Papers in PDF format

Proliferation of unattributable and unchallenged assertions: A statement such as, “Mayo Clinic
has approved this treatment,” will often go unchallenged, because an appropriate Mayo Clinic official is
unlikely to see it, and its originator may be difficult to identify, contact or hold responsible for accuracy.
Increased recipient expectations: The availability of “information on demand,” sorted and
classified various ways by search engines and subject trees, increases user expectations about the accuracy,
completeness and timeliness of information found. Even blatantly-commercial sites sometimes appear
more objective than they really are, due to a novelty factor and cross-links from more reputable sites.
Instant gratification for skilled information seekers: Within seconds on the Web, one can identify
the chemical formula of a drug, specific indications and side effects, arguments for and against its use, and
the results of recent clinical trials. A differential diagnosis, based on symptoms and a search engine, can
be obtained in less time than it takes to dial a doctor’s office and speak with a nurse.
Link between experience and usage: The extent and nature of users’ knowledge of medicine and
the Web affects the type of search conducted, which, in turn helps determine the degree to which
information is verified and acted on, if at all. Content providers thus must consider the advantages of
greater control over the search process. Except for limited-access professional societies, organizations do
not generally group information by specificity or required sophistication. However, the speed and
accuracy with which specific information is accessible largely depends on the expertise of the searcher,
and the learning curve is steeper for those easily frustrated with “dead ends.” Thus, the development and
use of software which records mouse clicks, text selections, and pages viewed, and offers increasinglyappropriate
selection options and questions to facilitate a user’s exploration is particularly relevant to
health information sites.
Ease of “broadband” transmission: The Web, IRC and Usenet allow a single individual to
simultaneously transmit a message to thousands of potential recipients and to successively and
unpredictably reach thousands more, who in turn may transmit information secondarily through
“rebroadcast” and/or personal contact.
Meta-awareness of information: The Web, spanning ancient texts to “real-time” updates,
encourages “meta-awareness” of health care and many other societal issues. That is, it stores and offers
parallel information about both health care products and their existence as products. The ability to view
simultaneously material designed for the lay public and medical professionals accelerates meta-awareness.
The Web’s medical strands will ultimately be judged by their relationship to the people,
procedures, policies and politics which affect, or seek to affect, users’ health status or organization. A
tighter weave between information about care and the care itself will maximize the Web’s benefits.