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

16Variable Formation

The variables that formed the final dataset were chosen according to the rating/evaluation variables that were used in the extant literature for the evaluation of the medical websites and according to the scope of this research. Through the study of past literature, we identified the need to include variables concerning the certification of the websites, their loading time, the offering of interactive services, and their rank estimation based on various measurements, like their traffic flow on specific time interval (daily, monthly, weekly), and their reputation among the Internet users. These variables were considered core to the success and survivability of medical websites, since they can affect the user experience, the traffic, the popularity and in general, the excellence of the medical websites in order to produce valid and comprehensive research results. In contrast to the aims of the past research efforts, this research is not going to examine the user experience or the accuracy of the medical information provided on the World Wide Web. Instead, the presented research aims to examine the factors of success and the factors that lead to or enhance the survivability/and sustainability of medical websites from a business-oriented point of view, rather than focusing on subjective assessments of the quality of the information they provide.

Moreover, variables were formed to represent the current status of the medical websites (online/offline), the offering of interactive medical applications from the medical websites, the category in which the website belongs to, according to its content, and the nature of the organization that provides and/or supports the website. Furthermore, variables were formed to reflect also the activity of the medical websites in social networks, the offering of blogs/forums and other forms of online communities, the disclosure of any kind of financial information about the organization supporting them, evidence of any kind of certification awarded to the medical website from well-known organizations, and finally the actors (patient/user, stakeholders, providers) for whom the offered information and services by the medical websites have value.

Furthermore, by implementing a search strategy using syntax commands on the Google search engine, it was possible to retrieve the number of websites of any kind that are/were linked to a given medical website in the sample (target website), or include links of the target website in their content or list of affiliations, or even cite content of the target website/websites. In addition to the above, using information from the Alexa the Web Information Company (http://www.alexa.com/, accessed on 10/1/2012), it was possible to collect data about the average three-month global traffic rank of the medical websites, their reputation among the users of the Alexa-tools, the country from which the website receives the most visits, the time that the users spent on the website, and the loading time of the website and the percentage of the websites that are faster or have the loading same speed with the target website, the websites that the users visit before and after the target website, as well as the fraction of the total Internet users that have visited the website (three-month average) and the fraction of the visits to the medical website referred to from search engines. In addition to this, by using Web Rank SEO (Search Engine Optimization) tool provided as add-ons by Google for the Google Chrome Web Browser it was possible to enhance the estimation of the medical websites’ lifespan, previously estimated using WayBack machine, and also estimate the Google Rank and the “Facebook Likes” for the medical websites in the sample.

Table : Chosen variables and their classification

The variable “Medical Web-Based Services” refers to the offering of user-interactive applications embedded on the medical website, enabling the users to book online appointments, search for health conditions that match their potential symptoms, search drug interactions, post a question to or have a live chat session with a relevant medical specialist/practitioner, locate medical facilities and doctors in close proximity of their location, and use various healthcare index calculators such as body mass index and optimal weight calculators (BMI calculators) or even online mood diaries for psychological assessment or special online diaries for specific medications and/or healthcare conditions. Moreover the “Ask a Doctor Online”, “Find a doctor/local care”, “Drug/ symptom checker” and “Other web medical services” variables refer to the kind medical web-based services /services that might be offered by the medical websites to its users either for a fee or without any monetary charge.

The “Category in which the medical website belongs to” variable categorizes the medical websites in categories according to their content. During the process of the data collection for this specific variable, medical websites where found to have content related to:

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  general healthcare issues and advices to improve health and physical condition, thus these medical websites where categorised under the “General Health/ Wellbeing” subcategory
  
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  medical specialists’ articles on healthcare issues, care advices and effective treatments for the children or the elderly people, thus the medical websites having this kind of content where categorised under the “Senior/Children Health” subcategory
  
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  specific healthcare issues like long-term diseases or serious and life-threatening conditions, thus these medical websites where categorised under the “Specific health issue” subcategory
  
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  the promotion of medical products, commercial services and medical devices, thus these medical websites where categorised under the “Medical Products” subcategory
  
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  the offering of access to medical databases, libraries and journal archives, thus these medical websites where categorised under the “Medical Resources” subcategory
  
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  medical courses and educational material, thus these medical websites where categorised under the “Medical Education” subcategory
  
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  drug identification and efficiency, thus these medical websites where categorised under the “Drug Information” subcategory.
  

Furthermore, the “Social Network” variable provides the active web presence and web 3.0 activity of the medical website on social networks such as Facebook, Twitter, while the “Facebook Likes” variable completes the set of this investigation by measuring how many Internet/social network users have accessed the profile of these medical websites on Facebook (which is the most popular and widespread social network) and provided them their ethical support.

Finally, the rest of the variables referring to the time the users tend to spend on the medical website, the fraction of visits to the website that are referred from search engines, the loading time of the medical websites, as well as the percentage of the Internet websites that are having faster loading time than the target medical website.