Hospitals and health systems are playing increasingly important roles as care coordination hubs and consumer information sources. In particular, the accountable care organization (ACO) and medical home models promoted in the Affordable Care Act place hospitals at the center of many activities related to health information exchange. Therefore, it is important for these organizations to have effective websites, and the need for a social media presence to connect with consumers is growing quickly.
The purpose of this study is to assess the websites of hospitals and health systems on four dimensions: accessibility, content, marketing, and technology. In addition, an overall score is calculated to identify the top 25 hospital and health system websites. Specific website elements that healthcare managers can inspect visually are described for each dimension in the discussion section.
Generally, hospital and health system websites can be more effective from an end user's perspective. In particular, hospitals and health systems lagged on the accessibility scale that measures the education level required to understand the language used on a site. The scale also assesses the extent to which web pages are designed for ease of movement from page to page using embedded links. Given that healthcare consumers come from every demographic and stratum of society, it is important that user-friendliness be optimized for a broadly defined audience. Hospital and health system websites can also be improved on the technology scale, as many sites do not return clear descriptions of links to search engines such as Google and Bing that use webcrawlers to collect information.
For customers seeking information about a facility's services and quality, a hospital's home page is an important first point of contact in many instances (Alpay, Overberg, and Schonk 2007; Revere and Robinson 2010). As a result, tire website for a health facility or system has become an important tool for marketing the organization to current and potential customers, as well as to visitors accompanying a patient (Coile 2000; Randeree and Rao 2004). In instances when consumers are able to make a choice in the location and type of care they seek (e.g., elective surgery, maternity services), it is increasingly likely that information gathered from a health system's website plays a role in helping the customer decide which facility to use.
In 201 1, more than 80 percent of adults report using the Internet as a resource for healthcare decisions (Reid and Borycki 2011; Szokan 2011). However, many of them have difficulty understanding such information (Keselman, Browne, and Kaufman 2008), and people seeking information related to illness behave differently tiian those seeking wellness information (Weaver et al. 2010). Based on these trends, many health system websites have begun to include tools and information for patients and visitors that make navigating complex health encounters more user friendly and that create a positive organizational image (LaPenna 2009). In so doing, hospitals are increasingly seeking to take on the role of trusted adviser that is closely aligned with the ACO model (O'Donnell et al. 2011; Simborg 2010; Wen et al. 2010).
Customers' evaluations of a health system's website, and by extension their perceptions of the facility itself, will be based in part on comparisons to their experiences using other consumer websites such as Amazon and eBay (Liang and Chen 2009). If a hospital's website does not conform to or exceed a customer's expectations based on those previous experiences, customers may make inferences about facility quality that may negatively influence their decisionmaking process.
The competitive advantage gained from building an effective web presence has led researchers to establish accessibility, content, marketing, and technical standards that define best demonstrated practices in website design (Oermann, Lesley, and VanderWal 2005; Oermann, Lowery, and Thornley 2003; Oermann and Mclnerney 2007) based on the application and adaptation of Health Information Technology Institute criteria for healthcare websites, including credibility, content, disclosure, links, design, interactivity, and caveats. …