Exploring the Effects of Online Rating and the Activeness of Physicians on the Number of Patients in an Online Health Community

Online Medical Consultation Service-Oriented Recommendations: Systematic Review

BACKGROUND

Online health communities (OHCs) have given rise to a new e-service known as online medical consultation (OMC), enabling remote interactions between physicians and patients. To address challenges such as patient information overload and uneven distribution of physician visits, OHCs should develop OMC-oriented recommenders.

OBJECTIVE

We aimed to comprehensively investigate what paradigms lead to the success of OMC-oriented recommendations.

METHODS

A literature search conducted through e-databases, including PubMed, ACM Digital Library, Springer, and ScienceDirect from January 2011 to December 2023. This review included all papers directly and indirectly related to the topic of healthcare-related recommendations for online services.

RESULTS

The search identified 313 articles, of which 26 met the inclusion criteria. Despite the growing academic interest in OMC recommendations, there remains a lack of consensus of e-service-oriented recommenders on their definition among researchers. The discussion highlights three key factors influencing recommender success: features, algorithms, and metrics. It advocates for moving beyond traditional e-commerce-oriented recommenders to establish an innovative theoretical framework for e-service-oriented recommenders and addresses critical technical issues in two-sided personalized recommendations.

CONCLUSIONS

The review underscores the essence of e-services, particularly in knowledge-intensive and labor-intensive domains like OMC, where patients seek interpretable recommendations due to their lack of domain knowledge, and physicians must balance their energy levels to avoid overworking. Our study's findings shed light on the importance of customizing e-service-oriented personalized recommendations to meet the distinct expectations of two-sided users, considering their cognitive abilities, decision-making perspectives, and preferences. To achieve this, a paradigm shift is essential to develop unique attributes and explore distinct content tailored for both parties involved.

CLINICALTRIAL

Consulting doctors online after offline treatment: investigating the effects of online information on patients' effective use of online follow-up services

Introduction

The use of online follow-up services (OFUS) is becoming an increasingly important supplement to hospital care. Through OFUS, patients can find their doctors in online health communities (OHCs) and receive remote medical follow-ups after hospital treatment. However, the rate of effective use of OFUS by current patients is still low, and there is an urgent need for research to investigate the online information factors that affect patients' effective use of OFUS.

Methods

Based on the elaboration likelihood model (ELM) of persuasion and an analysis of a panel dataset including 3,672 doctors in a leading OHC in China, this study explores how online information from doctors' knowledge contributions and patient feedback influences patients' effective use of OFUS.

Results

The results show that both doctors' knowledge contributions and patient feedback positively influence patients' effective use of OFUS. Doctors' paid knowledge contributions and patients' paid feedback have stronger persuasive effects than doctors' free knowledge contributions and patients' free feedback, respectively. Moreover, there is a substitutional relationship between doctors' paid and free knowledge contributions and between patients' paid and free feedback in influencing patients' effective use of OFUS.

Discussion

The findings of this study suggest that OHC platforms and healthcare providers should account not only for the persuasive effects of doctors' knowledge contributions and patient feedback but also for influential differences and relationships between the types of doctors' knowledge contributions and patient feedback to better persuade patients to effectively use OFUS.

Effect of Negative Online Reviews and Physician Responses on Health Consumers' Choice: Experimental Study

BACKGROUND

The COVID-19 pandemic has highlighted the importance of online medical services. Although some researchers have investigated how numerical ratings affect consumer choice, limited studies have focused on the effect of negative reviews that most concern physicians.

OBJECTIVE

This study aimed to investigate how negative review features, including proportion (low/high), claim type (evaluative/factual), and physician response (absence/presence), influence consumers' physician evaluation process under conditions in which a physician's overall rating is high.

METHODS

Using a 2×2×2 between-subject decision-controlled experiment, this study examined participants' judgment on physicians with different textual reviews. Collected data were analyzed using the t test and partial least squares-structural equation modeling.

RESULTS

Negative reviews decreased consumers' physician selection intention. The negative review proportion (β=-0.371, P<.001) and claim type (β=-0.343, P<.001) had a greater effect on consumers' physician selection intention compared to the physician response (β=0.194, P<.001). A high negative review proportion, factual negative reviews, and the absence of a physician response significantly reduced consumers' physician selection intention compared to their counterparts. Consumers' locus attributions on the negative reviews affected their evaluation process. Physician attribution mediated the effects of review proportion (β=-0.150, P<.001), review claim type (β=-0.068, P=.01), and physician response (β=0.167, P<.001) on consumer choice. Reviewer attribution also mediated the effects of review proportion (β=-0.071, P<.001), review claim type (β=-0.025, P=.01), and physician response (β=0.096, P<.001) on consumer choice. The moderating effects of the physician response on the relationship between review proportion and physician attribution (β=-0.185, P<.001), review proportion and reviewer attribution (β=-0.110, P<.001), claim type and physician attribution (β=-0.123, P=.003), and claim type and reviewer attribution (β=-0.074, P=.04) were all significant.

CONCLUSIONS

Negative review features and the physician response significantly influence consumer choice through the causal attribution to physicians and reviewers. Physician attribution has a greater effect on consumers' physician selection intention than reviewer attribution does. The presence of a physician response decreases the influence of negative reviews through direct and moderating effects. We propose some practical implications for physicians, health care providers, and online medical service platforms.

The Roles of Trust and Its Antecedent Variables in Healthcare Consumers' Acceptance of Online Medical Consultation during the COVID-19 Pandemic in China

Online medical consultation (OMC) is generating considerable interest among researchers and practitioners due to the mandatory quarantine measures implemented during the COVID-19 pandemic in China. However, the acceptance rate of OMC has declined over time. This paper aims to empirically investigate OMC acceptance using a proposed research model by integrating the technology acceptance model (TAM) with trust and its antecedent variables. A quantitative self-administered cross-sectional survey was conducted to collect data from 260 healthcare consumers. A partial least squares structural equation modeling method was used to examine the data. Results revealed that healthcare consumers' behavioral intention was influenced by attitudes, while perceived usefulness and trust significantly influenced behavioral intention through attitude as a mediator. In addition, perceived risk, perceived privacy protection, network externalities, cognitive reputation, and interactivity directly influenced trust. Overall, the research model explained 50% of the variance in attitude and 71% of the variance in behavioral intention. The study's findings should provide useful insights into making effective design, development, and implementation decisions for OMC services.

The Credibility of Physician Rating Websites: A Systematic Literature Review

OBJECTIVES

Increasingly, the credibility of online reviews is drawing critical attention due to the lack of control mechanisms, the constant debate about fake reviews and, last but not least, current developments in the field of artificial intelligence. For this reason, the aim of this study was to examine the extent to which assessments recorded on physician rating websites (PRWs) are credible, based on a comparison to other evaluation criteria.

METHODS

Referring to the PRISMA guidelines, a comprehensive literature search was conducted across different scientific databases. Data were synthesized by comparing individual statistical outcomes, objectives and conclusions.

RESULTS

The chosen search strategy led to a database of 36,755 studies of which 28 were ultimately included in the systematic review. The literature review yielded mixed results regarding the credibility of PRWs. While seven publications supported the credibility of PRWs, six publications found no correlation between PRWs and alternative datasets. 15 studies reported mixed results.

CONCLUSIONS

This study has shown that ratings on PRWs seem to be credible when relying primarily on patients' perception. However, these portals seem inadequate to represent alternative comparative values such as the medical quality of physicians. For health policy makers our results show that decisions based on patients' perceptions may be well supported by data from PRWs. For all other decisions, however, PRWs do not seem to contain sufficiently useful data.

Setting goal difficulty in monetary incentives to physicians: evidence from an online health knowledge-sharing platform

Purpose

Prior studies on the impact of incentives on physicians’ online participation mainly focused on different incentives while ignoring the difficulty of setting monetary incentives efficiently. Based on goal-setting theory, the current research examines the relationship between incentives with goals of varying difficulty and professional health knowledge sharing (PHKS) in online health knowledge-sharing platforms (OHKSPs).

Design/methodology/approach

Four field experiments with different monetary incentives were conducted by one of China’s largest OHKSPs, with whom the researchers cooperated in data collection. Monthly panel data on 10,584 physicians were collected from September 2018 to December 2019. There were 9,376 physicians in the treatment group and 1,208 in the control group. The authors used a difference-in-difference (DID) model to explore the research question based on the same control group and the Chow test with seemingly unrelated estimation (sureg) to compare regression coefficients between four groups. Several robustness checks were performed to validate the main results, including a relative time model, multiple falsification tests and a DID estimation using the propensity score matching method.

Findings

The results show that the monetary incentive significantly positively affected the volume of physicians’ PHKS directly with negative spillover to the duration of physicians’ PHKS. Moreover, the positive effect of incentives with higher difficulty on the volume of physicians’ PHKS was significantly smaller than that of incentives with low difficulty. Finally, professional title had a positive moderating effect on the volume of goal difficulty setting and did not significantly moderate the effect on the duration of physicians’ PHKS.

Research limitations/implications

Some limitations of this study are: firstly, because the field experiments were enterprise benefit oriented, the treatment and control groups were not balanced. Secondly, the experiments for different incentive measures were relatively similar, making it challenging to validate a causal effect. Finally, more consideration should be given to the strategy for setting hierarchical incentives in future research.

Originality/value

The research indicates that monetary incentives have a bilateral effect on PHKS, i.e. a positive direct effect on the volume of physicians’ contributions and a negative spillover effect on the duration of physicians’ PHKS. The professional titles of physicians also moderate such bilateral switches of PHKS. Furthermore, when a physician’s energy is limited, the goal difficulty setting of the incentive mechanism tends to be low. The more difficult the incentives are, the more inefficient the effects on physicians’ PHKS will be.

Governance mechanisms for chronic disease diagnosis and treatment systems in the post-pandemic era

"Re-visits and drug renewal" is difficult for chronic disease patients during COVID-19 and will continue in the post-pandemic era. To overcome this dilemma, the scenario of chronic disease diagnosis and treatment systems was set, and an evolutionary game model participated by four stakeholder groups including physical medical institutions, medical service platforms, intelligent medical device providers, and chronic disease patients, was established. Ten possible evolutionary stabilization strategies (ESSs) with their mandatory conditions were found based on Lyapunov's first method. Taking cardiovascular and cerebrovascular diseases, the top 1 prevalent chronic disease, as a specific case context, and resorting to the MATLAB simulation, it is confirmed that several dual ESSs and four unique ESS circumstances exist, respectively, and the evolution direction is determined by initial conditions, while the evolution speed is determined by the values of the conditions based on the quantitative relations of benefits, costs, etc. Accordingly, four governance mechanisms were proposed. By their adjustment, the conditions along with their values can be interfered, and then the chronic disease diagnosis and treatment systems can be guided toward the desired direction, that is, toward the direction of countermeasure against the pandemic, government guidance, global trends of medical industry development, social welfare, and lifestyle innovation. The dilemma of "Re-visits and drug renewal" actually reflects the uneven distribution problem of qualified medical resources and the poor impact resistance capability of social medical service systems under mass public emergency. Human lifestyle even the way of working all over the world will get a spiral upgrade after experiencing COVID-19, such as consumption, and meeting, while medical habits react not so rapidly, especially for mid or aged chronic disease patients. We believe that telemedicine empowered by intelligent medical devices can benefit them and will be a global trend, governments and the four key stakeholders should act according to the governance mechanisms suggested here simultaneously toward novel social medical ecosystems for the post-pandemic era.

The Impact of Popular Science Articles by Physicians on Their Performance on Online Medical Platforms

The public demand for popular science knowledge regarding health is increasing, and physicians' popular science practices on online medical platforms are becoming frequent. Few studies have been conducted to address the relationship between specific characteristics of popular science articles by physicians and their performance. This study explored the impact of the characteristics of popular science articles on physicians' performance based on the elaboration likelihood model (ELM) from the central path (topic focus and readability) and the peripheral path (form diversity). Data on four diseases, namely, lung cancer, brain hemorrhage, hypertension, and depression, were collected from an online medical platform, resulting in relevant personal data from 1295 doctors and their published popular science articles. Subsequently, the independent variables were quantified using thematic analysis and formula calculation, and the research model and hypotheses proposed in this paper were verified through empirical analysis. The results revealed that the topic focus, readability, and form diversity of popular science articles by physicians had a significant positive effect on physicians' performance. This study enriches the research perspective on the factors influencing physicians' performance, which has guiding implications for both physicians and platforms, thereby providing a basis for patients to choose physicians and enabling patients to receive popular science knowledge regarding health in an effective manner.

Understanding Physicians' Motivation to Provide Healthcare Service Online in the Digital Age

This study aims to investigate the factors that affect physicians' healthcare service provision behavior on healthcare service platforms. A research model was proposed based on the related literature and uses and gratifications theory and self-determination theory. The empirical data were collected from a popular Chinese healthcare service platform, and negative binomial regression was employed to test the proposed research model. The results indicate that competence satisfaction, autonomy satisfaction, and economic benefit have positive impacts on their service provision behavior and that when physicians have a higher level of offline status, they would be less likely to provide consultation service online if they have a higher level of competence satisfaction. This study contributes to the existing literature by integrating intrinsic and extrinsic motivations to investigate how they affect physicians' healthcare service provision behavior online. Findings from this study may derive recommendations for improving the features and design of healthcare service platforms.

Encouraging physicians' continuous knowledge-sharing in online health communities: A motivational perspective

Online health communities (OHCs) as an essential means of patient education can significantly improve patients' health literacy and treatment outcomes. However, sustaining these social benefits brought by OHCs establishes the prerequisite that physicians can continuously share their knowledge on OHCs. Although previous studies have explored physicians' knowledge-sharing in OHCs, scholarly knowledge related to the means of motivating physicians to continue sharing their knowledge remains limited. Therefore, this study developed a research model based on motivation theory to explore the influence of practical benefits, psychological rewards, and perceived connectedness with OHCs on physicians' continuous knowledge-sharing behaviors and the contingent role of physicians' online seniority status. The research model and relevant hypotheses were examined using objective data from one of the leading OHCs in China. The empirical results reveal that both practical benefits and psychological rewards positively affect physicians' continuous knowledge-sharing behaviors. However, an unexpected finding is that perceived connectedness is negatively associated with physicians' continuous knowledge-sharing behaviors. In addition, physicians' online seniority status strengthens the relationship between practical benefits and continuous knowledge-sharing behaviors but weaken the role of psychological rewards and perceived connectedness on continuous knowledge-sharing behaviors. This study contributes to the understanding of the motivational mechanisms underlying physicians' continuous knowledge-sharing behaviors in OHCs and provides significant practical implications for practitioners of OHCs.

How does physicians' educational knowledge-sharing influence patients' engagement? An empirical examination in online health communities

Online health communities (OHCs) are popular channels increasingly used by patients for acquiring professional medical knowledge to manage their own health. In OHCs, physicians provide not only consultation services but also educational medical knowledge to improve patient education. So far, it remains unknown regarding how the educational medical knowledge sharing influence engagement of patients in OHCs. Drawing on the signaling theory, we examined the effects of paid vs. free knowledge-sharing of physicians on patients' engagement behaviors (i.e., patient visit and patient consultation). Data collected from one of the largest OHCs in China show that both paid and free knowledge-sharing are favorable for patients' engagement. Particularly, these two types of knowledge-sharing vary in their impacts. Moreover, physicians' registration duration in OHCs has a positive moderating effect on the relationship between physician's knowledge-sharing and patient engagement. Managers seeking to engage patients at OHCs are advised to share educational medical knowledge to entice them and the patient engagement is more salient for the knowledge shared by physicians active at the platforms for longer time history.

Internal or External Word-of-Mouth (WOM), Why Do Patients Choose Doctors on Online Medical Services (OMSs) Single Platform in China?

(1) Background: Word-of-mouth (WOM) can influence patients' choice of doctors in online medical services (OMSs). Previous studies have explored the relationship between internal WOM in online healthcare communities (OHCs) and patients' choice of doctors. There is a lack of research on external WOM and position ranking in OMSs. (2) Methods: We develop an empirical model based on the data of 4435 doctors from a leading online healthcare community in China. We discuss the influence of internal and external WOM on patients' choice of doctors in OMSs, exploring the interaction between internal and external WOM and the moderation of doctor position ranking. (3) Results: Both internal and external WOM had a positive impact on patients' choice of doctors; there was a significant positive interaction between internal and third-party generated WOM, but the interaction between internal and relative-generated WOM, and the interaction between internal and doctor-generated WOM were both nonsignificant. The position ranking of doctors significantly enhanced the impact of internal WOM, whereas it weakened the impact of doctor recommendations on patients' choice of doctors. (4) The results emphasize the importance of the research on external WOM in OMSs, and suggest that the moderation of internal WOM may be related to the credibility and accessibility of external WOM, and the impact of doctor position ranking can be explained by information search costs.

Using Telemedicine during the COVID-19 Pandemic: How Service Quality Affects Patients' Consultation

The COVID-19 epidemic put pressure on the traditional healthcare system and offline consultation methods. Telemedicine platforms provide a more convenient and safer channel for online health communication. Based on the signaling theory, our study explores the impacts of three dimensions of physicians' service quality (need fulfillment, security, and responsiveness) on online patient consultation on telemedicine platforms. A negative binomial model was used to test cross-sectional data of 2982 physicians obtained from Haodf.com. The results show the following: (1) the need fulfillment dimension variables positively affect online patient consultation; (2) the security dimension variables positively affect online patient consultation; (3) the responsiveness dimension variables positively affect online patient consultation. Our results contribute to the theoretical aspect of signaling theory and service quality in the context of telemedicine platforms and have several practical implications for telemedicine platform physicians and platform operators.

Measuring knowledge contribution performance of physicians in online health communities: A BP neural network approach

Extant literature on measuring the performance of physicians’ knowledge contribution in an online health community (OHC) is limited. To address this gap, this article aims to (1) develop a measurement model for physicians’ knowledge contribution performance; (2) use BP neural network to assign reasonable weight to each indicator of the model; and (3) explore the status and differences of knowledge contribution performance among a group of physicians. Based on the sample of 5407 infectious disease physicians in a Chinese OHC, we propose the measurement model by integrating physicians’ active knowledge contribution (AKC) and responsive knowledge contribution (RKC), covering 11 dimensions of contribution quantity and quality. We employ the BP neural network to optimise the model weights using the initial weight of the model obtained by the entropy method. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is used to evaluate the performance of physicians’ knowledge contribution in the OHC. The results show that it is feasible to use BP neural network to assign model weights. The distribution of physicians’ knowledge contribution performance is uneven; only a few have a high-level knowledge contribution performance. Meanwhile, a significant positive correlation exists between a physician’s title and respective knowledge contribution performance. Our research may contribute to related literature and practices by offering a fine-grained understanding of the performance of physicians’ knowledge contribution.

Explore How Online Healthcare Can Influence Willingness to Seek Offline Care

With the recent development of internet healthcare, many hospitals have laid out their online platforms. However, there have been some poor service levels and low quality. The frequency of such problems has led to a decline in patient satisfaction. Therefore, it is vital to explore how hospitals can improve user satisfaction and willingness to visit them offline by setting up an online presence. Most studies conducted so far have remained limited to the single dimension of online or offline healthcare, with few studies exploring the relationship between them. While a few studies have explored the impact of online service quality on willingness to seek offline care, they also face the problem of a single perspective of analysis. Therefore, this study constructs a multidimensional model of the factors influencing online healthcare users’ willingness to seek offline care by integrating the value-based adoption model and the stimulus–organism–response model. Through a partial least squares-structural equation modelling analysis of 283 valid samples, this study found that online doctor–patient interactions and service quality positively impact user perception. This paper explores the development path of online healthcare from a new theoretical perspective. In addition, the findings provide new guidelines for hospitals to achieve economic and social benefits.

The Effects of Online Text Comments on Patients' Choices: The Mediating Roles of Comment Sentiment and Comment Content

As an increasingly important application of mobile social media usage, online healthcare platforms provide a new avenue for patients to obtain and exchange information, referring not only to online doctor’s advice but also to the patients’ comments on a doctor. Extant literature has studied the patients’ comments facilitated with the direct numeric information gathered in the web pages including the frequencies of “thanks letter,” “flowers,” and “recommendation scores.” Adopting the text analysis method, we analyzed patients’ comments on the healthcare platform, focusing on the comments from two aspects, namely, comment contents and content sentiment. Based on the analysis of the data collected from one of the most popular healthcare apps named “Haodaifu” in China, the results show that the vast majority of the comments are positive, which basically follows the L-shaped distribution. Meanwhile, comment sentiment covering sentiment tendency and proportion of positive comments demonstrates significant effects on recent 2-week consultation by a doctor. One of the comment contents “patience explanation” has significant effects both on the total consultation and recent 2-week consultation by a doctor. The research findings indicate that the online preferences for and evaluations on doctors provide strong support and guidance for improving doctor-patient relationships and offer implications for medical practices and healthcare platforms improvement.

The Impact of Health Information Privacy Concerns on Engagement and Payment Behaviors in Online Health Communities

Online health communities (OHCs) have enjoyed increasing popularity in recent years, especially in the context of the COVID-19 pandemic. However, several concerns have been raised regarding the privacy of users’ personal information in OHCs. Considering that OHCs are a type of data-sharing or data-driven platform, it is crucial to determine whether users’ health information privacy concerns influence their behaviors in OHCs. Thus, by conducting a survey, this study explores the impact of users’ health information privacy concerns on their engagement and payment behavior (Paid) in OHCs. The empirical results show that users’ concerns about health information privacy reduce their Paid in OHCs by negatively influencing their OHC engagement. Further analysis reveals that if users have higher benefit appraisals (i.e., perceived informational and emotional support from OHCs) and lower threat appraisals (i.e., perceived severity and vulnerability of information disclosure from OHCs), the negative effect of health information privacy concerns on users’ OHC engagement will decrease.

What Influences Physicians' Online Knowledge Sharing? A Stimulus-Response Perspective

During the COVID-19 pandemic, online health platforms and physicians' online knowledge sharing played an important role in public health crisis management and disease prevention. What influences physicians' online knowledge sharing? From the psychological perspective of stimulus-response, this study aims to explore how patients' visit and patients' consultation influence physicians' online knowledge sharing considering the contingent roles of physicians' online expertise and online knowledge sharing experience. Based on 6-month panel data of 45,449 physician-month observations from an online health platform in China, the results indicate that both patients' visit and patients' consultation are positive related to physicians' online knowledge sharing. Online expertise weakens the positive effect of patients' consultation on physicians' online knowledge sharing. Online knowledge sharing experience weakens the positive relationship between visit of patient and physicians' online knowledge sharing, and enhances the positive relationship between patients' consultation and physicians' online knowledge sharing. This study contributes to the literatures about stimulus-response in psychology and knowledge sharing, and provides implications for practice.

Understanding online review behaviors of patients in online health communities: an expectation-disconfirmation perspective

Purpose

Although online health communities (OHCs) and online patient reviews can help to eliminate health information asymmetry and improve patients' health management, how patients write online reviews within OHCs is poorly understood. Thus, it is very necessary to determine the factors influencing patients' online review behavior in OHCs, including the emotional response and reviewing effort.

Design/methodology/approach

Based on expectation-disconfirmation theory, this study proposes a theoretical model to analyze the effects of service quality perception (i.e. outcome quality and process quality perceptions) and disconfirmation (i.e. outcome quality and process quality disconfirmations) on patients' emotional response and reviewing effort. The authors test the research model by using empirical data collected from a popular Chinese OHC and applying ordinary least squares (OLS) regression and zero-truncated negative binomial (ZTNB) regression models.

Findings

Both service quality perception and disconfirmation have a positive effect on patients' positive emotional intensity in textual reviews, and disease severity enhances these relationships of process quality. Moreover, there is an asymmetric U-shaped relationship among service quality perception, disconfirmation and reviewing effort. Patients who perceive low service quality have higher reviewing effort, while service quality disconfirmation has the opposite relationship. Specifically, patients' effort in writing textual reviews is lowest when perceived outcome quality is 3.5 (on a five-point scale), perceived process quality is 4 or outcome quality and process quality disconfirmations are −1.

Originality/value

This study is the first to examine patients' online review behavior and its motivations and contributes to the literature on online reviews and service quality. In addition, the findings of this study have important management implications for service providers and OHC managers.

The Effects of Log-in Behaviors and Web Reviews on Patient Consultation in Online Health Communities: Longitudinal Study

Background

With the rapid development of information technology and web-based communities, a growing number of patients choose to consult physicians in online health communities (OHCs) for information and treatment. Although extant research has primarily discussed factors that influence the consulting choices of OHC patients, there is still a lack of research on the effects of log-in behaviors and web reviews on patient consultation.

Objective

This study aims to explore the impact of physicians’ log-in behavior and web reviews on patient consultation.

Methods

We conducted a longitudinal study to examine the effects of physicians’ log-in behaviors and web reviews on patient consultation by analyzing short-panel data from 911 physicians over five periods in a Chinese OHC.

Results

The results showed that the physician’s log-in behavior had a positive effect on patient consultation. The maximum number of days with no log-ins for a physician should be 20. The two web signals (log-in behavior and web reviews) had no complementary relationship. Moreover, the offline signal (ie, offline status) has different moderating effects on the two web signals, positively moderating the relationship between web reviews and patient consultation.

Conclusions

Our study contributes to the eHealth literature and advances the understanding of physicians’ web-based behaviors. This study also provides practical implications, showing that physicians’ log-in behavior alone can affect patient consultation rather than complementing web reviews.

Converting Visitors of Physicians' Personal Websites to Customers in Online Health Communities: Longitudinal Study

Background

With the dramatic development of Web 2.0, increasing numbers of patients and physicians are actively involved in online health communities. Despite extensive research on online health communities, the conversion rate from visitor to customer and its driving factors have not been discussed.

Objective

The aim of this study was to analyze the conversion rate of online health communities and to explore the effects of multisource online health community information, including physician-generated information, patient-generated information, and system-generated information.

Methods

An empirical study was conducted to examine the effects of physician-generated, patient-generated, and system-generated information on the conversion rate of physicians’ personal websites by analyzing short panel data from 2112 physicians over five time periods in a Chinese online health community.

Results

Multisource online health community information (ie, physician-generated, patient-generated, and system-generated information) positively affected the conversion rate. Physician-generated and patient-generated information showed a substitute relationship rather than a complementary relationship. In addition, the usage time of a personal website positively moderated patient-generated information, but negatively moderated physician-generated information.

Conclusions

This study contributes to the electronic health literature by investigating the conversion rate of online health communities and the effect of multisource online health community information. This study also contributes to understanding the drivers of conversion rate on service websites, which can help to successfully improve the efficiency of online health communities.

Analysis of Massive Online Medical Consultation Service Data to Understand Physicians' Economic Return: Observational Data Mining Study

Background

Online health care consultation has become increasingly popular and is considered a potential solution to health care resource shortages and inefficient resource distribution. However, many online medical consultation platforms are struggling to attract and retain patients who are willing to pay, and health care providers on the platform have the additional challenge of standing out in a crowd of physicians who can provide comparable services.

Objective

This study used machine learning (ML) approaches to mine massive service data to (1) identify the important features that are associated with patient payment, as opposed to free trial–only appointments; (2) explore the relative importance of these features; and (3) understand how these features interact, linearly or nonlinearly, in relation to payment.

Methods

The dataset is from the largest China-based online medical consultation platform, which covers 1,582,564 consultation records between patient-physician pairs from 2009 to 2018. ML techniques (ie, hyperparameter tuning, model training, and validation) were applied with four classifiers—logistic regression, decision tree (DT), random forest, and gradient boost—to identify the most important features and their relative importance for predicting paid vs free-only appointments.

Results

After applying the ML feature selection procedures, we identified 11 key features on the platform, which are potentially useful to predict payment. For the binary ML classification task (paid vs free services), the 11 features as a whole system achieved very good prediction performance across all four classifiers. DT analysis further identified five distinct subgroups of patients delineated by five top-ranked features: previous offline connection, total dialog, physician response rate, patient privacy concern, and social return. These subgroups interact with the physician differently, resulting in different payment outcomes.

Conclusions

The results show that, compared with features related to physician reputation, service-related features, such as service delivery quality (eg, consultation dialog intensity and physician response rate), patient source (eg, online vs offline returning patients), and patient involvement (eg, provide social returns and reveal previous treatment), appear to contribute more to the patient’s payment decision. Promoting multiple timely responses in patient-provider interactions is essential to encourage payment.

Understanding the factors influencing health professionals' online voluntary behaviors: Evidence from YiXinLi, a Chinese online health community for mental health

BACKGROUND

Normal users' voluntary behaviors (e.g., knowledge sharing) in virtual communities (VCs) has been well investigated; however, research on health professionals' voluntary behaviors in online health communities (OHCs) is limited.

OBJECTIVE

This paper focuses on OHCs for mental health and aims to explore how intrinsic and extrinsic motivations influence mental health service providers' voluntary behaviors.

METHODS

Based on motivation theory and prior studies, we incorporated technical competence as intrinsic motivation and online reputation and economic rewards as extrinsic motivations, and proposed five hypotheses. We crawled objective data from YiXinLi, a Chinese OHC for mental health, and tested the hypotheses based on the Poisson regression model. All hypotheses are supported.

RESULTS

1) Technical competence, online reputation, and economic rewards positively influence mental health service providers' voluntary behaviors; 2) the interaction effect between technical competence and online reputation negatively influences mental health service providers' voluntary behaviors; 3) the interaction effect between technical competence and economic rewards negatively influences mental health service providers' voluntary behaviors.

CONCLUSIONS

Both intrinsic motivations and extrinsic motivations positively influence mental health service providers' voluntary behaviors, and their interaction effects negatively influence mental health service providers' voluntary behaviors. This study first contributes to the literature on health professionals' voluntary behaviors in OHCs by verifying the positive effect of economic rewards. It then contributes to motivation theory by incorporating a situation where intrinsic motivations and extrinsic motivations could negatively interact.

Quantitative Ratings and Narrative Comments on Swiss Physician Rating Websites: Frequency Analysis

Background

Physician rating websites (PRWs) have been developed as part of a wider move toward transparency around health care quality, and these allow patients to anonymously rate, comment, and discuss physicians’ quality on the Web. The first Swiss PRWs were established in 2008, at the same time as many international PRWs. However, there has been limited research conducted on PRWs in Switzerland to date. International research has indicated that a key shortcoming of PRWs is that they have an insufficient number of ratings.

Objective

The aim of this study was to examine the frequency of quantitative ratings and narrative comments on the Swiss PRWs.

Methods

In November 2017, a random stratified sample of 966 physicians was generated from the regions of Zürich and Geneva. Every selected physician was searched for on 4 rating websites (OkDoc, DocApp, Medicosearch, and Google) between November 2017 and July 2018. It was recorded whether the physician could be identified, what the physician’s quantitative rating was, and whether the physician had received narrative comments. In addition, Alexa Internet was used to examine the number of visitors to the PRWs, compared with other websites.

Results

Overall, the portion of physicians able to be identified on the PRWs ranged from 42.4% (410/966) on OkDoc to 87.3% (843/966) on DocApp. Of the identifiable physicians, only a few of the selected physicians had been rated quantitatively (4.5% [38/843] on DocApp to 49.8% [273/548] on Google) or received narrative comments (4.5% [38/843] on DocApp to 31.2% [171/548] on Google) at least once. Rated physicians also had, on average, a low number of quantitative ratings (1.47 ratings on OkDoc to 3.74 rating on Google) and narrative comments (1.23 comment on OkDoc to 3.03 comments on Google). All 3 websites allowing ratings used the same rating scale (1-5 stars) and had a very positive average rating: DocApp (4.71), Medicosearch (4.69), and Google (4.41). There were significant differences among the PRWs (with the majority of ratings being posted on Google in past 2 years) and regions (with physicians in Zurich more likely to have been rated and have more ratings on average). Only Google (position 1) and Medicosearch (position 8358) are placed among the top 10,000 visited websites in Switzerland.

Conclusions

It appears that this is the first time Google has been included in a study examining physician ratings internationally and it is noticeable how Google has had substantially more ratings than the 3 dedicated PRWs in Switzerland over the past 2 and a half years. Overall, this study indicates that Swiss PRWs are not yet a reliable source of unbiased information regarding patient experiences and satisfaction with Swiss physicians; many selected physicians were unable to be identified, only a few physicians had been rated, and the ratings posted were overwhelmingly positive.