Ramifications of Web-Based Health Assessment Tools on Consumer Behaviors and Health Outcomes

By Susan Dorfman
A Dissertation Completed in Fulfillment of the Requirements for the Degree Doctor of Health Administration

Web-based health assessment tools can be defined as electronic interfaces that enable consumers to assess and diagnose medical conditions based on identified symptoms without the involvement of a health care professional. Potential health assessment sources include websites with automated modules that prompt users to enter information about symptoms, yielding possible conditions as a result; informational sites that describe symptoms associated with medical conditions; and consumer blogs that promote discussion of symptoms and conditions without the electronic presence or oversight of medical personnel. Tools such as these are common on the Internet, making self-diagnosis easier than ever before.

With a growing number of consumers using the Internet to self-diagnose and decide which symptoms require consultations with medical personnel, it becomes increasingly more difficult for medical leaders to assure a safe and quality health care environment. Health behaviors constitute health-related actions impacting one’s health status. Social learning theory states that the chance a person will engage in particular behaviors is a result of that person’s anticipation that such actions will generate specific outcomes as well as the perceived value of the resulting reinforcement. Health-related websites continue to expand consumer access to medical information once only available to physicians. As a result, there is a need to improve understanding of the ramifications that web-based health assessment tools have on consumer health behaviors and outcomes and develop a recommended plan that incorporates the use of such tools into quality health management. By meeting the needs of consumers, providers, and health care leaders, everyone will benefit.

A panel of health care experts was requested to participate in a qualitative Delphi study to reach a consensus on potential health benefits and risks of web-based consumer health assessment tools as well as provide recommendations for safe and effective use of such tools. The primary purpose of the study was to explore expert opinions, values, perceptions, and feelings of health care providers about future ramifications of web-based health assessment tools including potential health benefits and risks that such tools can have on patient health behaviors and health outcomes. Additionally, the study was conducted to explore recommendations for best practices in incorporating web-based health assessment tools into quality health insight, care, and continuing health management.