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The objective of this paper is twofold: first to determine to what extent Spanish public hospitals are using their web sites to provide useful information to users and to improve hospital‐patient relationships, and second to determine which factors have an influence on web site adoption and level of development over time.

The web sites of public hospitals were searched for and analysed in 2005 and 2008. Their contents and features were scored using an 86‐item checklist. Several hypotheses were proposed regarding the influence of internal and external factors on web site adoption and level of development. Logit and linear regressions were conducted to test the proposed hypotheses.

Half of the Spanish public hospitals do not have a web site. The hospital web sites were acceptable in the information dimension but should improve their interactive features, as well as their navigation and usability. No significant improvements were observed during the period analysed. The size of the hospitals was a determining factor for web site adoption and level of development in both years. However, from 2005 to 2008, external factors – in particular internet penetration – became a significant factor to explain the adoption and level of development of web sites.

Citizens are increasingly relying on the internet to search for health‐related information. Hospital managers should exploit the advantages of implementing and properly developing a web site in order to improve the patient‐care provider relationships and offer citizens reliable information about healthcare.

To date, no empirical study has analysed the factors that influence the implementation of hospital web sites or the evolution of their contents and quality over time.

Healthcare is becoming an important part of people's online content consumption, with people searching for information on diseases or medical problems, treatments or procedures, particular doctors or hospitals, or about parking. This paper aims to investigate what users deem essential on patient‐oriented interactive e‐health tools on hospital web sites.

The findings are based on 242 patients/users from diverse backgrounds in a purposive sample. A modified Delphi technique was used in two rounds of survey to collect and analyze data.

The respondents highly desire core‐business tools, especially access to medical records and lab results, while discounting hospitals' efforts to connect to social media. Hospitals' e‐health implementation on their web sites has greatly lagged behind the users' needs for interacting with hospitals online. It is concluded that, while continuing to provide traditional functional tools, hospitals should expedite their development in providing core e‐business tools and emerging functional tools in order to accomplish multiple objectives, including service, education, and marketing.

Hospitals' e‐health development efforts have been behind the users' expectations at large. Future research should explore whether such lagging has resulted mainly from the lack of technical know‐how, lack of funding, and/or lack of vision on the administrative level.

The paper provides solid empirical evidence for US hospitals to (re)consider how to prioritize their efforts in implementing e‐health online so as to build a user‐centric web site.

Most US hospitals have implemented some form of e‐health online to serve their patients/users, but rarely have researchers studied such efforts. As a result, hospitals have had little evidence to gauge their implementation success. This is the first empirical study that investigates from the patient/user perspective the usefulness of various interactive e‐health tools online.

The purpose of this paper is to examine the adoption of videos on US hospital web sites in an attempt to find out how this new medium had been used by hospitals for marketing purposes.

Based on a systematic probability sample of the 6,456 US hospital web sites, a content analysis is conducted to measure the effects that hospital service quality, hospital size, hospital affiliation, and geographic population had on the diffusion of online videos.

The paper has found that, although the critical mass for using videos on hospital web sites has been reached, for the overwhelming majority of the hospitals, including those that are already using videos, there is still a long way to go in learning how to harness the power of video for marketing and to make videos an integral and routine part of their marketing strategy.

Further studies need to be conducted to uncover hospitals' attitudes and users' attitudes toward new media adoption on hospital web sites for presenting healthcare information.

The paper gives readers an overview of the current state of hospitals' efforts in adopting new media for marketing and can greatly help hospitals better position their marketing strategies to serve their patients, communities, and hospital staff, and invest in the right technology and new recruits.

The literature search indicates that this is the first study of its kind that has attempted to find out how hospitals have taken advantage of video, a salient Web 2.0 phenomenon, to present healthcare information on their web sites as a marketing strategy.

The purpose of this paper is to propose and empirically test a theoretical model that considers the predictors of an individual’s perceptions of information privacy, and also how it relates to his/her behavioral intention toward approaching hospital web sites.

This paper collects data using survey methodology. A total of 331 usable participants are gathered and analyzed via structural equation modeling.

Significant predictors of information privacy concerns include a stated online privacy policy and a hospital’s reputation. Further, online privacy policy predicts a hospital’s reputation. Finally, hospital reputation and information privacy concerns significantly predict an individual’s behavioral intention toward approaching hospital web sites.

The study confirmed that an online privacy policy and reputation can effectively alleviate specific information privacy concerns; therefore, this may indicate that these two factors should be considered whenever investigating individuals’ information privacy concerns.

To acquire a good reputation and to diminish individuals’ information privacy concerns toward hospital web sites, hospitals should pay attention to the posting of an online privacy policy and communicating such policies to given individuals.

This paper fulfils the gap of exploring the relationship among online privacy policy, organization reputation, and information privacy concerns. Further, the hypothesized model and its findings could also provide useful information for managers who are intent on boosting hospital web site usage frequency patterns.

While hospitals have done much over the last five years to push new media marketing, little research has been done to find out whether such endeavors are justified by users' healthcare online information consumption. This study attempts to find evidence for or against such endeavors.

Using the Delphi technique, this study investigated both users' healthcare video consumption behavior and their underlying rationales through three rounds of questions among 30 users of varied demographic backgrounds as a purposive sample.

Most participants did not watch videos hospital web sites because of their stereotypical understanding that hospital web sites provide no more than clerical information and because of videos' perceived inefficiency in delivering relevant and personalized information. However, most participants expressed their willingness to watch videos if the presentation is improved.

Although the Delphi technique is arguably the best approach when there is no defined population for sampling, a small sample may still be inadvertently biased toward the participants.

Hospitals need to make users aware of the abundant healthcare information in multimedia formats including video on their web sites, present the relevant content, and make such presentations easily digestible.

Hospitals' move into online new media marketing may help hospitals establish levels of trust with their online users comparable to the levels doctors currently enjoy and encourage consumers to visit hospital web sites as part of their healthcare decision‐making process.

For the very first time, this study has answered from the users' perspective and with evidential support the question whether hospitals' march into new media marketing is justified.

Commercial healthcare and hospital‐based web sites appear to exhibit distinctive formats. This paper aims to compare two award winning medical web sites with two top commercial healthcare web sites in an effort to determine significant predictors of positive attitudes toward the web sites when actively searching for healthcare information.

Three linear regressions were utilized to test the paper's hypotheses. Subjects entered a computer laboratory and were given search tasks for health information to complete within four web sites (two commercial and two hospital‐based web sites – order randomized).

The study shows how user perception, attitude and gratification are revealing of the strengths and weaknesses of hospital‐based vs commercial healthcare web sites as a means of providing users with healthcare information. Commercial healthcare web sites are viewed significantly more positively than hospital‐based web sites, revealing that overall web site quality and ease of use to be the dominant predictors of positive attitudes toward the web sites.

The ecological validity of using real web sites presents challenges in terms of controlling for alternative explanations stemming from within web site type. Future research could explore different tasks that can be facilitated by medical web sites and assess the attributes of the web sites accordingly.

The paper can help design and develop better hospital‐based and commercial healthcare web sites.

This research explored actual information search behavior and the resulting web site user perceptions in an effort to bring academic inquiry into practice. Nothing similar to the hypotheses or this methodology has been found within the web site effectiveness literature, neither generally nor specifically within the healthcare industry.

The first objective of this study is to examine the nature and extent of intellectual capital (IC) information Australian hospitals disclose to their stakeholders (patients, general public, healthcare professionals) via the internet. The second objective is to examine whether four hospital characteristics influence the disclosure of IC‐related information.

Analysis reported in this study is based on IC disclosures by 128 hospitals on their internet web sites. IC disclosure is measured using an 85‐item research constructed index that covers six major sub‐categories. Measurement of IC disclosure was conducted during a four month period in the last third of 2005.

It is found that whilst the incidence rate of hospitals disclosing IC information is high, the extent of IC disclosure is relatively low. The quantity of IC disclosure varied significantly between different IC sub‐categories. In addition, the paper investigates possible determinants of variations in IC disclosure by Australian hospitals. Specifically, it is found that the quantity of IC information disclosed on a hospital web site varied according to the state location, designation as a private or public hospital, whether the hospital is specialized or general in its operations, and if the hospital is based in a city or regional location. A hospital's designation as being network or non‐networked is not a significant determinant.

Few studies have examined the disclosure of IC information by healthcare providers such as hospitals. No studies, to the knowledge of the authors, have examined the specific disclosure of IC information by hospitals on their internet web sites.

Following the “Patient Quality and Safety Contract” launch by the Belgian Federal Authorities, Belgian hospital web sites were scrutinized. The aim of this paper is to assess the presence of some sort of quality management strategy within Belgian Acute Care Hospital digital external communications.

Digital communications were assessed using a pre‐established grid focusing on direct quality improvement testimonies, like a quality manager presence, a quality committee, a specific strategy, etc.

Two hypotheses explain the poor results: structured quality improvement exists in organizations but senior managers do not feel the need to transparently communicate the subject; and quality improvement does not exist in a sufficiently structured way to allow open communication.

The proposed Federal Contract should improve both quality initiative quality and frequency as well as transparent communication to healthcare workers and patients.

The paper underlines the urgent need for Belgian healthcare executives to be aware of structured quality management strategy's importance and to be eager to openly communicate the strategy.

This paper aims to describe evolution of a new public information web site, through evaluation‐refinement prototyping cycles.

An expanding range of participants is being engaged in formal evaluations as the site design evolves. The Flesch‐Kincaid Grade Level Score is applied to assess ease of reading in the wording used; the National Quality Forum guideline statements are applied to determine whether the prototyping design process is meeting performance expectations; and then Nielsen's heuristics are applied to evaluate ease of use of the latest prototype.

The page wordings started at a high reading grade level to be technically correct, with a strategy to progressively reduce levels without losing meaning. Reading level was reduced to an average of two and as much as six grades through editing between the third and fourth‐generation prototypes. None of the National Quality Forum principles were found missing from the development process. The prototype web site was ranked at the middle compared to official public web sites of seven other States' healthcare‐associated infection programs, some of which had been open to the public for more than a year. Many of the heuristic violations that weighed against the prototype were described as being minor and easily fixed. Collaboration between a State health department and a university to advance this evaluation‐refinement process was valuable to both parties, enhancing the ability to produce a new public information web site that is more likely to meet the needs of its intended audience.

In response to increasing expectations of transparency and accountability, a growing number of public web sites are displaying hospital performance data. Washington State's mandatory public reporting of healthcare‐associated infection rates is a recent example of this trend. The Department of Health is required by law to launch a public information web site by December 2009. The research was based on an evidence‐based approach to understand and meet the information needs of the public.

Although few studies have evaluated the usage and impact of hospital comparison web sites, these studies uniformly show relatively low usage and disappointing impact. Using the research literature, issues thought to account for poor usage and low impact, and developed design principles that address this poor past performance were identified. Throughout 2008 and 2009, successive prototypes were developed for the web site structure guided by those principles and refined each generation of prototype through focus group evaluations. This paper explains the approach, and summarizes results from the evaluations, leading to improvements before the final design first opens to the general public.

The purpose of this paper is to present research into the area of internet support for professional‐public communication through a deeper understanding of the role that a web site can provide in meeting the information needs of critically ill patients in intensive care units (ICUs). The communication between clinicians and members of the patient's family in the stressful ICU is modelled to give an integrated view of the situation and thereby allow for the incorporation of the views of all stakeholders on how the internet can meet this communication need.

The paper takes a broad, holistic, systemic approach that integrates the latest information and communications technology tools and processes with rich qualitative data from all stakeholder groups. The data are interpreted through the use of system dynamic modelling to visually conceptualise information flows and communication between clinicians and family members of patients.

The paper conceptualises, visualises and simulates the communication that takes place in complex stressful settings, such as, in ICUs thereby increasing the understanding of web‐support for professional‐public communication in the complex area of healthcare.

The broad approach of the paper has sacrificed, detailed and in depth analysis of all aspects of this issue which would require a much more extensive study.

The results have been of practical value to those developing a particular ICU web site and thus could inform others.

In addition to the findings, this paper is innovative in the way systems dynamics is used to model information flows. The results demonstrate the value of this technique for visualising and manipulating entire systems of this kind.