Health Information Technology (HIT) has been introduced into the National Health Service (NHS) in order to improve the quality, efficiency, safety and cost effectiveness of the delivery of health care. The application of computerized information technology in health care settings has so far played a vital role in improving the accessibility of information and has replaced more labour intensive and unproductive methods (Shekelle and Goldzweig, 2009).
The Nursing and Midwifery Council (NMC, 2009) maintain that that nurses’ skills, knowledge and practice must be guided by the best available evidence. Often this evidence is found on the internet however many sources of information can be inaccurate so a good standard of critical evaluation is required (Kim, Eng, Deering et al 1998).
To evaluate the quality and reliability of a chosen website the use of a framework can be helpful such as Roberts (2012) 5 C’s website tool. This framework evaluates five areas: credibility, currency, content, construction and clarity. The website The Royal College of Psychiatrists (RC Psych, 2012 a) was chosen to be evaluated because as a mental health nursing student this will develop an awareness of how information technology is implemented and applied to practice in health care. Additionally, by using Roberts (2012) 5 C’s framework to critically evaluate this website, knowledge and skills of the quality and reliability of HIT will be acquired.
RC Psych is the professional and educational organisation for psychiatrist in the UK as well as being a registered charity (RC Psych, 2012 b). Their website is aimed at improving the lives of individuals affected by mental illness through educating the public. They claim to be at the head of developing and promoting best practice in mental health services through their education, training and research projects. Additionally they are involved in the publishing of the following world-class journals; British Journal of Psychiatry, The Psychiatrist, Advances in Psychiatric Treatment and International Psychiatry (RC Psych, 2012 c).
Having gained a royal charter this shows us that the organisation has been recognised by the Queen and seconded by the government to call itself a registered organisation of the highest regard. As stated by the Privy Council Office (2012) organisations granted a Royal Charter must have a solid record of achievement. 75% of its members should be qualified to at least first degree level and the work completed by the organisation must be in the interest of the public.
Professor Peter Tyrer is named as the Editor, of the website, and is said to be responsible for the editorial and production aspects of its publications in addition to the production of their online continuing professional development (CPD) e-learning resources and its sales and marketing (RC Psych, 2012 d). After researching Peter Tyrer it is evident that he is highly qualified within the field of mental health and is a professor of community psychiatry for the Department of Medicine, within the Imperial College London (Imperial College London, 2012).
The website offers a vast amount of information around mental health including conditions, diagnoses, treatments and types of therapies. The advice provided is produced in the form of online leaflets for the use of the public as well as professionals. Within the website there is no evidence to show that the same specific authors are used regularly for their published articles however, at the end of each article the producer, editor and sometimes an author are named in addition to any expert that has been involved in the making of it.
All these leaflets are produced by the RC Psych Public Education Editorial Board that is responsible for producing 300 educational leaflets. These leaflets have been accredited by the NHS Information Standard and subsequently gained numerous awards (Byrne, 2011). They have achieved Plain English and BMA patient information awards and have received consistently positive feedback for the web versions. The editor of these leaflets is Dr Phillip Timms who is currently employed as a consultant Psychiatrist for the South London & Maudsley NHS Foundation Trust as well as a senior lecturer in psychiatry at King’s College, London (BMJ Masterclasses, 2012).
This site’s web address shows that it is delivered by a UK based academic body as it has an ac.uk URL. This confirms their credibility and reassures the reader that they are qualified experts able to give advice in this field (Roberts, 2010).
Combining all this it is apparent that the producers of the website have appropriate qualifications and expertise to offer advice in regards to mental health and supports the credibility of the organisation and the website. Some of these points also link into the other five C’s for example, the awards that the leaflets have received show that the content and clarity of their work has been assessed and found to be of an acceptable standard.
When using a website for personal development reasons or to recommend to a patient the information being accessed should be the most current evidence available that has been proven in practice. In regards to the advice provided on the website RC Psych (2012 e) states that they endeavour to update it every two to three years. This is reflected in the articles by showing the date the information was last updated and the date it will be reviewed in the future. Additionally RC Psych (2012 d) state that their information derives from the best evidence available at the time of writing and is updated regularly to reflect any changes in knowledge.
Another way to determine the currency of information is to consider the references used to back it up (Roberts, 2010). If the sources are dated then what you are reading may not come from the most current research so there may be more up to date evidence elsewhere. The dates of the references used throughout the website are quite varied however, they do contain many recently published articles and up to date clinical guidelines so this suggests that they are committed to producing up to date information and evidence. This is seen in a leaflet on depression where RC Psyche (2012 f) cites a recently updated guideline by the National Institute for Clinical Excellence (NICE, 2009) which looks at the treatment and management of depression in adults. The currency and credibility of the website can also be reflected in its content and therefore this should also be assessed during the evaluation process.
As well as being credible and current the content must be assessed for its objectivity, accuracy and completeness (Roberts, 2010). The content of a website can be judged by assessing what the website aims to achieve. This could be selling a product, persuading the audience to believe in something or to provide the reader with unbiased and up to date information on a specific topic (Roberts, 2010). RC Psych (2012 a) profess that they aim to improve the lives of individuals with a mental health illness. They aim to do this by educating people through making information and advice available on their website. This would indicate that it falls under the category of providing unbiased and up to date information to the public.
The articles on the website are written in the third person so prevents the author from expressing personal opinion. Furthermore the leaflets produced provide links to various other sources of information on the topic being discussed. This encourages further reading which provides a complete and balanced view preventing bias and, where treatment is recommended, allows the reader to make an informed choice (Roberts, 2010). The references used within the website are taken from well known and respected sources that provide current and acknowledged recommendations such as NICE, the Department of Health (DOH) and various field related journals. This indicates that the website seeks to provide and maintain up to date, accurate and unbiased information that concurs with information available in books and journals on the same subjects.
The construction of a website, for example, the layout, colours, fonts, sizes and ease of access can determine whether or not a reader believes the website is of good quality or not (Roberts, 2010). A study by Lindgaard, Fernandes and Dudek et al. (2006) found that the first 50 milliseconds that the reader is exposed to a website can cause the reader to form an opinion as to whether a website is worth using or not. On first impression, the website in question looks colourful and professional. The eye is drawn to the bolder writing that states the websites purpose and there are minimal graphics to distract the reader from this.
There is a lot of information on the home page of the website and could be considered cluttered, however it is divided into clear sections and appears well organised, giving clear subheadings which guide the reader to their areas of interest easily. The main colour used for the website is grey and presents a professional look. It is subtle but effective in breaking up different sections of the website without being obtrusive. The font size is varied throughout but mainly of a larger size making the website easy to read. There is no option for the reader to change the font sizing or colour which could cause some difficulty as it is not possible to suit everyone with one font size, style and colour (Roberts, 2010).
As this is a registered charitable organisation it would be unfair to expect them not to promote money making offers. There are two links to buy books that are published by the royal college of psychiatrists and an option to support them in future development projects. They have presented these links as the last things you would come across on the website. Because of where they are situated it comes across to the reader that they are more interested in providing free and accessible information to educate the pubic over making money.
Clarity is another important area to consider when evaluating a website. Due to our continually growing multi-cultural society it is important that websites cater for all groups in society and not just the English readers. One part of the website caters for professionals working in psychiatry and another to the public wanting to learn more about mental illness. Both sections are presented and written in a way that is understandable to the general public. In the public section they offer their advice in 21 different languages in addition to visual aids using BSL sign language as well as audio pod casts and printable versions.
This shows that they have made an effort to cater for diverse cultures and needs. Unfortunately it appears that they have not taken into account the needs of people with dyslexia. Approximately two million people in the UK population are affected by dyslexia of which around 35 to 40 percent experience visual disturbances when reading (Dyslexia Action, 2012). The British Dyslexia Association, (2012) states that the reading ability of an individual with dyslexia can be negatively affected by bright white backgrounds and the use of too much text. By changing the background to an off white colour and spreading out the information over larger areas this would cater for yet another group in society.
Having the ability to access health information via the internet has given nurses the capacity to constantly improve their knowledge base and skills knowing that they are delivering the best possible care derived from the best available evidence. The RC Psych website not only offers nurses a place to go and build on their knowledge and skills but it also provides them with a safe, reliable and easily accessible knowledge base that they can confidently refer their patients to. The evaluation of this website has shown that the website contains quality, reliable evidence and could be recommended to anyone interested in the field of mental illness. In addition to this the use of the five C’s evaluation tool has provided a great foundation to the development of evaluating skills. It has given an opportunity to discover that the evidence being accessed is suitable for developing personal practice and to help educate patients and is accepted within the NMC code of conduct (Roberts, 2010).