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CMAJ
CMAJ - May 18, 1999JAMC - le May 18, 1999

CMA Online: usage triples in a year

CMAJ 1999;160:1487

© 1999 Canadian Medical Association

| On_the_Net@cma.ca  /  Sur_le_Net@cma.ca |
CMA Online is the first Web site in the world created by a national medical organization. By its fourth anniversary in March, the monthly number of visits by Internet users had grown to 73 000 — triple the number a year earlier — and the visitors had viewed nearly 425 000 pages in March alone. The increases continued despite mammoth growth in the number of Web sites offering health and medical information.

But who are these visitors? Are they physicians or health-conscious consumers? Are they even Canadian? Are they satisfied with the site? And, most important to the CMA, are its members using CMA Online? If they are, how could it be improved?

Unlike many similar sites, CMA Online has resisted asking visitors to register and use a password — this can cause visitors to leave after one glance. Only services developed exclusively for CMA members require registration. This is done to verify member status and ensure a high level of security.

Last fall, focus groups of CMA members told us how physicians are using the Internet and provided valuable feedback on the design and content of medical sites, including our own. Many members also participated in 2 voluntary and anonymous online surveys. The second one was run from the first page of the 3 most popular sections of the CMA part of the site: the online edition of CMAJ, the CPG Infobase (which provides access to more than 650 Canadian clinical practice guidelines) and OSLER (the CMA's personalized MEDLINE service). A questionnaire popped up for every fifth person accessing 1 of these 3 pages. It requested demographic information and asked the reason for visiting CMA Online; those who had visited before were asked how the site could be improved.

The target for the CMA survey was 500 respondents, and the questionnaire was pulled after 578 completed forms had been received. Although this number was reasonable for a "snapshot" of site visitors, the results could be biased by such factors as self-selection and the fact that the first page visited may not represent all the visitor's information needs on that occasion. Further, OSLER is available only to CMA members, whereas CMAJ and the CPG Infobase are freely accessible. Therefore, the results must be interpreted with caution.

Here are a few highlights.

  • Physicians and medical students accounted for 74% of respondents; the rest were mainly other health care professionals. The public accounted for a mere 9%, and most of them answered the survey from the CMAJ page.
  • Canadians represented only 72% of respondents; 8% were from the US.
  • Females accounted for only 30% of respondents. The proportion of physicians (other than residents) who were female was particularly low (14%). Of all respondents from the CMAJ page, however, 43% were female.
  • The largest number of respondents, by far, was found in the 35-to-44 and 45-to-54 year age groups. OSLER respondents (all physicians) tended to be older and to visit more frequently.
  • One-quarter of respondents were visiting CMA Online for the first time, but almost 50% visited more than once a month.
  • When asked which parts of the site they had visited before, CMAJ was by far the most frequent response.

The CMA's annual Physician Resource Questionnaire (PRQ) has let us track growing Internet use by Canadian physicians. In early 1998, 56% of the nearly 4000 respondents were personally using the Internet (up from 41% a year earlier). Email was still the most frequent application, used daily by 53% and weekly by 37% of the subgroup of Internet users.

By the end of 1998, according to our online survey, daily use of the Internet for various purposes was even more common among physicians (although not all of these respondents were Canadian). Notable among the uses: 71% of GP/FPs and 75% of specialists used email every day, while 12% of GP/FPs and 17% of specialists visited online journals daily.

Clearly, the Web has gone mainstream. We eagerly await results of the 1999 PRQ to verify these trends in a much larger group of Canadian physicians.

Ideas for making the site more useful are welcomed. Contact bolsta@cma.ca, 800 663-7336 (613 731-8610), x2117; (fax) 613 565-2382. — Ann Bolster, Associate Director (Online Services), Professional Development Directorate, with files from Sanjay Shah and Andrea Holroyd, research coordinators from MD Management.

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