nhs direct multi-channel service dr shirley large and kate arnold

NHS DIRECT MULTI-CHANNEL SERVICE

Dr Shirley Large and Kate Arnold

NHS DIRECT MULTICHANNEL SERVICE

• Telephone service – over 650,000 calls per month

• NHS Direct Online – 1 million visits per month

• Self-help guide in Thomson Local directory – 18 million homes

• NHS Direct Interactive – 5% of digital satellite viewers

Web log analysis: how users interact with NHS Direct

Online

Objectives• Develop an approach to web log analysis to enable

the NHS Direct New Media web logs to be analysed in a meaningful and informative way

• Establish an approach to extracting, truncating and analysing the data from NHS Direct New Media web logs

• Develop an awareness of the navigation and health information seeking behaviour of users accessing MRSA information web pages on the NHS Direct New Media website.

Death certificates showing resistant and

non-resistant MRSA 1993-2003

1 Day’s server activity

Even exploring just one day’s activity from three servers for the website the size of each server comprised large datasets as outlined below:

Server 1 = 40.2 MB Server 2 = 41.0 MB Server 3 = 40.3 MB

Global Metrics

32,728 visits to the website on 4th October 2004

MRSA was the 15th most commonly viewed topic on 4th October 2004.

242 visits to the MRSA topic

MRSA Introductory Page

MRSA treatm

ent

MRSA sym

ptoms

Prevention of MRSA

Causes of MRSA

External link to information

PDF or print

0

50

100

150

200

250

300C

ou

nt

26046.68%

111.97%

6211.13%

407.18%

7313.11%

549.69%

5710.23%

0<

1

1<

2

2<

3

3<

4

4<

5

5<

6

6<

7

7<

8

8<

9

9<

10

10<

11

11<

12

12<

13

13<

14

14<

15

15<

16

16<

17

17<

18

18<

19

19<

20

20<

21

21<

22

22<

23

23-2

4

Hour

0

5

10

15

20

25C

ou

nt

72.89%

41.65%

72.89%

41.65%

20.83%

10.41%

10.41%

62.48%

83.31%

114.55%

83.31%

156.2%

145.79%

156.2%

166.61%

114.55%

135.37%

187.44%

93.72%

239.5%

218.68%

208.26%

52.07%

31.24%

1 2 3 4 5 6 7 8 9 10 11 12 13 18

Number of pages visited

0

20

40

60

80

100

120

140

Co

un

t

13756.61%

4217.36%

166.61% 13

5.37% 114.55%

135.37%

31.24% 1

0.41%10.41%

10.41%

10.41%

10.41%

10.41%

10.41%

5 page pathways Visitors

Introduction → Causes → Treatment → Prevention → Symptoms 2

Introduction → Causes → Treatment → Symptoms → External link 1

Introduction → Causes → Symptoms → Treatment → External link 1

Introduction → Causes → Introduction → Prevention → Introduction 1

Introduction → Symptoms → Introduction → Treatment → Treatment 1

Introduction → Prevention → Causes → Symptoms → Treatment 1

Introduction → Treatment → Prevention → Symptoms → External link 1

Introduction → Treatment → Symptoms → Causes → Introduction 1

Symptoms → Treatment → Treatment → Treatment → Treatment 1

Symptoms → External link → Introduction → Prevention → Treatment 1

Total 11

6 page pathways Visitors

Introduction → Cause → Treatment → Prevention → Symptoms →External link

3

Introduction → Introduction → Causes → Treatment ? Symptoms → External link

1

Introduction → Cause → Treatment → Symptoms → Prevention →External link

1

Introduction → Treatment → Prevention → Cause → Symptoms →External link

1

Introduction → Causes → Introduction → Introduction → Causes → Causes 1

Introduction → Causes → Symptoms → Treatment → External link → Prevention

1

Introduction → Prevention → Causes → Symptoms → Treatment →External link

1

Symptoms → Treatment → Introduction → Cause → External link →External link

1

Symptoms → Treatment → Treatment → Symptoms → Symptoms → Treatment

1

External link → Introduction → Prevention → Causes → Symptoms → Treatment

1

External link → Symptoms → Prevention → Treatment → Causes → Introduction

1

Total 13

0

50

100

150

200

250

300

Me

an

225

156

95

82

47 43

75

4940

71

15 16

57

80

278

21 20

The main findings of this study show that MRSA was the 15th most viewed

health topic on 4th October 2004, which reflects the public and health care

concern.

The navigational path through the sections of the MRSA topic did not mimic

the classic textbook presentation; introduction, causes, symptoms, treatment and

prevention. Although in a few instances there appeared to be good coverage of

the topic, page views did not follow any discernibly logical pattern. More

research is required to understand; if the same for different topics, if the way

information is viewed is a phenomenon of Internet health information searching

or if reveals a problem with layout and navigational links on the webpage.

The PDF or print page was viewed nine times during the day, which indicates

that all the topic information was accessed, possibly to be viewed at the visitors

leisure or with friends/family/colleagues when offline.

Findings

Understanding the interest in and the navigational pathways through the health

topics on the website has implications for both the system design and the

information architecture of the website and consequently may improve the

efficiency and effectiveness of the website.

Analysing and exploring the patterns in the visitor’s behaviour when searching

for health information on the website will contribute of the understanding of the

quality and delivery of information services.

Web log analysis as just one component of a larger assessment of the activity

for evaluating NHS Direct New Media services. Other complimentary forms of user

analysis should be considered for evaluating the use of the Internet health

information such as an online questionnaire, face-to-face interviews, direct

observation of health information seeking behaviour or focus groups. These

methods will allow further exploration of some of the questions highlighted in this

study.

Conclusions