The document discusses Google's practice of online content control in healthcare searches. It describes how Google curates the top three search results for certain drug and medical queries, prioritizing sources like the National Library of Medicine, Wikipedia, and RxList. A study showed identical top search results across users for terms like "warfarin" and "pradaxa prior authorization". While intended to provide trusted health sources, the practice faces criticism for lacking transparency in criteria and potential biases of preferred content providers.

1. The rise of online content control in healthcare
Anthony Staresinic, PharmD

2.  Process of finding web pages and web page
content on the internet using an internet
search engine
 Requires the web page creator to assign their web
content with keywords or terms (tags or
metadata) to allow search engines to locate the
page when a searcher uses the same or similar
terms

3. “understands exactly what you mean and
gives you back exactly what you want.”
Larry Page, Google Co-founder

4.  Affects only organic
search results and n0t
‘paid’ or ‘sponsored’
results
 Process of improving a
website’s visibility to
search engines through
strategic organizing and
programming of the web-
page
 Companies and
consultants selling their
ability to improve website
rankings

5. http://www.buzzom.com/2009/09/google-continues-to-be-the-search-engine-leader-with-huge-margins/ Accessed on January 4, 2012.

6.  Google is a publicly traded company that has a fiduciary responsibility
first and foremost to it’s shareholders and increasing shareholder wealth

7. Health information is obviously an important category of information users are looking
for. For this health search feature we decided to offer users one source each from a
governmental health agency, a medical institution, and a commercial site. We’ll study
how users like these choices and continue to iterate. None of these sites is paying any
money to Google to be included in the feature. Google is 100% committed to ranking
websites objectively to provide the most relevant information to users. Websites
cannot pay for higher search rank.
Roni Zeiger of Google Health
http://e-patients.net/archives/2010/01/health-sites-some-are-more-equal-than-others.html. Accessed on January 4, 2012.

8.  National library of medicine drug content is supplied by the
American Society of Health System Pharmacists

9. http://sirensong.sireninteractive.com/search-engine-marketing/google-starts-editing-drug-results/ Accessed on January 4, 2012

10.  Utilized a modified online crowd-sourcing approach
 Ambulatory PRN list from American College of Clinical
Pharmacy was solicited to participate in a
standardized search experiment
 Used the same search terms on the same day and
roughly the same local time (topics chosen based on
personal interest of researcher)
 warfarin
 pradaxa prior authorization
 18 individuals submitted results of their search
 All U.S. time zones represented in search exercise
http://www.youtube.com/watch?v=Buyub6vIG3Q Accessed on January 4, 2012.

12.  National Library of Medicine result was always first
 Wikipedia was always second
 RxList was always third

13.  Sponsored Ad was always the same
 The link takes you to the Phillips patient self-testing
 One screen sh0t did not present any ads on top
 One screen shot presented an additional ad

14.  Physicians Plus Insurance result was always first
 Montana Medicaid was always second
 Wellmark was always third

15.  Sponsored Ad was always the same
 One submission did not present any ads on top
 Another one presented an additional ad

16.  Identical display of search results observed for
both searched terms
 Unintended consequences of altruistic intention in
controlling first page results in healthcare
information
 Lack of transparency in criteria for prioritizing content
 What site will be 4th, 5th, 6th and so on
 Hidden biases and conflicts in content providers
 Sharing of website analytics with third parties
 Controlled display of first page results is
controversial and remains unresolved