Review
Patients using the Internet to obtain health information: How this affects the patient–health professional relationship

https://doi.org/10.1016/j.pec.2005.10.006Get rights and content

Abstract

Objective

Health information is one of the most frequently sought topics on the Internet. A review of the literature was carried out to determine the use of the Internet for health information by the patient and how this could affect the patient–health professional relationship.

Methods

This study is a literature review, summarizing multiple empirical studies on a single subject and is not intended to be a meta-analysis.

Results

The review showed that the majority of health related Internet searches by patients are for specific medical conditions. They are carried out by the patient: (1) before the clinical encounter to seek information to manage their own healthcare independently and/or to decide whether they need professional help; (2) after the clinical encounter for reassurance or because of dissatisfaction with the amount of detailed information provided by the health professional during the encounter.

Conclusion

There has been a shift in the role of the patient from passive recipient to active consumer of health information. Health professionals are responding to the more ‘Internet informed’ patient in one or more of three ways: (1) the health professional feels threatened by the information the patient brings and responds defensively by asserting their ‘expert opinion’ (health professional-centred relationship). (2) The health professional and patient collaborate in obtaining and analysing the information (patient-centred relationship). (3) The health professional will guide patients to reliable health information websites (Internet prescription).

Practice implications

It is important that health professionals acknowledge patients’ search for knowledge, that they discuss the information offered by patients and guide them to reliable and accurate health websites. It is recommended that courses, such as ‘patient informatics’ are integrated in health professionals’ education.

Introduction

Health information is one of the most frequently sought topics on the Internet. Reuters [1] reported that on average 53% of Americans search the Internet for health information and, according to the Pew Internet and American Life Project [2], of the 63% of Americans who access the Internet (128 million people), 66% of these look for health and medical information. In the last decade, the percentage of adults who have accessed the Internet to look for health information has rapidly increased, especially in the United States of America. In 2002, 80% (110 million Americans) of all adults online in the United States were estimated to have looked for health information. This was an increase of 13 million users from 2001 and 50 million from 1998 [3]. Fox and Rainie [4] estimated that, at that time, Internet users could search as many as 10,000 medically related web sites.

With regards to Europe, a recent European Union (EU) Eurobarometer survey on online health information [5] found that, for Europeans, health professionals are still by far the main source of health information (45.3% of EU health population) followed by the traditional media, such as television (19.8%) and newspapers (7.4%). Nevertheless, on average, nearly a quarter of Europeans (23%) use the Internet to obtain health information (this varies between countries, for example, 40% in Denmark and the Netherlands and 15% or less in Greece, Spain and Portugal) and 41.5% of the people within the EU think that the Internet is a good way of obtaining health information [5].

Section snippets

Methods

This article is a review article, summarizing multiple empirical studies on a single subject, and is not intended to be a meta-analysis. To review the health application use of the Internet by patients, and how this could affect the patient–health professional relationship and communication, an Internet literature search was conducted on the following health electronic databases: PubMed, British Nursing Index, CINAHL, Ovid and AHMED using the terms ‘Internet’, ‘health information’,

The use of the Internet by patients and health professionals

Patients do not see the Internet as a replacement for the health professional. A study of 1322 British Internet users indicated that people go online after seeing the health professional for confirmation of the information given and to gather additional information [6]. However, female patients with breast cancer also turn to the Internet for health information if they become dissatisfied with the information provided to them by the health professionals and these information seekers tend to be

Discussion

Health professionals can respond to the more ‘Internet informed’ patient in three ways. In the first scenario, the relationship between health professional and patient becomes health professional-centred. Health professionals, especially those with poor information technology (IT) skills, may feel their medical authority being threatened by the information the patient brings and will respond defensively by asserting their ‘expert opinion’. They will use the short consultation to quickly and

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