketing Twelve (17%) sites seemed to target just 1 audience; 5 targeted only employers; 7 targeted only patients. All others targeted multiple audiences including physicians, pharmacists, investors, home health facilities and/or managed care organizations. 73% seemed to opt for niche marketing while approximately 54% attempted to create brand identity. 32% of the Web operators sent a "cookie" to the user's hard disk.
Technology The vast majority of sites (over 87%) invited feedback from users and provided an e-mail address. 86% of the sites failed to provide update information and 62% of them used a print size that made reading online difficult. To help the user navigate, 33% of the sites included a search function and 94% maintained some type of site map.
Content On 7 (10%) of the sites, it was not possible to determine the site’s purpose within 2 clicks of the mouse. 14% of the sites were connected directly to an on-line pharmacy; 59% offered mail-order pharmacy services. 17 sites (24%) provided medical advice, but only 2 clearly identified the credentials of the individual(s) offering such advice. 13 of the 17 sites included a statement that the medical advice provided was not designed or intended to replace the relationship between the site visitor and a medical care provider. 24% of the sites included a clear confidentiality statement. 8 sites included advertising (other than for their own services/products) but none included a clear advertising policy with it. In all 8 cases, it was difficult to differentiate clearly the PBM site from the outside advertising. Only 2 sites included the HON logo that indicates that the site comports with HON principles.
Taxonomy Although further analysis is required, it was possible to construct a gross taxonomy based on the information provided on the site. 16 sites attempted to provide information on a range of services to different types of customers and were thus classified as full service. 22 sites provided information on technological services only; 4 sites were mail order only; another 4 sites were directly identified with a large chain drugstore; 4 sites offered information on specialized pharmacy services only; 4 sites offered discount pharmacy cards only; and, another 3 sites were on-line pharmacies. 17% of the sites offered information on more than 2 types of service simultaneously, e.g., offered information on technological services and mail-order services but less than a full range of services.
The findings suggest that the PBM information on the Internet can and should be evaluated by users on dimensions such as purpose, structure, and content. Although a preliminary taxonomy of the information is suggested, more work is needed to fully characterize the Web sites.
Implications for Policy, Delivery or Practice
The Institute for the Future (Palo Alto, CA, 1999) has predicted that by 2005 "new consumers" -- people who are actively involved in making choices about the health care that they receive (or purchase for others) -- will become a majority. As these consumers are much more likely to turn to on-line sources of information, they will increasingly expect health care providers to be as well-versed in the information that is on the Internet as they are. It is important that patients, payers, and providers understand what information is available on the Web and how to evaluate it in order to foster meaningful interactions.
Primary Funding Source: NIMH.
We would like to thank the Scientific Visualization Center at the University of California, Berkeley for all of their help with poster preparation.
The PowerPoint Presentation
Table of Contents
|Author: Dr. Lucy Canter Kihlstrom|
Copyright © 2000 Institute for the Study of Healthcare Organizations & Transactions
Last modified: 04.08.2010 02:58 PM