Economic Evaluation of an Investment in Medical Websites and Medical Web-Based Services



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13Concluding Remarks


As it was mentioned above, the main contribution of this study is the development of a new theoretical framework formulated specifically for the evaluation of medical web-based services based on and using aspects from the above reviewed frameworks for the evaluation of IT and Information Systems (IS).

The framework (Figure 17) combines the strong aspects from the Aforementioned well-established evaluation frameworks, while trying to avoid or minimise their weaknesses, focusing more on the quantitative aspects but incorporating also qualitative data, so as to end up with a more accurate evaluation outcome. It includes five levels, similarly to the ROI Process Model (Patricia and Jack Phillips, 2000), and incorporating aspects from the HOT-fit framework (Mohd. Yusof et al, 2008).

The aspects that each of the aforementioned frameworks examined where categorised and the most relevant aspects according to the targets of the current research were selected and added in the framework.


Chapter 5: Success and Failure Factors of Medical Websites






14 Introduction


Medical websites are becoming more and more usable and popular among the Internet users since they offer better results than the traditional, constrained telephone communication between the physician and the potential patient and there is a continuously increasing interest in seeking medical advice, medical information and other medical services through the Internet (Silence E. et al., 2007a, 2007b; Moreno et al, 2009). The users/patients want to have more control over their health and use the ease of Internet to book medical appointments, access their medical records, or even ask their personal physician direct inquiries about their medication or their general health status (Silence E. et al., 2007a, 2007b; Moreno et al, 2009).

This chapter presents research aimed to identify the factors that affect the success and the survivability of the medical websites and medical web-based services. The knowledge acquired will be used to come up with a more accurate evaluation of the medical websites, focusing on financial, organizational, managerial, marketing factors, and user-related aspects. In contrast to previous studies, this research will assess the Aforementioned factors using website rating variables, such as the global and Google rank, other traffic flow related measures of the medical websites, as well as functional aspects of their operation, such as the offering of medical web-based services, rather than focusing on subjective assessments of the quality of the information they provide.

The first step to achieve the aims of this study was the formation of a sample of the population of the Anglophone medical websites that belong to different categories and have as targeted audience people with different needs and/or conditions. Each medical website in the sample was visited and data was collected, including variables such as the traffic rank of the websites, the interactive services they offer to user/patients or medical practitioners, the nature of the organization that supports them, the time-span during which they have been/were online, their activity in social networks, the web presence of any kind of certification awarded from well-known organizations, the number of unique visits that they receive as well as the number of other websites linked to them. Following the sample formation, statistical methods were implemented to examine the basic characteristic of the sample in order to extract useful knowledge and insights regarding the population of the medical websites.

In this research, the various variables were coded and analysed with the use of statistical methods. First sample’s medical websites are firstly ranked according to their global rank, and the higher and the lower ranked medical websites are compared, in order to identify the characteristics/features that have high relevance and can be considered as factors that affect the grade of excellence and the sustainability/survivability of the medical web websites. The impact of these factors is then assessed, using statistical methods and more specific regression models. The websites will be ranked then once again, according to the factors that have the greatest influence on their success. Two taxonomies are formed: one with the “highest ranked” and the other with the “lowest ranked websites”. The same feature selection process and the methodological steps followed to form a regression model were used also in order to select and examine the impact that some variables can have on the frequency with which the websites appear in search engines, on the time that the users tend to spend on the medical website, and on the offering of interactive medical web-based services as other factors of excellence. Finally, after the factors of excellence were assessed, an assessment of the factors that enhance the survivability of the medical websites based on the above methodological structure was also conducted.



The interpretation of the results will follow the data analysis and the results will be presented in the concluding remarks alongside with a comparison of the “highest ranked” and “lowest ranked” ranked websites in order to examine the specific characteristics that the most successful medical websites will have compared to the less successful ones, to identify the factors of excellence and the parameters that can influence the survivability and sustainability of the medical websites.

15 Sample Formation


The data collection process is a vital component in order to address the aims of this research work, in order to identify of the factors that enhance the success and survivability of the medical websites. A first sample of about 500 medical websites was formed using:

  • Keywords like “medical websites”, “symptoms and conditions”, “online doctor”, “medical resources”, “symptom checker”, “online medical appointment”, “ask a doctor online” and “drugs and interactions” in various search engines (Google.com, Yahoo.com, Ask.com).

  • Past qualitative and quantitative studies that used popular medical websites.

  • Lists of medical websites that were sourced from the recommendation or affiliation sections of other medical websites.

In a closer examination of this first sample, hyperlinks that were leading to websites providing content irrelevant to healthcare interventions and general medical practices, were excluded, after careful investigation using Internet archiving tools, like the “Internet Archiving WayBack Machine”, in order to examine if in the past these domains were hosting medical content that could be used for the purpose of this research. Moreover, duplicate links or links that were leading to the same domain as well as websites and links that were not archived or were unable to be accessed were also excluded from the sample, since they couldn’t offer any useful piece of information. The final sample numbers 316 medical website links and is considered an adequate sample to derive useful and easily generalised conclusions for the population of the medical websites.




The Internet Archive is a non-profit organization that was founded with the intention to build an Internet library in order to preserve the “archaeology” of the Internet and preserve the value of the information that it stores from permanent loss as the years pass. The main purpose of their main tool, the “WayBack Machine”, is to provide access for researchers, historians, scholars, analysts and the general public to historical data and webpage historical past views. The organization was founded in 1996 and is supported by receiving data and donations from various organizations related to Internet use and service offering (Internet Archive, accessed 10/12/2011).



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