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By Anne Federwisch, OTR
Illustration: Photodisc
May 27, 1999

With an estimated 60 million Americans flocking to the Web each year to find healthcare information, patient education has truly gone high-tech. But observers say that instead of usurping nurses' traditional role in patient education, technology can enhance their teaching.

"Nursing is about information and the transmission of that information from professional to healthcare consumer," said Carol Bickford, MS, RN, a certified informatics nurse and senior policy fellow in the department of practice for the American Nurses Association. It's no different when that information comes via the Internet. "We just have a different medium."

Nurses can't ignore the growing influence of the Internet as a patient resource, Bickford said. "There's an increasing number of information resources on the Internet that provide far more current information than we're seeing in the literature," she said. To become Internet savvy, nurses don't need to be informatics specialists. They just need to learn to surf the Net, she said.

Where are patients going?

According to a recent Louis Harris & Associates poll, consumers don't always remember where they've surfed for health advice on the Web. But the sites they think they go to most often include medical organization sites (40 percent), patient advocacy groups (32 percent), pharmaceutical companies (20 percent), and hospitals (16 percent).

"The public frequently is looking for good, authoritative, reliable health information on a specific disease," said Bob Mehnert, a spokesperson for the National Library of Medicine. The NLM hosts a bibliographic database of health-related journal articles called MEDLINE on its Web site, www.nlm.nih.gov. The number of MEDLINE searches has grown from 7 million a year at the beginning of 1998 to 175 million currently. Consumers initiate approximately one-third of those searches, Mehnert said.

Last October, the NLM unveiled MEDLINEplus (www.nlm.nih.gov/medlineplus) for consumers. In addition to providing access to MEDLINE, the site includes health topics, dictionaries, links to consumer organizations, and hospital directories. "Our feeling is that the more good information we make accessible to the public, the better it is," Mehnert said. The NLM has also instigated training programs for librarians to help the general public in medical searches on the Internet.

Reasons they're surfing

The Internet offers several advantages over conventional patient education brochures, Bickford said. Searching electronically is often more efficient and effective than scanning books or documents. Interactivity and links between Web documents allow more individualized learning, too. "You can't do such exciting things with a three-page pamphlet," she said.
Cyberspace also provides access to more in-depth materials than patients are usually given, said Lauren Spilsbury, RN, quality manager for MemorialCare in southern Los Angeles County. Most patient education materials are made very simple to appeal to a wide audience, she said. "Many patients have very inquiring minds," Spilsbury said. "They want more than fourth-grade-level patient education materials."

MemorialCare has its own Web site for patients (www.memorialcare.com), and deciding what goes on it is a team effort, Spilsbury said. Nurses, physical therapists, physicians, and other clinicians screen material for the Web.

The Internet provides more information than the typical hospital department can stock, Spilsbury said. "You can only buy so many books," she said. "When you get something that's a little unusual for your particular unit or your patient population, it's nice to be able to go [online] and be able to provide some education for your patients to help ease their minds."

Caveat surfer

Though the Internet offers advantages of accessibility and searchability, not everything people find on the Web is useful, cautioned Colleen Lindell, RN, co-author of Internet Medical & Health Searching & Sources Guidebook. "Patients find it easy to find information on the Internet," she said. But it's often tricky for them to interpret what they've discovered.

"Our job as healthcare providers is to help patients decipher the good from the bad," Lindell explained. "We've always done that; it's just been in print form."

But Kaiser spokesperson Kim Nguyen said it doesn’t make sense for every East Bay hospital to spend millions to meet earthquake standards when strategic alliances can be made.