to "e-health" and "e-medicine." Internet-related ventures by the healthcare
industry are quickly transforming the delivery of healthcare and the practice
of medicine. Few industries have more to gain from the Internet revolution
than medicine. Rapid advancements in medical research, increasingly curious
and wired patients who shop the Web for medical information, and pressures
from managed care companies to contain costs while satisfying sophisticated
consumers are driving the move to the Web. By now, most information professionals
in the field have felt a significant impact, whether from an upswing in
health-related requests or in the way we disseminate search results to
end-user clients. This article will arm you with information about useful
Web sites, some of which you may only access occasionally and others that
may become "must-have" arrows in your quiver. It will focus particularly
on sites relating to pharmaceutical decisions by patients.
In a recent issue
of Searcher [Eva Perkins, "Healthcare Resources on the Internet,"
November/December 2000, vol. 8, no. 10, November-December 2000, pp. 53-57],
I reviewed a core collection of print and online resources. This overview
was followed by several key Web sites that have become widely used, the
likes of which savvy searchers should learn to use for general purposes.
This article will follow up with more specialized sites beginning with
the most useful site of all, MEDLINEplus [http://www.nlm.nih.gov/medlineplus],
a consumer-oriented version of MEDLINE. To illustrate the importance
of MEDLINE, consider this: There has been an increase in MEDLINE queries
from 7 million searches in 1997 to over 220 million per year and growing.
It is estimated that one-third of MEDLINE searches today come from consumers,
not to mention MEDLINEplus usage [Wood, Fred, "Public Library Consumer
Health Information Pilot Project," Bulletin of the Medical Library Association,
vol. 88, no. 4, October 2000, pp. 314-322].
Remember the big
splash former-Vice President Al Gore made when he called a press conference
in 1997 to publicize MEDLINE's availability on the Web — and at no cost?
In fact, Gore conducted the first MEDLINEsearch on the Net at the press
conference although I cannot tell you what he searched on (no jokes, please).
Since then, public interest in MEDLINE has skyrocketed as people came to
realize that they could use the authoritative source for medical,
dental, nursing, and psychiatric literature. Since then, the National Library
ofMedicine (NLM) launched the MEDLINEplus pilot project in 1998,
designed to increase public awareness of, and access to, health information
via the Internet. The pilot project involved 39 public library organizations
with more than 200 locations in nine states (Alabama, Georgia, Maryland,
New York, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia)
and the District of Columbia ["MEDLINEplus Press Release," Medical
Library Group of Southern California and Arizona Newsletter, vol. 31,
no. 2, January 1999, pp. 12-13].
Produced by the
NLM, MEDLINEplus is a large, authoritative database of information
on medicine, health, and wellness specifically designed for consumer use,
as opposed to the original and more highly technical MEDLINE. Unlike the
dot-com sites whose commercial nature may make some of their offered data
suspect, this site delivers credible information in an easily navigated,
user-friendly environment. It carries links to self-help groups, access
to National Institutes of Health consumer health information, clearinghouses,
health-related organizations, and clinical trial information.
Unlike the bibliographic
abstracts of Medline, MEDLINEplus is a full-text database offering
immediate usefulness. The directory feature of MEDLINEplus linking
to organizations and other resources represents a key departure from MEDLINE,
as is the inclusion of social issues such as divorce, addiction, and policy
aspects. Clearly, MEDLINEplus focuses on a consumer audience. The
largest body of information appears in the Health Topics section, with
a huge collection of publications from such agencies as the Centers for
Disease Control and Prevention (CDC), the Food and Drug Administration
(FDA), the National Institutes of Aging, of Cancer, of Mental Health, etc.
Each topic entry offers an overview article plus related articles about
symptoms, prognosis, treatment, and medication. Other articles focus on
population subgroups such as women, children, teens, Native Americans,
etc. At this time, Spanish is the only foreign language available, but
other languages will be added in time.
Besides the Health
Topics, one can access the United States Pharmacopoeia, consumer
edition, for drug information and the Health Illustrated Encyclopedia,
which is licensed from Adam.com, a producer of online and CD-ROM health
reference works. The United States Pharmacopoeia covers 9,000 prescription
and nonprescription drugs searchable by brand or generic name. Entries
are comprehensive and include dosage, contraindications, side effects,
etc. Although the Health Illustrated Encyclopedia duplicates information
provided elsewhere in the site, it has the advantages of numerous illustrations
and short, readable entries. Users should find the links to Web resources
such as doctors, hospitals, medical organizations and libraries, news sites,
and medical research databases equally useful.
arranged for browsing; queries are answered with a menu of choices: overview,
treatment, symptoms, implications for special populations, etc. Searching
is somewhat clumsy since one may only search the Health Topics section,
with the United States Pharmacopoeia and Health Illustrated Encyclopedia,
or in combination with the drug database. Thus, one cannot search
the drug database or encyclopedia alone, or Health Topics and the encyclopedia.
Apparently, some committee hit upon the set combinations as being the most
useful, but are they? If one opts for searching the combinations available,
one receives search results grouped by relevance ranking and not by source,
which can be annoying. In addition to greater flexibility in cross-searching
the three databases, user-friendliness could be improved by offering users
a basic level of searching and an advanced level for Boolean operators,
field searching, etc. At present, searching requires some decision-making
about operators that must be off-putting to many folks out in the heartland.
The designers of
this incredibly valuable tool have redeemed themselves, however, by including
a clear and simple link to MEDLINE from any Health Topic. MEDLINE, established
by the National Library of Medicine to mirror Index Medicus in the
early years of online databases, includes every article written in every
important medical journal in the last 45 years. Once linked into MEDLINE,
users can determine their appetite for the technical, sophisticated medical
journal articles they will encounter and whether they want to try their
luck at finding relevant articles.
The Food and Drug
Administration's Web site [http://www.fda.gov]
is an excellent place to begin a search. Whether you need to know about
the status of a drug's approval for sale, the availability of a generic
version of a brand-name medication, or new reports of a drug's side effects,
this site provides authoritative information. Designed for all comers,
the site's home page features buttons for consumers or professionals. The
consumer links lead to a smorgasbord of information — online articles only
available on the Web, FDA pamphlets, congressional testimony, as well as
useful, nongovernmental resources.
drug site that has proven helpful and trustworthy is the Pharmaceutical
Information Network, or PharmInfoNet [http://www.pharminfo.com].
The site is one of many consumer sites operated by Mediconsult.com [http://www.mediconsult.com],
reviewed favorably in the November-December 2000 issue of Searcher.
Just as the commercial Laservision Center sponsors the Mediconsult.com
eye care center, so a consortium of medical firms, including drug giants
SmithKline-Beecham and Novartis, sponsor the Pharmaceutical Information
Network. Indeed, the site provides information about sponsor products and
links to these company' sites. Nonetheless, features such as Drug Infoline
are good to know about; in fact, Drug Infoline is a handy complement to
the FDA site. New medications are the focus here, including brand names,
availability, manufacturer, intended use, how they work, and results from
clinical trials. Drug DB lists hundreds of commonly used drugs (not necessarily
new as in Drug Infoline). Basic information, news items, and plenty of
outside links are available here. Searchable by disease, by brand name,
or generic name, this site offers chat groups as well for hearing what
others say about any given drug.
We must post one
caveat regarding the timeliness of information available from any healthcare,
prescription drug, etc., site covered here. In my article published in
the November-December 2000 issue of Searcher, I reported on a scandal
unearthed by Dr. Janet Sybil Biermann and colleagues at the University
of Michigan Medical School ["Evaluation of Cancer Information on the Internet,"
vol. 86, no. 3, August 1, 1999, pp. 381-90]. To quote from my article,
"Dr. Biermann and her colleagues had searched 371 sites for information
about Ewing's sarcoma, a rare bone cancer that typically afflicts children
and young adults. They discovered that half the online material was irrelevant
and 6 percent contained major errors. In an interview with National Public
Radio, Dr. Biermann described one such error that could devastate frightened
parents. One site reported a survival rate of only 5 percent, when in fact
the survival rate has improved a lot over the last
and survival rates of 75 percent to 80 percent are the norm!" In a similar
vein, The Los Angeles Times reported recently that the Pharmaceutical
Information Network site could be lax in updating vital medical information.
In one instance, the site gave no inkling of the FDA warning about Lotronex,
for irritable bowel syndrome, that can cause severe constipation and colon
damage when TheTimes checked a month after the warning was issued
[Benedict Carey, "Locating Timely Drug Information," Los Angeles Times,
October 2, 2000, S, p. S2].
The E-Commerce of Health
Many Web health
searchers will derive their information from commercial sites. Got an itch?
Got a headache? Got a cold? Many people ask their druggist for suggestions.
Now they ask online druggists.
online "drugstores" have received a lot of attention — Drugstore.com [http://www.drugstore.com]
and PlanetRx [http://www.planetrx.com].
Both sites are well established — and fiercely competitive with each other.
Although only launched in January 1999, Drugstore.com has become a leader
in the online drugstore market and hit the million-customer mark in February
2000, handily beating out competitors like PlanetRx. To achieve its preeminence,
Drugstore.com blanketed the airways, Web portals, and morning talk shows
with the virtues of buying vitamins and toiletries online. In time, however,
online drugstores have begun to struggle with the same problems as other
e-tailers on the Net — higher-than-anticipated start-up costs and too many
players, leading to stiff price competition and the inevitable winnowing
of the field.
first out of Seattle in early 1999 and enjoyed the backing of Amazon.com's
Jeff Bezos (a 29 percent stake) and Kleiner Perkins Caufield & Byers,
venture capitalists. More importantly, Drugstore.com became a click-and-mortar
company when it signed an equity investment and partnership transaction
with Rite Aid, a prescription drug retailer. PlanetRx debuted just 21 days
after Drugstore.com opened its site for business. Although the two companies
sprinted neck and neck through the chaotic business of getting operations
off the ground, by the time PlanetRx pulled off its initial public offering
(IPO) in October 2000, a mere 10 weeks behind Drugstore.com, it was already
clear that it would lose the race.
According to reports
in The Industry Standard, PlanetRx spent nearly $100 million on
marketing and sales during a 1-year period ending in June 2000 while generating
net revenues of only $26 million. Meanwhile, Drugstore.com struck a monster
$105 million co-branding deal with equity partner Amazon.com at the beginning
of 2000 — before the bottom fell out of e-commerce stocks. By that time,
however, Drugstore.com's coffers were full, having raised some $200 million
in financing, an amount it would supplement with a healthy $62 million
private placement at the end of the summer. Although PlanetRx signed a
3-year agreement costing $15 million for the privilege of being the "premier
online pharmacy partner" on AOL's Health and Women channels, and later
cut merchandising and marketing agreements with Yahoo! and Women.com, the
online pharmacy has not disclosed whether any of these deals paid off with
more traffic or sales boosts [Karl Schoenberger, "Can Any Medicine Cure
PlanetRx?" The Industry Standard, vol. 3, no. 38, September
18, 2000, pp. 154-170].
Begun as the dream
of Michael Bruner, a former medical student, NetPharmacy (its original
name) was launched in a low-rent apartment in Berkeley, California, to
help patients enjoy the efficiency and ease of online commerce. In the
spring of 1997, the renamed PlanetRx set up shop in a small office a few
blocks away from Oakland's bay-front Jack London Square. In late 1998,
PlanetRx progressed to the point of bringing in a big hitter as CEO, William
Razzouk of FedEx fame. What worked at FedEx, however, definitely clashed
with the laid-back culture of the California Internet start-up. CEO Razzouk's
gruff, micro-managing style stymied the development of solid management
decisions and sowed dissension in the ranks.
an offline drug chain partner and enduring management clashes, analysts
have pegged PlanetRx' problems to its failure to negotiate an advantageous
deal with the real power core of this sector, the pharmacy benefit-management
industry. Prescriptions purchased with medical insurance dollars are overwhelmingly
the majority of dollars in the industry, and benefit managers control the
insurance contracts. By comparison, Drugstore.com's alliance with Rite
Aid includes connections to its subsidiary, PCS Health Systems, which manages
prescriptions for 50 million insurance beneficiaries. Within a week of
Drugstore.com's IPO, PlanetRx announced its partnership with Express Scripts,
the nation's third-largest pharmacy benefit manager, but the deal was rashly
conceived and executed. PlanetRx had to pay almost $15 million annually
in fees — more than its annual revenue at the time — for vaguely defined
marketing services and the privilege of being Express Scripts' exclusive
In any case, PlanetRx,
like so many other Internet start-ups, placed its faith in an unstoppable
Internet boom that would allow it to grow greater and greater revenues
that would eventually lead to profits and eventually justify the exorbitant
costs of hyping the brand. The Industry Standard published figures
that indicate PlanetRx had net revenues of $18 million and net losses of
$94 million in the first half of 2000, as compared to Drugstore.com's revenues
of $47 million and losses of $104 million. A major retrenchment began in
early 2000 at PlanetRx, with lay-offs that continued through the summer
as well as relocation to its distribution center in Memphis, Tennessee.
CEO Razzouk has gone and PlanetRx stock dropped below the dollar level
by September 2000. By December 2000, PlanetRx was listed on a deathwatch
among scores of e-tailers not expected to survive the Christmas shopping
season [Charles Piller, "Like Garden.com, More E-Tailers Dying on the Vine,
Angeles Times, December 7, 2000, A1, A36, A42].
Bruner's original concept of the Internet becoming an interactive tool
that could do things like remind patients, particularly the chronically
ill, to take their medication has proven to be well founded. Unlike "real"
pharmacists, PlanetRx' virtual pharmacists send e-mail reminders to regular
customers of its satellite sites, including Alzheimers.com, Breastcancer.com,
Depression.com, and Diabetes.com, when prescriptions need refilling. Since
the chronically ill are responsible for about half of all prescription
drug sales, these relationships have kept PlanetRx afloat.
This article will
not cover the other click-and-mortar pharmacies, CVS.com and Walgreens.com,
but at press-time both were alive and well.
featured Drugstore.com in a recent issue dealing with the challenge of
finding and keeping online customers [Sarah L. Roberts-Witt, "Finders Keepers,"
vol. 19, issue 18, October 17, 2000, pp. 6-14]. Repeat customers spend
more than first-timers or one-timers, and it costs more to acquire a new
customer than to maintain the ones you have. Having attracted new customers
by the droves, Drugstore.com uses technological gizmos of all stripes to
get a complete picture of its customers and their behavior. A customer's
click-stream is logged into a massive data warehouse running on Oracle8I,
while proprietary software correlates this data with existing customer
and marketing data. Reports on how many customers purchased a particular
sale item, whether they clicked through from an ad, and which customers
use online shopping lists help determine everything from where the next
ads should be placed to what kind of e-mail newsletters should be created
and to whom they should be sent. As elsewhere in the zany world of business-to-consumer
and business-to-business Net economy, Drugstore.com is brokering partnerships
that will bring even more shoppers into the fold. This past summer, Drugstore.com
announced deals with national health insurance companies WellPoint and
CIGNA Healthcare. Under these agreements, Drugstore.com will become the
exclusive provider of online prescriptions for WellPoint's 22 million members
and CIGNA's 25 million, as well as marketing special promotions and sales
to those individuals.
How easy is it
to order your vitamins and prescriptions drugs using Drugstore.com? Very.
Taking a page from the Amazon.com model, both Drugstore.com and PlanetRx
are easy to use and hassle-free. Bearing in mind that Amazon.com and Drugstore.com
are business partners, it is not surprising to experience easy navigation,
an enormous inventory at discount prices, excellent search capabilities,
one-click purchasing, and an efficient delivery and return process. Visiting
Drugstore.com, you find a home page that offers Medicine Cabinet, Nutrition
and Wellness, and Pharmacy, plus others. Each has a clear hierarchy of
choices, easy-to-use Buy buttons, May We Suggest buttons, a shopping cart,
and all the proper disclaimers. For instance, clicking on the question,
"Why should I entrust my prescriptions to you?" leads users to a statement
verifying that Drugstore.com is a VIPPS site. The statement says, "The
National Association of Boards of Pharmacy recognizes Drugstore.com as
a Verified Internet Pharmacy Practice Site (VIPPS). The VIPPS seal assures
you that our pharmacy services meet the highest possible standards for
Internet pharmacies. Drugstore.com was a leader in helping establish these
credentials. Learn more about VIPPS cerification [sic]."
offered on Drugstore.com's home page reads, "Information on this site is
provided for informational purposes and is not meant to substitute for
the advice provided by your own physician or other medical professional.
You should not use the information contained herein for diagnosing or treating
a health problem or disease, or prescribing any medication. You should
read carefully all product packaging. If you have or suspect that you have
a medical problem, promptly contact your healthcare provider. Information
and statements regarding dietary supplements have not been evaluated by
the Food and Drug Administration and are not intended to diagnose, treat,
cure, or prevent any disease."
Whether you choose
Medicine Cabinet, Nutrition and Wellness, or Pharmacy, you are led into
a series of pages with a "Directory" listing of more specific options as
you progress. Medicine Cabinet leads to a directory of common complaints
such as digestion, cough and cold, allergy and sinus, pain and fever, etc.
One item in the list was Medical Equipment, and that leads to another directory
of choices, including independent living and bath safety products. At this
point, you begin to notice prominently displayed brand names available
for purchase. For instance, all the bath safety items and independent living
products are manufactured by Rubbermaid. Sunbeam is the manufacturer du
jour when looking for heating pads. When we checked eye and ear care, however,
we found buttons for three major brand names — Ciba, Opti-Free, and Bausch
& Lomb. By the way, the directory for eye and ear care includes logical
choices such as redness and allergy drops, artificial tears, eye ointments,
etc. Moving on to Nutrition and Wellness, the directory choices are diet
aids, homeopathy, and nutritional supplements, among others. Narrower terms
under diet aids are scales, shakes and powders, weight loss supplements,
But can you search
directly to scales? Yes, but the keyword search option may have a catch!
Searching on "scales" in the Medicine Cabinet section yielded only three
scales priced from $39.99 to $149.99, while the Nutrition and Wellness
section yielded nine scales priced from $39.99 to $2,999.99. Maybe Drugstore.com
needs to hire a few librarian/taxonomists? You think?
A nice feature
of the Pharmacy section is Ask Your Pharmacist. Typing in keywords results
in canned FAQ-type responses. For instance, the keyword "earache" retrieves
two options that you can click on for the answer, "I think my child has
an ear infection. What should I do?" and "What is the difference between
a cold and the flu?"
Once you have filled
your shopping cart, you are led through the usual information about payment,
shipping, and price choices. Data about these transactions is transferred
to the personalized features of Drugstore.com. The next time you log on,
you may click on Your Account, Your Prescriptions, or Your List and short-circuit
some of the click-stream you went through initially. PlanetRx is arranged
very similarly in terms of these personalized links to your own history.
Also, both sites have message boards.
Once you begin
to shop at drugstore sites, be sure to look for the Verified Internet Pharmacy
Practice Sites, or VIPPS. In 1999, the National Association of Boards of
Pharmacy (NABP) created a program called Verified Internet Pharmacy Practice
that gives consumers a single place to check out an online pharmacy to
ensure that it meets current standards. To receive VIPPS certification,
an online pharmacy must meet the licensing and inspection requirements
in the state where it is located and each state to which it dispenses pharmaceuticals.
In addition, VIPPS online pharmacies must protect a patient's right to
privacy, ensure authentication and security of prescription orders, adhere
to a recognized quality assurance policy, and provide a mechanism by which
patients can get their questions answered by a pharmacist. At this time,
the FDA is working with the NABP to protect consumers from unscrupulous
Internet sites selling prescription pharmaceuticals.
Only a handful
of online drugstores in addition to Drugstore.com and PlanetRx carry the
VIPPS seal of approval. Caremark, Inc. [http://www.rxrequest.com],
and Tel-Drug, Inc. [http://www.teldrug.com]
are some of the more familiar. Not all offer the same features, however.
Caremark, Inc. is limited to filling prescriptions. The site is very streamlined,
no bells and whistles, and certainly no drugstore stock such as bathroom
scales. Clickpharmacy offers an Ask Your Pharmacist feature that links
to an e-mail window in contrast to the FAQs at Drugstore.com. So, depending
on the credentials, knowledge, and literacy of the individuals responding
to the e-mail, you might be better off going to Clickpharmacy for this
service. On the other hand, Clickpharmacy has one real disadvantage. When
you click on the Consumer link from the front page, you get a difficult
to read, very small window, so small that you need to scroll on each line
to completely read a sentence. Overall, Clickpharmacy is not as grand or
user friendly as other sites.
Till We Meet Again
So, what's it
all about, Alfie? In this reporter's opinion, the exciting, marvelous aspect
of online pharmacies is that they take the power of interactivity via the
Web and run with it. Chronically ill people are e-mailed reminders to refill
their prescriptions and even to take their medication! Virtual pharmacists
are available to answer questions, some 24/7. Consumers can look up adverse
effects at their leisure and in the privacy of their homes. And information
professionals can mine the wealth of pharmaceutical knowledge as never
Long live the Web!
A librarian since
1967 and information consultant since 1992, Eva Perkins launched
EPA Research to support medical, healthcare and legal professionals who
need information and related services. Ms. Perkins holds an MA degree in
Library Science and became a Certified Hazardous Materials Manager in 1994,
when she completed the certificate program offered by the Environmental
Protection Agency through the UCLA Department of Engineering. Her e-mail
address is email@example.com.
for a moment, how much do health information consumers depend upon the
Net? A new survey of Americans' use of the Internet shows that it is becoming
a first stop for medical information and even guidance. The survey, prepared
by the Pew Internet and American Life Project, queried more than 12,000
people about their Internet habits to discover how the Internet has changed
the way people make health decisions [D. Hopper, "Internet Access Alters
How Users Approach Care," Los Angeles Times, November 27, 2000,
C1, C4]. Of those surveyed, 92 percent said their online search was useful
and 81 percent said they learned something new. About 47 percent of those
seeking help said the answers influenced their decisions about treatment.
In terms of their
searching approach, it was scattershot, with only a few Web sites preferred
over others. WebMD and Drkoop.com were "name brands" that many started
with, but then soon ventured onto other healthcare sites by typing keywords
into Yahoo! and other generic search engines. Unreliable health information,
privacy, and legal recourse were primary concerns of those seeking information,
with 86 percent of all respondents to the telephone survey reporting a
concern, with reliability as the most important concern. To allay this
fear, many users consult several sites and compare information, hoping
that consistency of information among sites will establish reliability.
Apart from the
quest for timely, reliable, and useful information about diseases and their
cures, the next most pressing issue facing healthcare consumers is the
bitter reality of ever-increasing drug expenditures. Locating authoritative
prescription drug sites on the Web has become important to millions of
Americans. Overall spending for prescription drugs in the U.S. has more
than doubled since 1990, according to a study recently released by the
Kaiser Family Foundation. Surprisingly, it is not that prices have risen
so dramatically, as that greater overall use of these drugs has increased,
along with heightened demand for newer, more expensive medications. The
study researchers discovered that annual usage per capita jumped 32 percent
between 1992 and 1998, resulting in almost 10 prescriptions each for every
person in the country by 1998 — and climbing. The study concluded that
a major contributing factor to this trend was a huge jump in consumer advertising
by drug makers, which tripled between 1995 and 1998 ["Why Those Drug Costs
Are Up," Business Week, vol. 3699, November 6, 2000, pp. 36].
Since we expect
a certain percentage of e-commerce companies to close their doors and dismantle
their Web presence, a few words about the fabulously expensive horse race
for consumer dollars between the major online drugstores, Drugstore.com
and PlanetRx. Customers establish loyalty to sites based on how quickly
they can find and purchase products, how easily they can track their orders,
and, most perilous of all, how quickly and assuredly they will get their
In 2000, the Ziff
Davis Smart Business Labs teamed up with eyeTracking.com to find out which
e-commerce sites make it easiest and fastest to find what you look for,
get questions answered, and complete and track an order [Jerome, Marty.
"E-Commerce Showdown," Smart Business for the New Economy, vol.
13, no. 12, December 2000, pp. 104-118]. The study pitted two leading companies
in each of the 10 hottest e-commerce categories based on these indicators
of customer satisfaction. For example, Amazon.com and Barnesandnoble.com
were compared to each other. Selected to represent the drugstore industry,
Drugstore.com and PlanetRx had the lowest success rates of any e-tail sector
in the tests. Users found the sites difficult to navigate, the Pharmacy
tab was easily confused with the Medicine Chest tab, and, worst of all,
advertisements were hard to distinguish from content on more than one occasion.
Although the author did not encounter difficulties to the extent reported
in this study, online drugstores clearly need to improve their Web designs
if they want to continue as viable e-commerce sites.
Anyone who has
searched the Internet for healthcare information is immediately aware of
the big problem — too much information. How to choose which sites to rely
upon for current, reliable content on disease states, treatment, etc.?
In time we will see more authoritative sites from clinics such as the Mayo
Clinic Health Oasis [http://www.mayohealth.org]
and certainly "filter" sites from a Consumer Reports type of group
or government service that helps people interpret what search engines locate.
Some sites already provide this type of service, such as Medmatrix.org
and many medical societies post reviews of other sites in their particular
specialty. To locate site reviews from the American Academy of Pediatrics
for instance, enter "web sites" into the home page's search box and you
will go to press releases about sites in pediatrics. Before moving on to
a review of Medmatrix.org, consider that within 5 years most physicians
and insurers will have Web sites. Depending on the confidence your doctor
inspires in you, their site may be the perfect answer. A recent survey
by Dr. Edward Fotsch, chief executive of Medem, Inc., confirmed that 50
percent of physicians already have their own Web site or belong to a practice
that maintains one. Also, about 10 percent of physicians communicate regularly
with patients online [Benedict Carey, "E-Health: Act 2," Los Angeles
Times, December 11, 2000, S, p. S1, S6].
Matrix Project assigns ranks to Internet resources based on their utility
for point-of-care clinical application. Quality, peer review, full content,
multimedia features, and unrestricted access are emphasized in the rankings.
To ensure the systematic application of ranking standards and their objectivity,
they use the following ranking system:
* Suitable, well-authored
clinical content but lacking in substance, or currency (1-10 points).
** Clinical content
is generally reliable and up-to-date. Site design is logical and easy to
use. Limited usefulness as a regular clinical resource (11-20 points).
accurate, current clinical content. Good site design, well-maintained,
and extensive functionality. Easily accessed and navigated by the routine
user. An overall valuable clinical resource (21-30 points).
site across all categories and a premier Web page for the discipline (31-40
***** An award
winning site for Medical Internet. (41-50 points).
various codes such as "REG," meaning it requires registration, and "$,"
which flags a fee-for-service site.
Searching the Pharmacy
section yielded these results.
**** FDA News [www.fda.gov/opacom/hpnews]
— Announcements regarding drug products, enforcement reports, and position
statements regarding government regulation of the pharmaceutical and medical
devices industry. U.S. Food and Drug Administration .
*** Drug Discovery
— Feature articles, news headlines, and a searchable archive regarding
the pharmaceutical industry and drug development. VerticalNet / Drug Discovery
**** Clinical Drug
— REG Original research articles on all phases of clinical drug development
and therapeutic use of drugs. Free registration. Adis International Limited
section offers an interesting cross section of topics:
**** Annual Reviews
of Nutrition [http://nutr.annualreviews.org]
— Publishes high-quality review articles on all aspects of nutrition and
diet. Free access to TOCs and abstracts, free subscription to eTOCs. Access
to full text is restricted to subscribers. Searchable, with hypertext links
to related articles. Annual Reviews and Stanford University's HighWire
*** Nutrition and
— REG, An International Journal. Reports and reviews current findings on
the effects of nutrition on the etiology, therapy, and prevention of cancer.
Free registration. Lawrence Erlbaum Associates and Medscape.