Objective: the objectives of this article are: (a) to provide an analysis of the key factors of an efficient web strategy with regard to the issue of patient empowerment, (b) to build an index for measuring the degree of empowerment of healthcare providers ' web sites, (c) to measure the degree of "patient web empowerment" within the Italian National Health Service (INHS). Methods: a Patient Web Empowerment Index (PWEI) was built, through aggregation and weighting of 8 sub-indicators. Results:

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... WEI was calculated in order to assess yearly (since 2009 to 2011) the web sites of 340 INHS healthcare organizations, the aim being the appraisal of the current degree of maturity of their web strategies for an effective increase in patient empowerment. Conclusions: the web strategies of health organizations basically reflect a state of deep immaturity and they still display a tendency to modulate their approach with the accent all too frequently placed on the structures and responsibilities of the organisation itself, rather than on the needs of citizens-patients. Practical implication: PWEI could play a role in order to benchmark, also at international level, the web strategies of health organizations and could therefore support a patient-centered web design of information and services.