Prevalence of web trackers on hospital websites in Illinois.

Web tracking technologies are pervasive and operated by a few large technology companies. This technology, and the use of the collected data has been implicated in influencing elections, fake news, discrimination, and even health decisions. Little is known about how this technology is deployed on hospital or other health related websites. The websites of the 210 public hospitals in the state of Illinois, USA were evaluated with a web tracker identification tool. Web trackers were identified on 94% of hospital webs sites, with an average of 3.5 trackers on the websites of general hospitals. The websites of smaller critical access hospitals used an average of 2 web trackers. The most common web tracker identified was Google Analytics, found on 74% of Illinois hospital websites. Of the web trackers discovered, 88% were operated by Google and 26% by Facebook. In light of revelations about how web browsing profiles have been used and misused, search bubbles, and the potential for algorithmic discrimination hospital leadership and policy makers must carefully consider if it is appropriate to use third party tracking technology on hospital web sites.