Reading level of privacy policies on Internet health Web sites

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Original Research

Reading level of privacy policies on Internet health Web sites

J Fam Pract. 2002 July;51(7):642-645

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References

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Many patients are beginning to use the Internet as a source of information and many are unaware that their every move is being tracked. Physicians can help to protect patients by making them aware of this problem and suggesting that patients take steps to protect their information.

A number of possible solutions can be applied to this problem. Rewriting privacy policies to be comprehensible to most Internet users should be the initial step. Resources are available to Web site developers that help to maximize the readability of information.^27-29 More widespread use of the “Health on the Net” (HON, http://www.hon.ch) privacy criteria would reassure individuals that their data are secure. Consideration should also be given to extending the same protection to medical information gleaned from the Internet by Web sites and advertising companies as is given to the formal medical record because, in effect, they can reflect the same type of information. For example, on several sites, users can enter medications they are taking and diagnoses (http://www.drkoop.com and others).

The first limitation of this study is that the Web sites studied represent a minority of the health Web sites on the Internet. However, the study set includes the top 25 visited health Web sites and did seek many different types of Web sites for evaluation. Also, none of the Web sites had a policy that was written at a level comprehensible to most of the English-speaking people in the United States. It is unlikely that including more Web sites would substantially change the outcome. Finally, given the large (and unknown) number of health Web sites on the Internet, it is not practical to obtain a large enough sample to be representative of all health Web sites.

The second problem is readability levels themselves. Readability calculations have been criticized because they depend mainly on sentence length and the number of syllables per word. If an individual is familiar with the sentence terminology, it may be possible to interpret the information correctly using context clues. However, most individuals do not have a working knowledge of legal terminology (eg, “indemnify”) and thus may not be able to use these clues to determine the meaning of a sentence.

Conclusions

Thirty percent of health Web sites do not have privacy statements, and those that are posted are beyond the reading level of most adults. For this reason, current privacy statements do not function to adequately inform users of a Web site’s privacy policy and do not protect users’ privacy rights.