October 26, 2021

The E-A-T of Disease Awareness and Why Brands Need to Get It Right

Man searches Google on laptop at desk

The dangers of misinformation are often discussed in the context of social media, but this subject is similarly pressing in search. Over the past few years, Google has heightened its scrutiny in a few key verticals, including health, due to the real, human consequences of getting it wrong.   

Non-branded patient and healthcare provider (HCP) disease awareness (DA) websites present unique challenges when it comes to establishing expertise, authoritativeness, and trustworthiness (E-A-T) in the eyes of Google, so let’s explore the ins and outs of E-A-T, the dilemmas DA sites face, and areas of consideration that can evolve to meet the changing needs of SEO. 

Before considering potential solutions, here’s some background on a few foundational topics:  

Quality Rater Guidelines 
It’s easy to think of Google Search as an AI-driven autonomous machine, and while there are certainly automated components, humans still play critical roles in key areas. One of those areas is the Quality Rater Guidelines (QRG). Google employs over 10,000 people to manually assess search results, according to Google’s nearly 200-page QRG document.   

While rater feedback doesn’t directly influence Google Search, it’s used to evaluate algorithm changes and benchmark the quality of the results. Thus, it’s critical for SEOs to be familiar with these guidelines as they depict the outcome that Google’s algorithm is aiming toward.   

Expertise, Authoritativeness, and Trustworthiness (E-A-T) 
E-A-T is mentioned extensively in the QRG. Although there is debate around how E-A-T might be directly or indirectly incorporated into Google’s algorithm, the QRG lists the following characteristics. 

  • Expertise – This refers to the qualifications of the creator in relation to the topic of their authored page. The expertise of a website may change from page to page since the author may vary. The required level of expertise differs by topic. 
  • Authoritativeness – This may refer to the content, creator, or website, but the QRG examples mostly focus on the website as a whole. This includes a website’s consistency with its content quality and topic (e.g., you wouldn’t trust tax information on a recipe website), branded properties (i.e., brands should be seen as the authoritative sources for their own information), and being recommended by other experts. 
  • Trustworthiness – This may also refer to the content, creator, or website. A common example includes the accuracy of a topic, with expert consensus being leaned on when there’s uncertainty. Trustworthiness could also refer to something unrelated to the content, like a non-secure connection on an e-commerce checkout page. Finally, the transparency of the author, website owner, and the website’s contact information are cited as important to being considered trustworthy.

While the three words in E-A-T are often used interchangeably in the QRG and can be somewhat difficult to dissect, here is how E-A-T is described for pharma content:

“High E-A-T medical advice should be written or produced by people or organizations with appropriate medical expertise or accreditation. High E-A-T medical advice or information should be written or produced in a professional style and should be edited, reviewed, and updated on a regular basis.”  

Your Money, Your Life  
First introduced in 2013 within the QRG, Your Money, Your Life (YMYL) refers to content that should be held to a higher page-quality standard because it affects your money or your life. YMYL content can impact your present or current well-being, so the validity of the content and its sources is paramount. As you may imagine, health-related content falls squarely under the YMYL umbrella.   

In relation to E-A-T, the QRG directs raters to raise the bar for YMYL content. Even though YMYL and E-A-T have been around for the better part of a decade, Google’s interest in promoting them has skyrocketed in recent years. In fact, ‘YMYL’ & ‘E-A-T’ QRG Mentions Increased by 198% from 2014 to 2020

YMYL & EAT QRG Mentions Increased by 198% from 2014 to 2020

Google Core Algorithm Updates 
Although Google makes over 3,000 updates to its algorithm per year, it generally releases large, confirmed updates three to four times annually. These are often referred to as core algorithm updates. Since August 2018, most core updates have disproportionately impacted the health vertical.   

Given the impact on health websites, it’s clear that pharma should pay attention to and anticipate these updates.

Google’s official core algorithm documentation contains significant mentions of E-A-T and given the impact on health websites (where E-A-T importance is raised), it’s clear that pharma websites should pay attention to and anticipate these updates.   

Beyond E-A-T, Google’s core algorithm direction to webmasters encourages original, referenced, clean, and comprehensive content. In other words, thin or cluttered pages that simply parrot what’s already been published have a higher likelihood of losing out when these updates are pushed. 

Where Disease Awareness Sites Fit In  
Branded sites are undoubtedly related to this subject, but there’s even more connectivity to DA sites. Based on the characteristics described in the previous section, here’s a high-level comparison between branded and disease-related websites:

CategoryBrandedDisease Awareness
Site ownership visibilityYesMostly
Authorship visibilityNoNo
Expert consensusYesMostly
Reviewer visibilityNoNo
Update frequency visibilityNoNo
Contact information accessibilityYesYes
Linked or referenced contentYesMostly

Areas for Consideration 
The relative anonymity of DA sites, combined with their high-standards YMYL label, leave them vulnerable to being devalued in search. Based on the categories listed in the table above, the following recommendations are designed to help futureproof DA sites with stronger E-A-T.  

  • Site Ownership Visibility  
    When visiting ESPN.com, CapitalOne.com, or Lowes.com, we never wonder who owns the site. Similarly, pharma brands are their own entities, so the organizations behind these sites are never in question to Google or users. Disease awareness sites don’t have the same luxury. Closing this gap can actually build audience trust rather than erode it. Continuing to craft a unique DA identity for each site is also recommended.  
  • Authorship Visibility 
    As a reminder, the QRG states, “High E-A-T medical advice should be written or produced by people or organizations with appropriate medical expertise or accreditation.” The guidelines go on to describe low-quality content in this way: “There is an unsatisfying amount of website information or information about the creator of the MC (main content) for the purpose of the page (no good reason for anonymity).” 
  • Expert Consensus 
    How does Google know if what you’re saying is accurate? Algorithmically, we’re not sure, but the QRG points out that expert consensus is one way. In other words, does what respected experts in the field say corroborate your content claims? Branded sites have it a little easier since the content it puts out is on label and approved by the FDA. While DA site content is also FDA-approved, do visitors and Google know this?  
  • Reviewer Visibility  
    Pharma content endures one of the most rigorous content-approval processes that exists. Wouldn’t sharing a glimpse into this process only reinforce confidence to site visitors? Highly qualified reviewers also may afford the flexibility of having less-qualified authors. In other words, if a doctor approves it, does it matter as much who wrote it?  
  • Update Frequency Visibility 
    Google’s QRG states, “High E-A-T medical advice … should be edited, reviewed, and updated on a regular basis.” This is another example where pharma must adhere to strict procedures, even going as far as temporarily removing content if it fails to get routed for continual use in time. However, this information is rarely shown to users. If content was reviewed or updated recently, wouldn’t that give visitors more peace of mind knowing what they’re reading is up to date and trustworthy?   
  • Originality 
    Originality is possibly the most abstract and hardest to quantify out of these categories. Branded sites, once again, have an edge because they are the exclusive sites for their brands; that alone offers originality. With DA sites, what can they produce that is truly unique and not generally found on dozens of other health sites?  
  • Contact Information Accessibility 
    The QRG explicitly states websites, particularly those covering YMYL topics, should have sufficient information about the site, including how to contact the website owner. Without any contact information, the site may appear suspiciously anonymous and be perceived as being of low quality. 
  • Linked or Referenced Content 
    When determining page quality, the QRG suggests reviewing a site’s reputation via reviews, expert recommendations, and other references. One of the main ways Google measures referenced content is through links. Links from other sites can help improve organic search ranking and its perceived E-A-T. An ongoing link-building campaign can also improve E-A-T for active DA websites. 

The pharmaceutical industry’s response to the pandemic has boosted its public sentiment. While historical public perception may have been a driver to distance DA sites from their pharma parent, could it be time to reassess? SEO aside, is it possible that in 2021 our audience would prefer to read medical content from pharma rather than from a comparatively unknown source? The robust checks and balances of creating pharma content are not going away. It’s time we start using them to our advantage. 

If you’re wondering how your DA site measures up to E-A-T, reach out to your Intouch Group contact for an audit.

Author information: Tylor Hermanson is VP, SEO at Intouch Group.