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

28 Current Research Limitations

The main limitation of this study arose from the unavailability of data regarding the costs related to the operations of the medical websites and the reluctance of the administrator of these kind of websites to provide the researcher with the needed data in order this research to produce more accurate results. In order to overcome this issue and find the required data, the researcher instead of estimating the costs related to the medical websites’ operations evaluated the cost of acquiring and managing a medical website. As it was afore-mentioned, the researcher was able to calculate the cost of acquiring and managing a medical website by using WebRank SEO add on for Google Chrome Browser, relying on the accuracy of estimations of these sources.

Another limitation of this research is considered to be related with the estimation of the “Benefits” related to the medical websites. Since it was not possible to identify the profits that this kind of websites have, due to the lack of information and the reluctance of the medical websites’ administrators to provide such kind of information, the researcher in order to assess the “Benefits” of an investment in a medical website, to be used in the calculation of the CBA and ROI ratios, estimated the broader value of the use of these websites. This task was achieved by using the WTP approach in an online survey setting to explore the value that the consumers/users/patients think that the medical web-based services offered to them. The “benefits” from the use of medical websites’ services/web-based services are majorly intangible and cannot be accurately translated into comparable monetary unit. WTP online survey setting is aiming particularly in the identification and monetizing of these benefits offering a comparable to — the costs — value. The value that the consumers/users/patients are willing to pay for the use of these services is considered the only income of the medical website without taking into consideration other sources from which the medical website can generate income, such as revenues through advertising or sponsorship.

Moreover, other limitations of this study are related to the WTP survey itself. Although attempts were made to be completely unbiased the researcher cannot be totally sure if all biases were alleviated. The format of the study alleviated the major biases related to the WTP approach. The age and the level of education of the participant was biased due to the fact that the survey was spread majorly in universities although this was considered to have only a minor impact on the final results. In addition to this, due to the fact that the medical websites used in the sample are accessible through the Internet to people all over the world, case that applies also to the methods/networks used to spread the survey to the public, the researcher cannot be totally sure that all the people that completed the survey are living currently in the United Kingdom. As it was Aforementionedin the methodology section very tense attempts were made to isolate the survey spreading in people living in UK and it was achieved for the most of the participants.

Other limitations are due to the fact that the researcher was forced to rely on the sources’ accuracy of information. This might affected the accuracy of the traffic rank estimations of the medical websites, the duration of life of the medical websites, the time that users tend to spend on the medical websites as well as the number of the unique visits to each medical website. Although the data concerning the lifespan of the medical websites in some cases may be objective since WayBack machine launched in 1996 so there are no archiving data before that year and Google tools may present the lifespan of the domain rather than the specific period that the domain was hosting a medical website, this cases was considered small in number and not able to have a significant impact on the validity of the analysis’ outcomes. It is also important to mention that there was not possible to find the unique visits from the global Internet users but only for the users based on the USA region. Since the majority of the users of the medical websites in the sample were from USA we consider that this did not caused any significant loss of validity of the models that was applied in the following paragraphs.

Furthermore, the proposed evaluation framework mentioned in the methodology chapter, was formed based on economic and non-economic evaluation frameworks in order to reflect as many perspectives as possible. This might lead to confusions during the evaluation process. Additionally this framework needs to be tested and validated by applying it into various medical IT interventions, in order its impact on such a kind of evaluation processes to be identified and accurately measured.

To conclude, this research could achieve more accurate results if except from the time and resources restraints there were granted access to all the required data needed for the aims of this thesis and the WTP survey covered a greater percentage of the population.

29 Future Research Directions

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  Further research should be conducted towards the investigation of the success and failure factors of the medical websites, merging quantitative and qualitative data in a more extended sample in order to validate the results of the current research.
  
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  Willingness to Pay studies towards the use of the medical websites should be conducted in to various countries covering a more extensive sample of the population of the Internet users.
  
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  Further research could be carried out having access to the actual data from the medical websites and Ministries of Health in various countries.
  
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  This research did not go in depth in studying the technical aspects of information security as well as some other aspects, such as the legal acts and the ISO standards that guard and cover data protection and information security in information sharing in the medical websites field. Therefore, further research in this field will help to understand and develop information security strategies as well as to have a better view on the public’s preferences and requirements towards the medical websites.
  
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  The proposed evaluation framework needs to be tested and validated by adopting it in different evaluation processes, monitoring any changes that could happen, and investigating if it is having an a dramatic impact on improving the evaluation processes and the validity of their results.
  
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  Finally more research could be done on other telemedicine and e-health interventions and web-based services to investigate their importance and their impact towards the improvement of the efficiency and cost effectiveness of the healthcare systems as well as towards the societal “wellfarism”.