Intended for healthcare professionals


Evaluation of ehealth systems and services

BMJ 2004; 328 doi: (Published 13 May 2004) Cite this as: BMJ 2004;328:1150
  1. David H Gustafson, director (,
  2. Jeremy C Wyatt, associate director of research and development (
  1. University of Wisconsin Center of Excellence in Cancer Communication Research, University of Wisconsin, Madison 53726 USA
  2. National Institute for Clinical Excellence, London WC2N 5HR

    We need to move beyond hits and testimonials

    For this article the term ehealth includes use of the internet or other electronic media to disseminate health related information or services.1 Many ehealth sites report huge numbers of users and testimonials of their benefits. Unfortunately, similar testimonials can be found for snake oil,2 and pornography sites boast large numbers of hits. Although a systematic review seeking evidence of harm from ehealth websites was inconclusive, few rigorous studies exist that show benefit from ehealth.3

    Ehealth evaluations must move beyond testimonials and usage reports, but how much evaluation is enough depends primarily on the user. When creating internet applications, we can easily forget who our users are and what they need. We may forget that a woman with a diagnosis of breast cancer is facing a life threatening disease, must make critical decisions very quickly, and must cope with treatments that alter her quality of life dramatically. One …

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