NHS DIRECT MULTI-CHANNEL SERVICE
Dr Shirley Large and Kate Arnold
NHS DIRECT MULTICHANNEL SERVICE
• Telephone service – over 650,000 calls
per month
• NHS Direct Online – 1 million visits per
month
• Self-help guide in Thomson Local
directory – 18 million homes
• NHS Direct Interactive – 5% of digital
satellite viewers
Web log analysis: how users
interact with NHS Direct
Online
Objectives
• Develop an approach to web log analysis to enable
the NHS Direct New Media web logs to be analysed
in a meaningful and informative way
• Establish an approach to extracting, truncating and
analysing the data from NHS Direct New Media web
logs
• Develop an awareness of the navigation and health
information seeking behaviour of users accessing
MRSA information web pages on the NHS Direct
New Media website.
Death certificates showing resistant and
non-resistant MRSA 1993-2003
1 Day’s server activity
Even exploring just one day’s activity from three servers
for the website the size of each server comprised large
datasets as outlined below:
 Server 1 = 40.2 MB
 Server 2 = 41.0 MB
 Server 3 = 40.3 MB
Global Metrics
 32,728 visits to the website on 4th October 2004
 MRSA was the 15th most commonly viewed topic on 4th October
2004.
 242 visits to the MRSA topic
150
Count
300
260
46.68%
250
200
100
40
7.18%
54
9.69%
57
10.23%
62
11.13%
73
13.11%
50
11
1.97%
0
F
PD
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in
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or
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at
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ge
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te
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s
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pt
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en
ev
Pr
SA
R
M
SA
R
M
SA
R
M
25
23
9.5%
21
8.68%
20
8.26%
20
18
7.44%
16
6.61%
15
15
6.2%
6.2%
14
5.79%
Count
15
11
4.55%
13
5.37%
11
4.55%
9
3.72%
10
7
2.89%
7
2.89%
4
1.65%
5
8
3.31%
8
3.31%
6
2.48%
5
2.07%
4
1.65%
3
1.24%
2
0.83%
1
1
0.41%
0.41%
0
23-24
22<23
21<22
20<21
19<20
18<19
17<18
16<17
15<16
14<15
13<14
12<13
11<12
10<11
9<10
8<9
7<8
6<7
5<6
4<5
3<4
2<3
1<2
0<1
Hour
140
137
56.61%
120
Count
100
80
60
42
17.36%
40
16
13
6.61% 13
11
5.37%
5.37%
4.55%
20
3
1
1
1
1
1
1
1
1.24%
0.41% 0.41% 0.41% 0.41% 0.41% 0.41% 0.41%
0
1
2
3
4
5
6
7
8
9
10
Number of pages visited
11
12
13
18
5 page pathways
Visitors
Introduction → Causes → Treatment → Prevention → Symptoms
2
1
1
1
1
1
1
1
1
1
11
Introduction → Causes → Treatment → Symptoms → External link
Introduction → Causes → Symptoms → Treatment → External link
Introduction → Causes → Introduction → Prevention → Introduction
Introduction → Symptoms → Introduction → Treatment → Treatment
Introduction → Prevention → Causes → Symptoms → Treatment
Introduction → Treatment → Prevention → Symptoms → External link
Introduction → Treatment → Symptoms → Causes → Introduction
Symptoms →Treatment → Treatment → Treatment → Treatment
Symptoms → External link → Introduction → Prevention → Treatment
Total
6 page pathways
External link
Visitors
Introduction → Cause → Treatment → Prevention → Symptoms → 3
Introduction
External link
→ Introduction → Causes → Treatment ? Symptoms →
1
Introduction
External link
→ Cause → Treatment → Symptoms → Prevention →
1
Introduction
→ Treatment → Prevention → Cause → Symptoms →
1
External link
Introduction
Introduction
→ Causes → Introduction → Introduction → Causes → Causes 1
1
→ Causes → Symptoms → Treatment → External link → Prevention
Introduction
External link
→ Prevention →
Causes → Symptoms → Treatment →
Symptoms → Treatment → Introduction → Cause → External link →
External link
1
1
Symptoms → Treatment → Treatment → Symptoms → Symptoms → Treatment 1
External link → Introduction → Prevention → Causes → Symptoms → Treatment1
External link → Symptoms → Prevention → Treatment → Causes → Introduction1
Total
13
150
156
Mean
300
278
250
225
200
95
100
49
40
43
47
50
71
80
75
82
57
20
n
io
16
15
14
13
12
11
0
2
1-
3
2-
4
3-
5
4-
6
5-
7
6-
8
7-
9
8-
1
9-
10
11
12
13
14
15
8
17
-1 16-
17
at
ur
D
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io
n
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at
ur
D
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ur
D
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ur
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ur
D
ur
D
ur
D
ur
D
ur
D
ur
D
at
ur
D
0
16
ur
D
21
15
Findings
 The main findings of this study show that MRSA was the 15th most viewed
health topic on 4th October 2004, which reflects the public and health care
concern.
 The navigational path through the sections of the MRSA topic did not mimic
the classic textbook presentation; introduction, causes, symptoms, treatment and
prevention. Although in a few instances there appeared to be good coverage of
the topic, page views did not follow any discernibly logical pattern. More
research is required to understand; if the same for different topics, if the way
information is viewed is a phenomenon of Internet health information searching
or if reveals a problem with layout and navigational links on the webpage.
 The PDF or print page was viewed nine times during the day, which indicates
that all the topic information was accessed, possibly to be viewed at the visitors
leisure or with friends/family/colleagues when offline.
Conclusions
 Understanding the interest in and the navigational pathways through the health
topics on the website has implications for both the system design and the
information architecture of the website and consequently may improve the
efficiency and effectiveness of the website.
 Analysing and exploring the patterns in the visitor’s behaviour when searching
for health information on the website will contribute of the understanding of the
quality and delivery of information services.
 Web log analysis as just one component of a larger assessment of the activity
for evaluating NHS Direct New Media services. Other complimentary forms of user
analysis should be considered for evaluating the use of the Internet health
information such as an online questionnaire, face-to-face interviews, direct
observation of health information seeking behaviour or focus groups. These
methods will allow further exploration of some of the questions highlighted in this
study.