Use of Google Analytics to Explore Dissemination Activities for an Online CKD Clinical Pathway: A Retrospective Study

Abstract

Background: Data on dissemination strategies that generate awareness of clinical pathways for kidney care are limited. Objective: This study reports the application of Google Analytics to describe the reach and use of the Chronic Kidney Disease Pathway (CKD-P) using a multi-faceted dissemination strategy. Design: The design of this study is a retrospective descriptive study. Setting: This study was conducted in Alberta, Canada. Patients: Individuals who accessed the CKD-P Web site between November 5, 2014, and May 31, 2019. Measurements: Dissemination activities included print, electronic, in-person meetings, and a laboratory prompt. We used Google Analytics over a 5-year period to evaluate the following CKD-P Web site user metrics: number of sessions, pageviews, visit duration, user path, and bounce rate (when an individual visits a single page of the Web site and leaves the Web site without interacting with additional pages). Methods: We plotted dissemination activities alongside Web site metrics using control charts and described the data using means and percentages. We performed chi-square test for trends to evaluate year-over-year usage. Results: There were 83 294 users, 90 805 sessions, and 231 684 pageviews. The overall bounce rate was 45.7%. Each user had an average of 1.5 sessions and a session duration of 2 minutes and 8 seconds. There was a significant positive trend for total annual users ( P = .008), new users ( P = .009), number of sessions ( P = .006), and pageviews per day ( P = .016). Limitations: We were unable to confirm if users were primary care providers and if word-of-mouth dissemination among providers/researchers drove people to use the CKD-P. Conclusions: Google Analytics was a useful and accessible tool for evaluating CKD-P reach and use trends. It was challenging to identify how individual dissemination activities contributed to CKD-P reach; however, repeated dissemination appeared to play a role in increasing CKD-P use. Trial registration: Not applicable—observational study design.

Trends in nephrology referral patterns for patients with chronic kidney disease: Retrospective cohort study

“…Use of renal care pathways such as the Alberta Kidney Pathway [ 41 ] have made referral and triage processes more efficient [ 42 ]. The Alberta Kidney Pathway has shown to lead to an increase in urine ACR testing especially in non-diabetic patients [ 43 ] and prior work has examined ways to disseminate this tool locally [ 44 ]. In studies focused on electronic advice requests and consults to nephrologists where 18% [ 45 ] to 27% [ 46 ] of the consults were related to CKD, researchers found that only a minority of electronic system referrals led to in-person consults [ 45 , 46 ] highlighting the potential of e-referrals to reduce in-person nephrology visits.…”

Optimizing Care Delivery in Patients with Chronic Kidney Disease in the United States: Proceedings of a Multidisciplinary Roundtable Discussion and Literature Review

“…One online CKD clinical pathway found the interaction time between the user and CKD pathway website to be only 2 min 8 s, and the end-user (provider or researcher) was not clearly defined [77], whereas another resulted in improvements in uACR testing, although primarily in patients who did not have diabetes [78]. Other clinical pathways have been used to support future patient-centered approaches [79], visualize patterns of the co-progression of multiple clinical events in a chronic disease (such as CKD) by using patients' own clinical data [80], or improve and/or maintain quality of care while reducing costs for patients with CKD (i.e., CMS ESRD treatment choice [ETC] model) [81].…”

A Method for Analyzing Navigation Flows of Health Website Users Seeking Complex Health Information with Google Analytics

“…The numbers of users that are new to a website or revisiting a website [4,13,16] Session Count and Length A session refers to a period of time that a user is active on a website. These variables count the number of sessions and their durations [16][17][18]20,21] Bounce Rate…”

“…Bounce rate is the ratio of users that visit a website exiting without going to the second page. It usually means that users do not achieve their goals through interacting with a website [6,7,10,13,[16][17][18]20,21] Time on Site The duration of time users spent on a website [6,10,13,[16][17][18][20][21][22] Page Views The total number of web pages viewed in a session on a website [7,10,11,13,[16][17][18][20][21][22] Stem cell science is a particularly challenging space for people seeking information to navigate due to the proliferation of commercial clinics marketing unsubstantiated claims directed towards consumers about their reputed "stem cell" service; a heightened awareness of the promise of stem cell science exists, and unmet needs of many living with currently incurable conditions affecting their quality of life [26]. In addition, because of the complexity of stem cell treatments, involving different body parts, treatment choices and fast-paced research, patients and information consumers demand credible, understandable and easy-to-access information in this space [19].…”

“…As web-based interventions are actively developed for various purposes, GA is used for evaluating the processes of sexual health interventions [10] and health portals [11,12]. In the meantime, there are many health information websites and social media campaigns created for health promotion and education, and GA is adopted for understanding the demographics of visitors [13,14], browsing behaviors [14,15], activities and durations on websites [13,16], as well as the effectiveness of the websites [17][18][19]. Additionally, websites of medical schools can gain advantages with GA [20,21].…”