The FDA.gov homepage is transforming on March 18.

I am happy about this unveiling not only because it is a superior layout and design, but also because FDA did it the right way—they listened to their customers.

They tested the usability of the page and focused on the most important user tasks. They even "sampled more than 188 consumers, health care professionals, and industry representatives and other audiences." Wow!

I am impressed with FDA web leaders. They are working hard to improve FDA.gov by using respected methods, and they even keep in touch with their "constituents".

Following the recent .gov Watch article, How FDA.gov Can Save Lives, both the Medical Director of MedWatch and the Director of FDA Web Communications followed up with positive notes to me. I am happy to report that as .gov Watch recommended, the new FDA homepage features a significantly more prominent section for reporting problems and side effects with drugs and medical products.

FDA says this is only the beginning. The agency has even more plans to improve FDA.gov later in 2008. I am eager to see the results of that work too.

I hope to have a follow-up story soon with more insight about how FDA did the work behind their homepage redesign. I expect FDA's methods could serve as a model for other agencies.

Did you know that serious side effects from prescription drugs kill over 100,000 Americans every year?

The number of deaths would be even greater without the FDA website, which communicates health warnings and risks. So the FDA website is central to saving thousands of lives annually, but it can do more.

Serious side effects (also called "adverse drug reactions" or "adverse drug events") are between the 4th and 6th leading cause of deaths in the United States. No drug is without risks, but the FDA depends heavily on reports of adverse drug reactions to issue warnings that can save lives.

Unfortunately for you and me, only a small fraction of serious reactions are reported to the FDA. Research suggests that once drugs are approved, FDA learns of less than 10% of serious reactions leading to hospitalization or death. This low level of reporting that save lives. And this is very real--51% of new drugs have serious, undetected adverse effects at the time of approval.

So, increasing the rate of reporting adverse drug reactions is central to drug safety.

Recent research suggests three easy ways to increase the rate of reporting:

1. Increase awareness of MedWatch, FDA's online reporting system. — Only a little more than half of doctors are aware of MedWatch, FDA's online drug reaction reporting system, and only 16% of adverse drug reactions are reported through MedWatch. This is despite FDA's wish to emphasize online reporting.
   
2. Encourage patients to report. — Patients are actually more likely to report adverse reactions than health professionals, and they have been critical for detecting previously-unknown serious reactions. But they need to be aware of the need to report.
   
3. Improve the usability of MedWatch. — Of those doctors who do know about MedWatch, many consider it inconvenient (including my own rheumatologist), which discourages reporting.
   

FDA's web team can save lives by doing these things. The first two goals can be supported with simple changes to the FDA.gov homepage and the MedWatch homepage. Improving the usability of MedWatch requires usability and design effort, but it should be a priority for FDA.


A quick look at the FDA website suggests why there is little awareness of MedWatch; the only link to it is easily overlooked below the fold. However, placing a well-chosen graphic or button on the homepage could educate millions of doctors and patients about reporting adverse drugs reactions to FDA. In a study by FDA's own scientists, the authors found that publicity increases reporting of adverse drug reactions.


For example, graphic like the one to the right might serve this purpose.

If FDA wishes to use its website to improve public health, then increasing the use and awareness of MedWatch ought to be a key goal and metric of success.

Update: USASpending.gov removed the intimidating warning from its home page! The warning was removed about one week after .gov Watch published an exposé on it.

Thank you to all who helped spread the word.

This is a victory for government transparency, because it allows the website to get closer to its goal of providing "the public with information about how their tax dollars are spent."

I am also impressed by OMB's response. Robert Shea of OMB posted a comment on .gov Watch expressing his agreement and notifying me that he took corrective action.

OMB is clearly eager for USASpending.gov to be a success, so I will post a more thorough review including strengths and recommendations for the site in the future.

In the meantime, please explore the site and find ways to take advantage of its open API into the government budget. I am eager to follow USASpending.gov to see what happens when the government successfully embraces Web 2.0 technologies.

FDA now serves up "mystery meat" email lists.

FDA revamped its email lists last week to use GovDelivery. In doing so, it exposed a long-standing problem with GovDelivery: lack of descriptions for email lists.

GovDelivery is the federal government's premier email list solution. But GovDelivery not only manages email lists, it also automatically monitors agency websites for changes and emails those changes to subscribers. This can save significant staff time, because it can essentially automate email updates.

However, GovDelivery has some quirks....

The U.S. Government has some great health information online. However, finding the best of it can sometimes be difficult, because there is so much available.

After a lengthy review of .gov health sites, I rated the following six websites as among the best for their content, presentation, focus, and ability to improve the health of broad audiences. This list is not meant to be exhaustive, but feel free to share additional .gov health information sites you recommend.

Search the Best Health & Nutrition Sites

#1 — MedlinePlus

This is the definitive health information site from the Government—absolutely the best and more thorough collection available! It is a service of the National Library of Medicine and a few partners. The site is easy to navigate, search, and read. This one is worth bookmarking no matter what health information you are looking for.

Topics: All health information, drugs, news

Check out:

• The Health Topics and Medical Encyclopedia both have in-depth health information on many topics.
  
• The Drugs, Supplements, and Herbals includes thousands of drugs cross-referenced by generic and brand names.
  
• The News RSS Feed is a great source for health news, but you will need to have an RSS reader.
  

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Which hospital in your area follows the best clinical practices? According to CDC estimates, about there are 1.7 million infections acquired in U.S. hospitals every year, and almost 100,000 of them result in death. These sobering statistics show the importance of checking up on hospital clinical practices before an operation. The Health and Human Services website, "Hospital Compare", lets you do just that.

Search the Best Health & Nutrition Sites

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Cancer.gov provides an excellent collection of cancer research from the National Cancer Institute (NCI) and the National Institutes of Health (NIH). However, the site should also provide excellent public health education on topics such as prevention, coping, and care giving. Cancer.gov already includes this information, but it could do a much better job of communicating and promoting it to visitors to yield public health results....

It is disappointing to see the same Federal department that spearheaded user-centered design in the Government through Usability.gov unveil such an agency-centric homepage earlier this month.

The Department of Health and Human Services (HHS) has always been a usability leader in the Federal Web community. It conducted substantial usability research to redesign and optimize their homepage in 2002 to help visitors find valuable health information easier and faster. That is exactly what HHS should be doing—making it easy for the American public to find useful health information. Unfortunately, HHS practically threw out all the findings from that work when it released its latest incarnation of its homepage.

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Which airline is most likely to leave your airport on time? Which airport is more likely to have departure delays? These questions can be answered using a great database and web application on the Bureau of Transportation Statistics’ (BTS) website, TranStats. You can find some interesting information directly on the BTS homepage, but the good stuff for avoiding airline delays is cleverly hidden in TransStats.

TranStats records, publishes, and makes easy to explore every airline delay in the United States for about the last 5 years.







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The Federal Highway Administration (FHA) posts the National Bridge Inventory (NBI) database online, but the agency should do a better job of making the contents accessible to citizens....