The rise of online content control in healthcare

Anthony Staresinic, PharmD

Process of finding web pages and web page content on the internet using an internet search engine

Requires the web page creator to assign their web content with keywords or terms (tags or metadata) to allow search engines to locate the page when a searcher uses the same or similar terms

“understands exactly what you mean and gives you back exactly what you want.”

Larry Page, Google Co-founder

Affects only organic search results and n0t ‘paid’ or ‘sponsored’ results

Process of improving a website’s visibility to search engines through strategic organizing and programming of the web-page

Companies and consultants selling their ability to improve website rankings

http://www.buzzom.com/2009/09/google-continues-to-be-the-search-engine-leader-with-huge-margins/ Accessed on January 4, 2012.

Google is a publicly traded company that has a fiduciary responsibility first and foremost to it’s shareholders and increasing shareholder wealth

Health information is obviously an important category of information users are looking for. For this health search feature we decided to offer users one source each from a governmental health agency, a medical institution, and a commercial site. We’ll study how users like these choices and continue to iterate. None of these sites is paying any money to Google to be included in the feature. Google is 100% committed to ranking websites objectively to provide the most relevant information to users. Websites cannot pay for higher search rank.

Roni Zeiger of Google Health

http://e-patients.net/archives/2010/01/health-sites-some-are-more-equal-than-others.html. Accessed on January 4, 2012.

National library of medicine drug content is supplied by the American Society of Health System Pharmacists

http://sirensong.sireninteractive.com/search-engine-marketing/google-starts-editing-drug-results/ Accessed on January 4, 2012

Utilized a modified online crowd-sourcing approach Ambulatory PRN list from American College of Clinical

Pharmacy was solicited to participate in a standardized search experiment

Used the same search terms on the same day and roughly the same local time (topics chosen based on personal interest of researcher) warfarin

pradaxa prior authorization 18 individuals submitted results of their search All U.S. time zones represented in search exercise

http://www.youtube.com/watch?v=Buyub6vIG3Q Accessed on January 4, 2012.

National Library of Medicine result was always first

Wikipedia was always second

RxList was always third

Sponsored Ad was always the same

The link takes you to the Phillips patient self-testing One screen sh0t did not present any ads on top One screen shot presented an additional ad

Physicians Plus Insurance result was always first

Montana Medicaid was always second

Wellmark was always third

Sponsored Ad was always the same

One submission did not present any ads on top Another one presented an additional ad

Identical display of search results observed for both searched terms

Unintended consequences of altruistic intention in controlling first page results in healthcare information Lack of transparency in criteria for prioritizing content What site will be 4th, 5th, 6th and so on Hidden biases and conflicts in content providers Sharing of website analytics with third parties

Controlled display of first page results is controversial and remains unresolved