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How do Medical Professionals

Find Accurate, Trusted Health Information Online?

Rob Styles Jeremy Walker Nicole Chalmers Charles Care
the medical search the medical search the medical search the medical search


Medical professionals rely on accurate, trusted information much of which is found, and consumed, online. Little research has
been done into the behaviour of those involved in healthcare when looking for and assessing healthcare information online.
This paper reports the findings of a survey of 313 medical professionals, medical students and non-medical professionals
working in a health context.


Healthcare Professionals, Medical Professionals, Healthcare, Medicine, Health Information, Health Informatics, Search,
Discovery, Provenance, Web, Internet, Online.

1. Introduction additional analysis.

The survey, How Do You Find Health Information

Online, ran from 15 August 2014 until 31 August 2014 as Q1 Role
a web-based survey. It was promoted via targeted emails Respondents were asked to self-report their role or job
to medical professionals and via the Facebook and Twitter title. 85% of respondents completed this information with
social networks. In total 412 responses were submitted. a recognisable role. 15% of respondents either provided
Some of these were discarded as they contained no no information or provided information that could not be
answers and others as the respondent reported no construed as a role.
connection to the medical profession. After qualification
there were 313 suitable responses from 49 countries. The reported roles were then grouped 5 high-level
categories for broad analysis and reporting. These 5
2. Qualifying and Context Questions groups are shown in Table 1.
The first 6 questions of the survey were used to
understand the context of the respondent, including
nationality, language and role. These context questions
allow for the survey to be filtered and analysed on these
axes. The qualifying questions are included in the
supporting data for this paper to allow others to provide

Copyright © 2014, the medical search

This paper is research conducted by the medical search
and can be found at

Figure 1 — Respondents by group

This work is licensed under a Creative Commons The five high-level roles of Medical Professional,
Attribution 4.0 International License. Medical Student, Unknown, Educator and Non-Medical

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Professional are used to split reporting of answers to the Q4 Country of Residence
remaining questions.
Respondents to the survey were asked to report their
country of residence. The largest country represented is
Q2 Age the UK, with 51% of respondents stating UK residence.
Respondents were asked to give their age. This is useful The US and India account for 5% of respondents each and
in indicating potential career position, experience and also Egypt and Pakistan account for 4% each. The remaining
has implications for behaviour. We have not analysed responses come from 44 further countries. The sample
reported behaviours by age and the data is available for size for each of the remaining countries is very small with
those who would wish to do this. just one or two respondents. We must be cautious to draw
conclusions and have worked mostly with the data in
The distribution of age reported by respondents shows an aggregate as a result.
expected spread, with students featuring in the 18-29-age
range and medical professionals covering the ages above Countries represented in the 313 qualifying responses are
that. Afghanistan, Australia, Bahrain, Brazil, Brunei, Canada,
Catalonia, China, Congo, Democratic Republic of the,
Egypt, Estonia, Ghana, Greece, Hong Kong, Hungary,
India, Indonesia, Ireland, Italy, Japan, Jordan, Kenya,
Macedonia, Malaysia, Mozambique, Netherlands,
Netherlands Antilles, New Zealand, Nigeria, Pakistan,
Peru, Portugal, Qatar, Saudi Arabia, Slovenia,
Somaliland, South Africa, Spain, Sudan, Switzerland,
Tanzania, Thailand, Trinidad and Tobago, Turkey, USA,
United Arab Emirates, United Kingdom, Uzbekistan, and
Figure 2 — Distribution of Respondent's Ages

Q3 Language

Respondents reported reading regularly in 36 different

languages. 95% of respondents read regularly in English
despite only 55% living in the UK or US (see Q4). This
result will also have been affected by the promotional
activity for the survey, and the survey itself, being in

Figure 4 — Countries of residence

Figure 3 — Languages read most often by respondents

Q5 Working Style
A more useful consideration is that the variety of
languages used suggests the survey achieved a good level Respondents were asked if they work on their own or as
of diversity in the non-UK/US 45% of respondents. part of a team. Medical professionals generally work as
part of a team (84%), while medical students are more
split with 57% working on their own. Analysis to
understand correlation with more detailed role (Q1) or

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country (Q4) may provide further insight but has not been Figure 7 shows that our respondents overwhelmingly have
performed as part of this work. internet access at work. Educators all have access, and
almost all medical professionals have access.

Grouping by country shows a slightly different picture —

that our respondents almost all have internet access at
work regardless of the country they are in. Figure 8 —
Internet access by country shows this clearly. Number of
respondents has been shown on this chart to indicate the
Figure 5 — Team working by group small sample sizes involved.

Q6 Patient Contact Internet access at work for medical professionals around

the globe is extremely encouraging for anyone
The majority of respondents spend at least half their
considering the ability of medical professionals to
working time directly with patients (68%), higher when
network, learn and reference critical information in a
considering only medical professional (80%) and lower
timely way.
when considering students (61%).

Figure 6 — Percentage respondents working time with patients

A minority of respondents had no direct contact with Figure 8 — Internet access by country
patients (23%). Lower when considering only medical Q7 also asked about the device used to access the internet
professionals (16%). Of note is that even those we while at work, distinguishing between computers and
consider non-medical professionals, more than half work mobile devices — tablets or smartphones.
directly with patients.
Use of mobile devices is high across all of the respondent
3. Quality and Method of Internet Access groups (65%), highest as a proportion amongst educators
(83%) and a majority of medical professionals (67%) and
Q7 Access and Device students (67%).

Respondents were asked a dual-axis question used to

indicate how they access the internet while at work. This
is analysed in two ways: what percentage have internet
access at work; of those who have internet access what
kind of device is used.

Figure 9 — Internet access devices by group

For those building information access solutions for
medical professionals this suggests that mobile
compatibility, if not a mobile-first strategy, will be
essential to adoption.
Figure 7 — percentage internet access by group

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Q8 Quality of access parts C — The internet access I have at work is outdated

Q8 is broken down into a number of parts, each a question Asked in a related way, in reverse, we maintain a similar
in it’s own right. The respondents are asked to record their outcome. A significant 1/3 minority agree that their
agreement with a statement, choosing from strongly internet access at work is outdated (33%) with just over
disagree, disagree, neither agree nor disagree, agree, and half disagreeing (51%).
strongly agree. Respondents may choose not to answer. A
number of the statements form re-phrased pairs.

Statements a, b, c, d, f, and h cover the quality of internet

access a respondent has at work.

A — The internet access I have at work is excellent

A majority of respondents feel the level of internet access

they have at work is excellent (59%) while a substantial Figure 12 — The internet access I have at work is outdated
minority do not (27%). No significant variance is seen in
The large minority of medical professionals and non-
this between the groups. As a similar percentage of the
medical staff working in healthcare that consider their
survey respondents are using their own mobile devices to
internet access to be outdated and failing to meet their
access the internet, presumably unhampered by corporate
needs is disappointing.
IT policy, this may be connected.

D — I can access all the sites I need

Figure 10 — The internet access I have at work is excellent

Figure 13 — I can access all the sites I need

B — The internet access I have at work meets my needs
Again, a significant minority (35%) of respondents
When asked if the internet at work met their needs a disagreed with the statements I can access all the sites I
slightly higher proportion agreed (65%) and a slightly need. Qualitative conversations with healthcare
lower number disagreed (23%). professionals following this survey suggest the
commonest issue here is corporate IT policy. This is
confirmed by related statements f and h.

Figure 11 — The internet access I have at work meets my needs

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F — Often a site I need is blocked through the internet E — It is easy to find the information I need online while
access I have at work at work

Surprisingly, given the dominance of Google, one-fifth of

respondents (21%) disagreed with this statement. Two-
thirds agreed (65%). Combined with later statements we
can see that providers of medical information still have
much work to do in making the information readily

Figure 14 — Often a site I need is blocked through the internet

access I have at work
Consistent with the responses for statement d, more than
one-third of respondents (36%) experience that sites they
need are blocked at work.

H — I have to use my internet at home to use some sites

Figure 16 — It is easy to find the information I need online
Asking the question in a broader phrasing gives an even while at work.
stronger signal with a majority of respondents (62%)
agreeing with the statement I have to use my internet at G — All the health information I need is on Google
home to use some sites. The increase here may be due to
an omission in the statement — other statements refer to
sites I need implying strongly that the statement refers to
health information sources. This statement could be
interpreted more broadly to include all sites, including
social networks and other sites some would consider
legitimately blocked. Qualitative conversations with
medical professionals lead us to believe this wasn’t a
significant factor and that the phrasing of this statement Figure 17 — All the health information I need is on Google
simply elicits a more complete picture of limited access
Almost half of respondents (48%) disagreed with this
for medical professionals.
statement confirming that, while Google is good, it fails to
meet all of the needs of medical professionals. Only one-
third of respondents agreed with this statement.

Disagreement was similar for medical professionals and

medical students. There was a significant difference for
educators who disagreed (83%) and non-medical
respondents (27%). This indicates that Google serves non-
medical personnel better than medical professionals.
Google is not able to completely meet the needs of four-
Figure 15 — I have to use my internet at home to use some sites
fifths of educators.
4. Ease of Discovery of Trusted Health Information
I — Google gives me great results for medical searches

Half of respondents agreed with this statement (50%), just

less than two-fifths disagreed, with the remaining third

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W — I know how to find trusted, up-to-date health
information online

Later in the survey respondents were asked a broader

variation of statement j where find it easy is replaced with
know how.

Figure 18 — Google gives me great results for medical searches

The large undecided response, along with the low
responses strongly agreeing or strongly disagreeing,
suggests that the statement involved a complex response
process amongst participants.

Qualitative questioning of a small sample of medical Figure 20 — I know how to find trusted, up-to-date health
professionals suggests that the tension in the statement is information online
caused by the lack of coverage reported in statement g. In this variant of the question, agreement increase from
That is, Google produces very good search results over three-fifths (61%) to three-quarters (74%), and
the content that it has indexed, yet does not index all the disagreement decrease from one-sixth (15%) to around
information medical professionals need. This dichotomy one-eighth (12%).
of good, but incomplete, search results is what we believe
explains the responses to this statement. This suggests that, the process of finding trusted, up-to-
date, accurate health information is understood by most,
J — I find it easy to find accurate, up-to-date, trusted but not necessarily considered easy.
K — I can easily assess how trustworthy online
Three-fifths of respondents agreed with this. Superficially
information is
this seems to contradict the responses to statements g and
i yet read in combination with later statements, s and t, on Being able to assess if content found online is trustworthy
behaviour can be understood. or not is fundamental to being able to use that information
to inform patient treatment. One-in-five (20%)
respondents are not able to easily assess how trustworthy
the information they find really is.

Figure 19 — I find it easy to find accurate, up-to-date, trusted

A fair explanation would that healthcare professionals feel
able to find trusted, accurate information online by Figure 21 — I can easily assess how trustworthy online
directly visiting a small number of sites they have learnt information is

to trust. Three-fifths agree here (61%) while around one- Three-fifths of respondents (57%) are able to easily assess
sixth disagreed (15%) how trustworthy the information is. This may be related to
the behaviour of visiting known, trustworthy, sites.

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L — I rely on subscription sites that do not appear in T — I look for health information by going to specific
Google sites (e.g. Pubmed, UpToDate, WebMD)

With many medical sites, journals in particular, being

behind pay-walls, this statement was expected to elicit
overall agreement. Only one quarter (25%) of respondents
agreed with this statement and almost half (48%)
disagreed. Qualitative research to understand this result
would be beneficial but we have not done this yet.

Figure 24 — I look for health information by going to specific

sites (e.g. Pubmed, UpToDate, WebMD)
A significantly higher proportion, four-fifths (86%) of
respondents report going to specific sites to look for the
information they need, with just one-in-ten (9%) not
doing this. A significant response (37%) strongly agreed.

Figure 22 — I rely on subscription sites that do not appear in

S & t combined
When we consider responses to statements s and t in
S — I search for health information using a mainstream combination we see a strong correlation between the two
search (e.g. Google or Bing) questions. This indicates that for the majority of
respondents use mainstream search engines and go to
With the capabilities of mainstream engines, Google in
specific sites directly; employing both strategies.
particular, it is no surprise that almost three-quarters
(72%) of respondents use a mainstream search engine to
find health information. A slightly higher proportion of
students (76%) and non-medical respondents (80%) use
mainstream search engines.

Figure 25 — Statements s and t combined

5. Types of information searched for online

Figure 23 — I search for health information using a mainstream
search engine (e.g. Google or Bing)
M — I often look up drug dosages and/or interactions

Three-fifths (62%) of medical professional responding

agreed that they often look up drug dosage and/or
interactions online. One quarter of medical professionals
do not report this behaviour.

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P — I read detailed research into conditions and
treatments online

Figure 26 — I often lookup drug dosages and/or interaction

The lowest agreement was amongst non-medical
Figure 29 — I read detailed research into conditions and
respondents where less than of respondents (45%) agreed treatments online
with statement m.
Three quarters of our respondents read detailed research
online (75%) with more than one quarter (27%) agreeing
N — I refer to clinical guidelines online strongly. One-in-ten (12%) disagreed.
Agreement for this statement was strong across all groups
with four-fifths (81%) agreeing and only one-in-ten (10%) Q — I use the internet to find guidance to give to my
disagreeing. patients

Figure 30 — I use the internet to find guidance to give to my

Figure 27 — I refer to clinical guidelines online
Two-thirds (66%) of respondents reported using the
O — I sometimes lookup summaries of conditions online
internet to find patient guidance. When considering
responses to Q6 where one quarter of respondents
reported not working directly with patients this signal
may be stronger still.

Only one-sixth of respondents disagreed suggesting that

some respondents do not have patients contact but do
search for patient guidance.

Figure 28 — I sometimes lookup summaries of conditions online

The strongest agreement on our types of content, nearly
nine-tenths (87%) look up summaries of conditions online
while only one-in-twenty (5%) do not.

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R — I subscribe to online journals

Figure 33 — My colleagues share health information they find

online with me
Figure 31 — I subscribe to online journals
Our respondents report that they share more than they
More than half (55%) of respondents report subscribing to receive.
online journals. Medical professionals are slightly lower
than the overall average (53%) with the highest subscriber
group being non-medical respondents (69%).

A quarter (26%) of medical professionals do not subscribe

to online journals.

6. Sharing of information found online

U — I share health information I find online with


Figure 32 — I share health information I find online with

Three quarters (72%) of respondents report that they share
information they find online with colleagues. Only one-
in-ten respondents report not sharing.

V — My colleagues share health information they find

online with me

Two-thirds (67%) of respondents report that their

colleagues share content with them. This figure is lower
than the response to statement u.

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7. Referenced Sites

Respondents listed a total of 172 sites they felt were important to their use of health information online. This list included
some that we were unable to find under the name given or that have been discontinued (these are prefixed with ** in the table

The sites are a mix of reference sites, educational content, journals and professional bodies. Some cover quite wide areas of
medicine and others are focussed on a specialty. The sites are a mixture of open content, available for anyone to read and
closed, where users are required to sign-in. Some students reported “Athens” which we assume is shorthand for their
institutions journal access.

Further analysis of this list of sites to understand their scope, geographic relevance, and access policies would be valuable.

AAP Policy

ALIEM Academic Life in Emergency Medicine
Adjuvant! Online
AHA Australian Heart Association
Almost a Doctor
American Thoracic Society
AMH Australian Medicines Handbook
BJA Anaesthesia
The Aspergillus Website
** Athens
BMC BioMed Central
BMJ Clinical Evidence
BMJ Best Practice
BMJ Learning
BNF British National Formulary
British Journal of Anaesthesia
BSSH British Surgical Society of the Hand
School of Clinical Medicine, University of Cambridge
CDC Centers for Disease Control
NICE Clinical knowlegde summaries
ClinicalKey, Elsevier
Clinical Radiology (Journal)
The Cochrane Library
Cochrane Journal Club
Critical Care Reviews
DermNet NZ

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** DXS core
Medscape emedicine
EBSCO Health
emc Electronic Medicines Compendium
EMCrit Blog
EMIS web
eTG Electronic Therapeutic Guidelines
ERS European Respiratory Society
NICE Evidence Updates alerts/evidence-updates
NICE/NHS Evidence Search
** Expert Consult
** Facebook
First Word Pharma
FOAM Search
GINA Global Initiative for Asthma
CGHR Centre for Global Health Research
GMC General Medical Council
Google scholar
GP Notebook
RCOG Royal College of Obstetricians and
Gynaecologists "greentop" Guidelines
Harrison's Principles of Internal Medicine
The Healing Foundation
WHO HMN Health Metrics Network
HIV Drug Interactions
HSE Health and Safety Executive
iSEEK Medical
The JAMA Network
John Hopkins University
The Lancet
LITFL Life in The Fast Lane
** Local formulary
Mayo Clinic
McMaster PLUS
MD Consult
Measure Evaluation
University of Groningen Central Medical Library
Medical Teacher

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Medicines Complete
Medline plus
The Merck Manual
MJA The Medical Journal of Australia
MSH Management Sciences for Health
** msn
National Guidelines Clearinghouse
NCBI National Center for Biotechnology Information
NEJM The New England Journal of Medicine
NHS (Choices)
NHS Direct (now closed)
NICE bites
NICE CKS Clinical Knowledge Summaries
NICE Guidelines
NICE Pathways
NIH National Institutes of Health
BHIVA British HIV Association
BASHH British Association for Sexual Health and HIV
NJM The Netherlands Journal of Medicine
NLM National Library of Medicine
NORA The Neuro-Optometric Rehabilitation Association
NYSORA The New York School of Regional Anesthesia
OBG Management
The Society of Obstetric Medicine
Orthopedics Hyperguide
Oxford Handbooks Online
WHO PAHO Pan-American Health Organization
Pathfinder International Pro
The Pharmaceutical Journal

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Physical Therapy
PLOS Public Library of Science
NHS Predict
Radiology Assistant
RCGP Royal College of General Practitioners
RCP Royal College of Physicians
RCR Royal College of Radiologists
RCS Royal College of Surgeons of England
Royal College of Anaesthetists
Royal College of Psychiatrists
RSNA Radiological Society of North America
Sanford Guide
Science Direct
SIGN Scottish Intercollegiate Guidelines Network
Skyscape Medical Library
The Lancet
United Nation Population Fund
** Unity for Health
Rx List
European Association of Urology
Vietnam MOH
Web of Knowledge/Science
** webmed
WHO World Health Organization
WHO Hinari

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