May 2010: Keep It Simple, Doc: How to Build a Consumer Health Portal
Health information is a broad category covering many complex topics. When creating a consumer health Web site, it’s more effective to build an index of trustworthy resources than to point people straight to the most comprehensive source. Librarians at the Health Sciences Library of the University of North Carolina-Chapel Hill learned this while developing and managing their NC Health Info Web site.
In 2001, they created a consumer health site called Go Local. It pulled information from the National Library of Medicine’s MedlinePlus Web site and connected it to local health resources in North Carolina.
After a few years, the library realized that the detailed information in MedlinePlus might be too overwhelming for the novice user, and what was needed was another layer, or portal page, that would highlight the topics of most interest to people in the state.
"Our goal was to design a more simplified portal, called NC Health Info, that focused on the most important health topics to North Carolinians," said Diana McDuffee, who led the project. "And we developed that site with the intended audience of public libraries, librarians, and their users as well as those who find it on their own on the Web."
There certainly is a need for the state’s libraries to have access to organized, trusted health information. In one survey, North Carolina public librarians said up to 40 percent of questions they field are about health issues.
On a broader level, between 75 to 80 percent of Internet users look online for health information, according to the Pew Internet and American Life Project.
The library’s NC Health Info project modified the Go Local site to meet these needs. In 2005, the library received an IMLS planning grant for the project. It was also awarded consecutive one-year grants funded by the IMLS Grants to States program in 2006 and 2007.
The Health Sciences Library at the University of North Carolina-Chapel Hill led the project on behalf of a statewide steering committee made up of the following partners: libraries at Wake Forest University Medical School, Duke University Medical School and East Carolina Medical School; the state library of North Carolina and public libraries including New Hanover County Public Library and Forsyth County Public Library; North Carolina Area Health Education Center libraries; and the Institute of Public Health at the University of North Carolina-Chapel Hill.
Managing a Portal Site
In 2006–2007, the partners built and launched the NC Health Info portal at www.nchealthinfo.org. During the 2007–2008 grant years, they continued developing the site and created a version in Spanish.
The site’s home page is a directory of health topics divided into 10 categories, including Diseases & Conditions; Military Health; Medications; Treatments & Procedures; Health Care (including insurance information); and Public Health & Wellness. One column showcases timely content, such as H1N1 flu information, and a rotating monthly feature. Each topic page contains links to trusted, noncommercial sources, including MedlinePlus and North Carolina state agencies.
Thirty-eight volunteer librarians currently participate in the project from across the state and serve as Web page editors for each of the topic pages, using criteria provided by the NC Health Info Content Subcommittee. Once the librarians have compiled their Web pages, they submit them to the project staff, which sends them to the project’s Content Subcommittee, the members of which are health sciences content experts. They look over each page and make any necessary changes before it goes live to the public. In addition, every page gets reviewed by the content experts thoroughly every six months.
"We thought it was important that public libraries relied on sources—particularly of health information—that were trustworthy and had been evaluated by health sciences librarians for the quality of their content," said McDuffee.
Providing Spanish pages has doubled the number of Web pages on the site. "Each page editor is asked to identify Spanish-language resources that are comparable to what they chose for each English-language page. Each page editor has both an English and a Spanish page to maintain," McDuffie explained.
During the 2007–2008 grant period, the team also created metadata for each page and added Google Analytics tracking so that they could be assured of search engine optimization. They licensed "Easy-to-Read" content tutorials from the Patient Education Institute; added eight instructional tip sheets for librarians to use in answering FAQs; and hired promotional consultants to develop two separate marketing plans: one for the general public and one for public libraries.
The partners promoted the site at the North Carolina Library Association’s Biennial Conference, at a workshop hosted by Elsevier (a health and science publisher), and at La Fiesta del Pueblo in Raleigh. The library created new print materials (bookmarks, brochures, and flyers) for the project in both English and Spanish and distributed those to public libraries.
Growing Content and Usage
At the end of the 2007-2008 grant period, the portal had 120 Web pages with links to health information sites, about half of those in Spanish. The project boasted 25 volunteer content editors; five were added during that funding year.
There were 224,644 unique visitors to the portal site: 61.7 percent come from search engines, 21 percent from referring sites (e.g. links from public libraries), and 17 percent from direct traffic. A total of 340 sites linked to NCHealthInfo.org at the end of the grant year.
Internet users in the state quickly found the new Spanish pages.
"As soon as the Spanish pages were launched, immediately our Google Analytics started showing that the Spanish language was drawing lots of people to our site. We started to see that in the top 10 terms that were used to come to our site, Spanish terms were appearing right away," said McDuffee. "And we think that’s an indication, more than anything, of how little there is out there in Spanish for those who are using the Internet to seek information."
One of NC Health Info’s marketing consultants was also teaching a social marketing class during summer school. The library provided questions for the class to brainstorm a social marketing campaign for NC Health Info; the resulting surveys produced some great ideas, including the project’s new tag line: "Your State. Your Health."
Challenges and Lessons Learned
"The success of this project depends on the continued participation of health sciences librarians who bring the expertise in selecting and evaluating health information and who understand the importance of designing a Web site that functions effectively on the Internet to bring those searching for health information to our site," said Diana McDuffee.
Since the NC Health Info site relies on volunteer editors, retaining them is important. "It’s always going to be a challenge to keep our pages staffed with volunteer editors and manage that," said McDuffee.
Coding, updating, and maintaining the Web pages is very labor-intensive, especially since the site doubled from 60 pages to 120 pages after being translated into Spanish. The partners recommend that others working on similar projects need to have the backing of a library that can provide the Web management tools needed for developing and maintaining a Web portal for the long term. The availability of a content management system can automate some parts of the process and reduce the technical aspects of the content review.
Promoting a noncommercial Web site like NC Health Info is very difficult since the usual methods for advertising a Web site are not financially feasible. This deficit can be made up in part by having staff who know how to design Web sites that are easily found by Internet search engines.
Planning for Sustainability
The project obtained a third grant from the Grants to States program to continue through the 2008-2009 funding year. As of September 2009, NCHealthInfo.org had 140 Web pages and some 548 sites linked to the site. The project does not expect to increase the number of Web pages significantly since the goal is to remain a more focused site rather than a comprehensive site.
In 2008–2009, the site’s traffic grew to 304,536 visitors, with the most visited page being the alternative medicine page in Spanish. McDuffee said the rising traffic shows that the site meets a need for state residents. "I have to think that the level of effort we’re putting into this to make it a trustworthy site and the continuing increase in traffic indicates that it is finding a user group out there," she said.
Another of the project’s community impacts is that the library was able to establish linkages to many public libraries.
"One of our goals in developing this project was for it to be a collaboration between health sciences librarians and those librarians who work with the public. We wanted to combine the expertise of these two groups," explained McDuffee.
The library received a final one-year Grants to States award for half the funding needed in 2009–2010; the library will pick up the other half. The primary focus of the final year is to develop a sustainability plan for post grant funding. The sustainability plan will look at governance, employing technology to streamline the workflow, developing new sources of support and, most of all, maintaining the collaboration among North Carolina’s premier libraries.