Table 1: Table Summary of Functionality of Medical Tourist Sites

Information	Connectivity	Assessment	Commerciality	Communication
To be seen to provide a range of health resources. The link to information on Medical Tourists sites is usually via a keyword web search, such as Google, e.g. ‘surgery overseas’, ‘breast augmentation’ etc. The site content is to encourage and assure the consumer/patient that they are making an ‘informed’ and independent choice(s) about procedural medical care, travel and potential after care for their treatment overseas. Through these provisions, the aim of the medical tourist sites is to have ‘enough’ information to secure, and be seen to support, patient interest, in a clear and easy to understand layout.	Medical Tourism sites offer related information to insurance brokers, travel partners and other medical websites. These can include official sources such as clinical and public health systems for a particular country and/or be purely commercial/ privatized. One issue is limited health service integration (especially cross-country) where the promotion of consumer services may be prioritized over official organizations, institutions and cross-country legislation.	A key element to the functionality of the Medical Tourism sites is to attract and sustain consumer interest. The assessment of the reliability and validity of the information and site content can be (largely) unregulated – particularly where sites are ‘outside’ of resident country domains. This means that content can be unclear, incomplete and misleading [27]. Moreover, the individual assessment of information and related health portals is made more uncertain when it is unlikely that content is based on the systematic review of medical care, knowledge and procedures. This means that the assessment of site content is only as ‘good’ or reliable as the authors declare, and the ability of the consumer to navigate and evaluate information.	The commerciality of Medical Tourism sites is built on the profiling/data gathering of the individual as they navigate sites. Key data is obtained in the form of cookies, surveys, newsgroup postings and web forums. Further data is also obtained and secure when the consumer is encouraged to sign up to newsletters or to register with the site to access the full content. In terms of functionality, this is about the provision of services and elective procedures, rather than reliable source of medical information.	In terms of communication Medical Tourist sites usually facilitate a traditional ‘paternalistic’ model of relationships. This establishes distance between those who are the ‘medical professionals’ and the ‘patient’ as a consumer. In addition, the direct communication and/or assessment of a procedure/patient health is often via a gate-keeper or mediator. In this way, the direct access to a medical professional and assessment is being reformed, and there is a problem with identifying the official owner/keeper of sites.