The online communication of healthcare organisations in the 'post-truth' era: An analysis of 167 websites in Italy

Introduction: The advent of the Internet and the availability of health information online has posed new challenges and opportunities to the healthcare sector. The amount of people who surf the Internet for health-related purposes is dramatically increasing. Actually, the ‘post-truth’ phenomenon had interested also the healthcare field, where the quality of the online information is really variable. In addition, the health literacy of people and their consequent capacity to correctly understand and therefore use health-related information is crucial. The quality and usability of information provided by the healthcare organizations online appear very important, in order to avoid the risks of fake news as well as of a misunderstanding of information. The websites can be used as a powerful channel for improving the access to care, the use of healthcare services, the health literacy and the empowerment of people. Methods: By analysing the websites of 167 healthcare organizations from 13 Italian Regions, we verified whatever online communication of Italian public hospitals and local healthcare authorities was readable and comprehensible for people with different level of education and different level of literacy, by using the Gulpease Index and by measuring the adoption of words from the Italian Fundamental Vocabulary the data refers to December 2015. Results: The results showed that, in Italy, the healthcare organisations’ online communication is still not structured by taking into consideration literacy and health literacy of people who may surf the Internet. In fact, the websites were difficult to read and understand for people with a low educational level according to both the indexes used. The healthcare organisation’s websites appeared built on the healthcare organisations’ needs, rather than on those of the potential readers. The healthcare management of the Regions recognized the importance of these findings. For this reason, the Collaborative of the Italian Regions, coordinated by the MeS Laboratory of Sant’Anna School, decided to monitor and evaluate these aspects by introducing specific indicators in the healthcare Performance Evaluation System they voluntarily adopted. Implications: In the ‘post-truth’ era, it is important to consider the risks of more readable and comprehensible information available on other than the healthcare organisations’ websites. This suggests an urgent consideration of the health literacy of people, in addition to their information needs. The availability of our findings was fundamental to inform managers of Italian regional healthcare systems and support them in addressing this issue and working for an equal access to good quality but also comprehensible and readable information online.