Health care on the internet: Can you trust it?

As the Internet becomes ever more ingrained in our lives, it increasingly affects the way patients interact with each other and with their doctors. They can more easily learn about conditions, treatments, and providers and can find the solace and support of others in similar circumstances.

Web-based services serve a range of important needs. For example, two social media sites, CaringBridge and CarePages, allow supporters near and far to read journals in which patients post updates of their condition. Outlets like these allow patients and their families to post information on a real-time basis concerning sometimes-critical conditions. Among the posts are pleas for group prayer, requests for advice or support from others who have been down the same path, and descriptions of the frustrations of dealing with illness. This avenue for communication can be an invaluable help.

Websites such as WebMD and sites maintained by many hospitals provide detailed information about medical conditions and potential treatments. The ability to research a diagnosis with ease increases patients' independence and autonomy because it frees them from the need to call their doctor with every question.

But using the Internet for health care help also has a dark side. A particularly serious concern is reliability. Much of the information that is posted online is unverifiable. While there are many reliable websites, it can be difficult to distinguish between those that are trustworthy and those that are not.

The flip side of empowering patients with information is allowing them to attempt self-diagnosis, which can be dangerous. Patients may avoid or delay treatment if they conclude from an online search that their symptoms are not serious. When information is false, patients may also be led to ignore their doctors' instructions. Do you know who has been editing the last Wikipedia entry you read?

While the Internet is a valuable resource for hospitals and medical providers in addition to patients, they face risks of their own. Online reviews can include derogatory remarks posted by disgruntled patients and family members. Providers are often limited in their ability to respond by federal and state privacy laws. Other patients who rely on these reviews may receive a biased perspective without being able to consider the other side.

Online reviews may work well in choosing a restaurant, but that does not mean they are useful for selecting a hospital or a physician. For example, the Hospital of the University of Pennsylvania (HUP) is ranked as one of the best in the nation, but it received only three out of five stars on Yelp. Patients may focus their reviews on personal peeves like a long waiting time for a broken arm in the emergency room, with no knowledge of the hospital's overall quality of care. In one of HUP's Yelp reviews, a patient complained that she was released from the emergency room at 3 a.m. with no cab fare. It would be unfortunate if this were to deter a cancer patient from seeking care from one of the best treatment centers in the world.

The lesson is that you can't always trust what you read, especially on the Internet. Patients must take care to vet the websites they visit. While the Internet can be an invaluable tool for seeking help with health care concerns, there are times when there is no substitute for in-person exploration.

-       By Erica B. Cohen