Managing Your Practice

Why (and how) you should encourage your patients’ search for health information on the Web

OBG Manag. 2011 December;23(12):36-41

References

1. H1N1 vaccine and pregnancy. Organic Health Adviser. http://organichealthadviser.com/archives/h1n1-vaccine-and-pregnancy. Accessed November 12 2011.

2. Pregnant women and influenza. Centers for Disease Control and Prevention. http://www.cdc.gov/flu/protect/vaccine/pregnant.htm. Accessed November 12 2011.

3. Fox S. The social life of health information 2011. Pew Internet and American Life Project. http://pewresearch.org/pubs/1989/health-care-online-social-network-users. Accessed November 12, 2011.

4. Horrigan J, Rainie L. The Internet’s growing role in life’s major moments. Decision-making Communities, Health. Pew Internet and American Life Project. http://www.pewinternet.org/Reports/2006/The-Internets-Growing-Role-in-Lifes-Major-Moments.aspx. Accessed November 12, 2011.

5. Neelapala P, Duvvi SK, Kumar G, Kumar BN. Do gynaecology outpatients use the Internet to seek health information? A questionnaire survey. J Eval Clin Pract. 2008;14(2):300-304.

6. Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW. Patients’ use of the Internet for medical information. J Gen Intern Med. 2001;17(3):180-185.

7. Bernstam EV, Walji MF, Sagaram S, Sagaram D, Johnson CW, Meric-Bernstam F. Commonly cited website quality criteria are not effective at identifying inaccurate online information about breast cancer. Cancer. 2008;112(6):1206-1213.

8. Scullard P, Peacock C, Davies P. Googling children’s health: reliability of medical information on the Internet. Arch Dis Child. 2010;95(8):580-582.

9. Walji M, Sagaram S, Sagaram D, et al. Efficacy of quality criteria to identify potentially harmful information: a cross-sectional survey of complementary and alternative medicine web sites. J Med Internet Res. 2004;6(2):e21.-

10. Charnock D, Shepperd S, Needham G, Gann R. Discern: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health. 1999;53(2):105-111.

11. Hardwick JC, MacKenzie FM. Information contained in miscarriage-related websites and the predictive value of website scoring systems. Eur J Gynecol Reprod Biol. 2003;106(1):60-63.

12. Khazaal Y, Chatton A, Zullino D. HON label and Discern as content quality indicators of health-related websites [published online ahead of print May 2011]. Psychiatr Q. doi: 10.1007/s11126-011-9179-x.

13. Meric F, Bernstam EV, Mirza NQ, et al. Breast cancer on the world wide web: cross sectional survey of quality of information and popularity of websites. BMJ. 2002;324(7337):577-581.

The Health on the Net Foundation (HON) is an independent, seven-person, Geneva-based panel that evaluates accuracy of medical Web sites based on specific guiding principles. It can be accessed at http://www.hon.ch/. Web sites that meet these criteria are awarded seals of approval. Only one problem: Not all sites that carry the seal are compliant with HON, and sites that don’t carry the seal can nevertheless be complete and accurate.^11,12

JAMA benchmarks are four disclosures intended to help ensure the quality of a Web site: authorship, references, conflict of interest, and currency of content. Some research suggests that sites that have three or four of the benchmarks are more likely to have accurate content, but there is also evidence to suggest that JAMA benchmarks may not always reliably identify inaccurate information.^7,13

Recommend a mini-course

Because these tools may be difficult to use or unreliable at identifying quality content, I recommend that every patient spend time on the National Medical Library Web site learning how to look up information. The other benefit of this site is that it lists top 10 Web sites for content, so it is a great launching point for a multitude of searches. It can be found at http://www.mlanet.org/resources/userguide.html.

If the patient finds the information at this portal too dry, there is a fantastic 16-minute tutorial about evaluating online health information; it’s a service of the National Library of Medicine and the National Institutes of Health. I recommend that every provider do this tutorial. Why? So you can better educate yourself on how to use the Internet and so you can tell your patients how great it is. It’s available at http://www.nlm.nih.gov/medlineplus/webeval/webeval.html.

Take the bull by the horns

Discuss the Internet with every one of your patients. Specifically, ask if she has read any information online and, if she has, how it stacks up with what you have just discussed during her office visit. That’s what I do. Explain that accurate content is critical in health-care decisions, guide your patient to sites that are more likely to be accurate, and teach her how to maximize the Internet to enhance her health care.

In my experience, patients are thrilled to be pointed in the right direction.

We want to hear from you! Tell us what you think.