title: What Internet services would patients like from hospitals during an epidemic? Lessons from the SARS outbreak in Toronto.
abstract: BACKGROUND
  International health organizations and officials are bracing for a pandemic. Although the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto did not reach such a level, it created a unique opportunity to identify the optimal use of the Internet to promote communication with the public and to preserve health services during an epidemic.
  
  
  OBJECTIVE
  The aim of the study was to explore patients' attitudes regarding the health services that might be provided through the Internet to supplement those traditionally available in the event of a future mass emergency situation.
  
  
  METHODS
  We conducted "mask-to-mask" surveys of patients at three major teaching hospitals in Toronto during the second outbreak of SARS. Patients were surveyed at the hospital entrances and selected clinics. Descriptive statistics and logistic regression models were used for the analysis.
  
  
  RESULTS
  In total, 1019 of 1130 patients responded to the survey (90% overall response rate). With respect to Internet use, 70% (711/1019) used the Internet by themselves and 57% (578/1019) with the help of a friend or family member. Of the Internet users, 68% (485/711) had already searched the World Wide Web for health information, and 75% (533/711) were interested in communicating with health professionals using the Internet as part of their ongoing care. Internet users expressed interest in using the Web for the following reasons: to learn about their health condition through patient education materials (84%), to obtain information about the status of their clinic appointments (83%), to send feedback to the hospital about how to improve its services (77%), to access screening tools to help determine if they were potentially affected by the infectious agent responsible for the outbreak (77%), to renew prescriptions (75%), to consult with their health professional about nonurgent matters (75%), and to access laboratory test results (75%). Regression results showed that younger age, higher education, and English as a first language were predictors of patients' interest in using Internet services in the event of an epidemic.
  
  
  CONCLUSIONS
  Most patients are willing and able to use the Internet as a means to maintain communication with the hospital during an outbreak of an infectious disease such as SARS. Hospitals should explore new ways to interact with the public, to provide relevant health information, and to ensure continuity of care when they are forced to restrict their services.
authors.affiliation: Centre for Global eHealth Innovation, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Rizo
authors.forename: Doina
authors.initials: D
authors.lastname: Lupea
authors.forename: Homayoun
authors.initials: H
authors.lastname: Baybourdy
authors.forename: Matthew
authors.initials: M
authors.lastname: Anderson
authors.forename: Tom
authors.initials: T
authors.lastname: Closson
authors.forename: Alejandro R
authors.initials: AR
authors.lastname: Jadad
mesh_terms: D001294:Attitude to Health; D004196:Disease Outbreaks; D006306:Health Surveys; D006801:Humans; D007255:Information Services; D020407:Internet; D009864:Ontario / Q000453:epidemiology; D045473:Severe acute respiratory syndrome-related coronavirus; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology