1. Nicoll, Leslie H. PhD, MBA, RN, Editor-in-Chief

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I officially joined the ranks of "Internet-savvy patients" when I showed up for a healthcare appointment with an article in my hand that I retrieved from the Internet. I have been dealing with persistent pain in my right foot for several months now-I finally decided to pursue an alternative therapy (acupuncture) to see if it would relieve the pain. The acupuncturist thanked me for the article, read it on the spot, and then discussed treatment options with me. This process of bringing information found on the Internet to a healthcare provider for a final quality check is used by approximately one third of online health seekers. The doctor's acceptance of the information mirrored the experience of many other online health seekers, 79% of whom have reported that "their doctor was interested in the information found online."1


The Internet is quickly becoming the second opinion of choice for Americans with online access. Of the 113 million Americans who have gone online, 64% have searched for health/medical information. 2 Every day, approximately 6 million Americans go online for medical advice, which is more on any given day than visit health professionals. 1


How do people find information on the Internet? According to Vital Decisions,1 they tend to start at a search site, not a medical site. The typical health seeker uses links to visit 2 to 5 sites and spends at least 30 minutes on a search. Finding information that was already known is reassuring; similarly, finding the same information at different sites is used as confirmation of its accuracy. Sites that sell something or that do not clearly identify the source of the information are not viewed as credible.


What are people looking for? Disease information tops the list, followed by information on weight control and facts about prescription drugs. In the 2 years since this survey was first conducted, there have been significant increases in the use of the Internet for mental health information and sensitive medical topics.


Are online health seekers satisfied with what they find? In general, yes. Most reported that it was quite easy to find the information, with 82% saying they found what they needed "most of the time" or "always." They say that the Internet has improved how they take care of their health (61%). One third of health seekers know someone who has been helped by health information found on the Internet, compared with 2% who know someone who has been seriously harmed.


What does this mean for us as nurses? We have long cherished the role of patient educator, in which we would teach a patient specific content about his or her disease or condition. Clearly, the Internet is changing that. Patients are finding content online; our job will be to help them understand and analyze the information they find and determine what is useful and appropriate. In a nutshell, we'll need to teach them to use critical-thinking skills to analyze health information.


We also have a responsibility to help patients learn how to use to the Internet to find information. It is not enough to expect them to search and bring information to us; we must be proactive and provide Internet teaching sessions during patient encounters. Because we know they are going to go online to find information, I think it behooves us to help them get started on the right foot.


Finally, we must remember those patients who do not or cannot find information online. In the latter case, it may be a lack of access. The article by Margaret Cashen and colleagues in this issue illustrates an innovative solution to this problem. 3 Other reasons people choose not to go online include fear, confusion, and perceived difficulty. 4 Again, proactive education may be the way to help patients to overcome these barriers. All these factors must be considered as we re-think patient education in the Internet era. Internet-savvy nurses are the best bet for Internet-savvy patients.




1. Fox S, Rainie L. Vital Decisions: How Internet Users Decide What Information to Trust When They or Their Loved Ones Are Sick. Washington, DC: Pew Internet & American Life Project; May 2002. [Context Link]


2. Daily and overall Internet population. Pew Internet & American Life Project. Available at: Accessed October 14, 2002. [Context Link]


3. Cashen MS, Sklar BM, Nguyen HHT, Just M, Galzagorry GG. Implementing a Web-based information resource at an inner-city community church: lessons learned. CIN. 2002; 20:243-249. [Context Link]


4. Lenhart A. Who's Not Online. Washington, DC: Pew Internet & American Life Project; September 2000. [Context Link]