Improving Health Information: Focusing on the National Health Information Online Service

Abstract

The internet is an important tool for increasing opportunities for people who need information about their health. However, it also presents limitations and issues when it comes to utilizing online health information. The Korea Disease Control and Prevention Agency (KDCA) operates the National Health Information Portal to respond to the risks associated with inaccurate or misleading information exposure. The core value of the National Health Information Portal is to provide verified, easily understandable, and integrated information related to health and disease. In pursuit of this core value, the KDCA is establishing a standardized system to facilitate the efficient production and quality management of content. Moreover, It’s making an efforts to generate health information that takes into account consumers’ health literacy. This includes providing training for authors and striving to enhance consumer engagement for utilization. Furthermore, KDCA is connecting channels in a way that enable public to access information, which has been distributed by different institutions, in an integrated and systematic manner from one place. As of 2022, the National Health Information Portal holds and provides 852 types of health information, over 4,000 media items, and 1,070 terms. Achieving results are included in plans outlining the direction of media to long-term policies for disease prevention and health promotion, such as the 5th Health Plan. KDCA is continually seeking ways to further develop the National Health Information Portal, enabling its active utilization as a public platform that integrates and systematically provides health information based on the needs of the public.

Key messages

① What is known previously?

There are issues and limitations associated with the utilization of online health information. The Korea Disease Control and Prevention Agency (KDCA) has been operating the National Health Information Portal since 2017 to respond to the risks associated with the dissemination of inaccurate or false information on the on-line. Through this portal, the KDCA supports the production, distribution, and consumption of health information for the public.

② What new information is presented?

KDCA is making efforts to provide verified national-level health information by creating contents, managing quality, and standardizing data.

③ What are implications?

Minimizing the digital accessibility gap and promoting active portal usage require continuous improvement.

Introduction

The Internet is becoming an increasingly vital source of health information for patients, their families, and all those who need it, while also addressing potential health risks and the currently unmet need for information [1]. According to a survey of 1,000 adults conducted in 2020 by the Korea Institute for Health and Social Affairs, Internet portals ranked first as the main channel for obtaining health information. Nevertheless, they ranked fifth in terms of satisfaction [2], which could be due to the limitations and problems arising from the use of online health information despite the various advantages of the Internet. Medical fields and academia have indicated that much of the information circulating online is likely to be inaccurate or incorrect [3] and have highlighted the digital gaps that affect the acquisition, management, and utilization of health information [4], as well as the limitations of its application in terms of the ability to understand the information acquired (health literacy) [5].

The Korea Disease Control and Prevention Agency (KDCA) operates the National Health Information Portal (https://health.kdca.go.kr, hereinafter referred to as the “health information portal”) to respond to the risks caused by exposure to inaccurate or incorrect health information. The health information portal is a public portal that provides verified health information at the national level, so that people can make the right choices regarding health promotion and disease treatment [6]. In this article, we introduce the major reforms that have been introduced over the past five years in the health information portal, which was transferred from the Ministry of Health and Welfare to the KDCA in 2017 to strengthen the stability and accountability of its operation.

Results

The health information system consists of production, distribution, and consumption [7]. The KDCA strives to efficiently produce and manage the quality of content, expand access to information through data standardization, and promote consumer use with “verified information, easy-to-understand information, and integrated information.” As of 2022, it has provided 852 types of health information, 4,000 media, and thousands of terms. It is included in plans that present mid- to long-term policy directions for disease prevention and health promotion, such as the 5th national health promotion comprehensive plan [8].

1. Production and Quality Management of Nationally Verified Health Information

The UK’s National Health Service (NHS) has a “content policy” to ensure that all content and related service offerings are accurately and clearly presented to meet users’ needs [9]. Inconsistent content formats and organization can hinder the provision of cohesive information and confuse consumers with disparate formats. The KDCA has also systematized health information production and quality management procedures to enhance content uniformity to improve quality management and speed up development.

The new health information lists and topics were selected through expert consultation and consumer needs surveys by compiling the names of highly prevalent domestic diseases and the necessary information for target audiences, such as older adults, children, and women. Since then, content planning, writing, and proofreading procedures have been systematized and implemented. Initially, the information previously gathered on domestic topics was reviewed, the needs of consumers were identified, and a proposal was created and handed over to the author, following which the writing was completed. Thereafter, the content cross-checked by the editor to verify whether it was evidence-based was uploaded on the portal. For information that has already been produced and provided, a three-year management cycle is set to evaluate the need for information renewal and continuously manage the quality of health information by making it current.

To produce reliable and up-to-date health information, the writing and editing were verified by several experts. With the recommendation of professional societies in the field, a health information writing team and a medical profession supervision group were formed, and online and offline competency improvement training programs were operated for health information providers so that they would not produce information with terminology that was difficult to understand. In addition, the information generated was corrected by literacy experts.

The KDCA established content writing guidelines and quality evaluation tools to ensure consistent production and development of health information (2019. 2.) (Table 1). The guidelines include the purpose and principles of writing to produce health information that is reliable, consistent, up-to-date, and easy to understand. To unify the content format, it presents a large classification (diseases and disorders, health problems, self-management, lifestyle habits, risk factors, diagnosis and testing, support system, and treatment) and a detailed table for each content (Table 2). This standardization allows to identify information that needs to be updated or is insufficient when managing it. In addition, a “copyright standard contract” has been included to prevent copyright issues related to the use of developed works before writing health information.

Table 1. Health information quality assessment tool.

Evaluation items	Value
1. Based on medical and scientific evidence	F	P
2. Reflecting the latest information	F	P
3. Content source and date of creation is provided and accurate	F	P
4. Helpful in assisting readers’ decision making and behavior change	F	P
5. Clearly and concisely described in simple terms and easy to understand	F	P
6. Constructed with a relevant theme and appropriate content, and includes easily comprehensive visuals (table, picture, graph)	F	P
7. Contains sufficient elements (benefits, drawbacks, uncertainty of effect) for understanding	F	P	NA
8. Includes an introduction to related national services or external content, and if it’s website, the hyperlinks are well connected	F	P	NA
9. Contains no commercial advertising	F	P
10. No bias or prejudice towards any specific individual, group, or gender	F	P

F=fail; P=pass; NA=not applicable.

Table 2. Contents by category and type for health information standardization.

Main category	Contents by type
Disease and disability	Type A: disease and disability content excluding mental health and statutory infectious disease
	Type B: mental health and related diseases
	Type C: statutory infectious disease
Health issue	Type D: health issues excluding trauma
Self management	Type G: chronic disease self management
	Type H: vaccination
Lifestyle	Type I: health promotion and lifestyle for health issues and self management
Risk factors	Type J: environmental risk factors and trauma related
Diagnosis and testing	Type K: testing
Support service	Type L: support service
Treatment	Type M: treatment

2. Laying the Foundation for Revitalizing the Use of Health Information Content

To ensure continuous and stable operation of the portal as a source of information for public institutions, the overall operation of information production and management is conducted with the content management system, and various methods are introduced to increase the accessibility of the health information portal.

The health information portal had a challenge in that a single document was provided for each topic. For example, when consumers searched for hypertension-related health information, considerable effort had to be expended to access only specific areas of information, such as the treatment and symptoms of hypertension. In addition, the single long-document format had to be reprocessed by institutional consumers, such as by private portals, to distribute the data. The KDCA is building and standardizing ontology-based metadata to reduce the difficulty of finding specific health information that consumers want and increase its utilization by linking it with other data and systems.

Ontology is a knowledge model that analyzes knowledge in a specific area of interest, extracts concepts, and clearly and explicitly defines the relationships between the extracted concepts in a form that can be interpreted by a computer. To achieve this, text, images, and videos are segmented into minimum thematic units of health information in the health information portal, and concepts, relationships between concepts, and analogs/synonyms correspond to the ontology to structure the information. Metadata provide information about the data, including ontology management, content management, and user management information, and support the systematization of information management and improve the efficiency of search. The portal is preparing to improve the consumer-centered search function by building a database of 18,237 hierarchies, 15,362 attribute relationships, and 12,082 synonyms for 3,823 concepts of health information by major categories included in the ontology to improve the consumer-centered search function (Table 3).

Table 3. Numbers of National Health Information Portal ontology.

Superclass	Concepts (n)	Synonym (n)	Hierarchical relationships	Attribute relationships
Disease and disorders	1,683	5,450	18,237	15,362
Health problems and conditions	588	1,751	18,237	15,362
Assessment and evaluation	525	1,532	18,237	15,362
Treatment	642	2,122	18,237	15,362
Lifestyle management	138	427	18,237	15,362
Self-care	55	234	18,237	15,362
Risk factors	179	525	18,237	15,362
Support service	13	41	18,237	15,362
Total	3,823	12,082	18,237	15,362

The KDCA has implemented a feature that provides health information as a secondary source, serving as an information transmitter that disseminates reliable information. Individuals can use the “link sharing” function on their personal blogs or SNS (Social Network Service), and institutional consumers can receive information through the “health information request” function after a review. Currently, it provides health information to institutional consumers such as private portals (Naver, Kakao) and public institutions (National Health Insurance Service, Health Insurance Review and Assessment Service, and Statistics Korea). It uses Open API (Application Programming Interface) to link real-time information and expand the provision of content.

Among the various health-related topics, information related to cancer and mental health, which are dispersed through clearly defined providers of health information, is linked to the National Cancer Center and the National Center for Mental Health so that the information can be linked to searches within the portal and an integrated service can be provided. In addition, to produce and provide nationally verified health information that cater to the public’s needs, a forum is set up to listen to the opinions of media and consumers and discuss the current state of technological innovation, regulations, and the possibility of technological expansion.

3. Produce and Install Health Information Tailored to Consumer Needs

The health information portal conducts user weblog analysis and satisfaction surveys, and considers information requests, to reflect consumer needs, and strives to operate in a “consumer-centered” way, starting from health information planning to development, quality management, and dissemination and promotion.

To produce health information tailored to the consumers’ needs, we have formed a standard user group of the health information portal and prepared a mechanism for consumers’ opinions to be reflected at all stages of health information production. We are conducting surveys related to consumer needs, health information literacy reviews, and health information portals. To enhance the understanding of information that is difficult due to the use of specialized medical terminology, everyday terms are used instead of complex ones; moreover, in the case of essential terms that cannot be replaced, an “easy-to-understand glossary of terms” has been developed to enhance consumers’ understanding with speech bubbles.

In addition, to increase the use and accessibility of the portal by providing information that can be easily consumed, we are producing “health information of the month” on timely issues, such as various disease awareness days (anniversaries). A subscription service containing information that can help change behavior and descriptive information about diseases is provided on the third Wednesday of every month to increase access to the health information portal [10]. Finally, we are improving the environment to solve the inconvenience of users in settings such as PCs and mobiles. Design enhancements have been introduced, such as user experience and user interface, and efforts are being made to attract the public’s attention by promoting the portal through contests such as images, slogans, and logos.

Conclusions

The KDCA is continuously exploring ways to develop the health information portal to promote its use as a public portal that integrates and systematically provides health information tailored to the public’s needs. Considering that participation in multidisciplinary academic societies and establishing a continuous and stable operation and management system are essential due to the nature of health information, we plan to promote a commission system led by the health information writing team and the medical profession supervision group of the health information portal. The commission system encourages experts to be the writer, evaluator, and quality manager of health information in related fields and to work for a certain period. In addition, to develop content that meets the public’s needs and continuously manage quality, we intend to operate a more systematic training program to revise and manage the writing guidelines and improve the competency of medical professionals in writing health information.

Above all, we plan to continuously improve the quality and usability of information so that health information provided by the public portal is prominently featured on private portals when the public searches for health information. By systematizing health information with a data structure that is easy to link and distribute, we plan to build a foundation to continuously disperse verified health information in the developing digital environment.

Finally, to minimize the gap in access to digital health information, we will consider a multifaceted review and approach to the methods, means, and contents related to information provision. We will monitor the status of health information both internally and externally to identify vulnerable groups for health information and prepare strategies for providing information that are tailored to the actual level of health literacy in the Republic of Korea.