1 Introduction

The widespread dissemination of information and communication technologies (ICT) has changed the functioning of our society, creating the so-called information society (Roztocki et al 2019). In this scenario, in which the use of the Internet has become widespread, it has transformed all sectors and especially the tourism sector (Aramendia-Muneta and Ollo-Lopez 2013; Januszewska et al. 2015). This sector is information- intensive, so its evolution is strongly linked to ICTs (Moliner-Velázquez et al. 2015). On the one hand, it has changed the way travellers prepare and book their trips, and on the other hand, the way their businesses operate. In this regard, companies in the tourism sector are immersed in highly competitive markets both nationally and internationally, so they must adopt ICTs in order to achieve competitive advantages to survive (Abrhám and Wang 2017). The use of ICTs according to Law et al. (2009: 599), allows to “cut costs, save on labour, increase operational efficiency, and most critically, improve service quality and customer experience”.

One of the chief objectives of organisations in using the Internet and social networks is to integrate the Information and Communications Technologies (ICT) into their marketing strategies in order to enhance contact with customers and become an important source of information for them (Benslimane & Yang 2007; Filipiak et al. 2020; Hofacker & Belanche 2016). This fact is supported by data from the latest Eurostat reports (2022a, b), which show that 46% of people in Spain use the Internet to search for information on travel and accommodation and 31% purchase these services online. Thus, the use of ICT by companies improves access to foreign markets (Lee and Pang 2022) and is key to reaching their target audience (Wong and Sa’aid Hazley 2020). Using ICT for e-commerce provides organisations with better market access, both domestically and internationally (Burstein and Vogel 2017). By eliminating the geographical barriers that exist in traditional trade, e-commerce allows the reduction of transaction costs and facilitates the connection between users anywhere in the world (Cristobal-Fransi et al. 2015).

The use of Information and Communication Technologies (ICT) and specifically, having a website is important for all types of organizations and especially for spas, which are a prime health tourism resource. According to Sun et al. (2017), websites are currently the most important platforms for promoting the services of organizations and thus, boost profit generation by attracting customers. Therefore, their appropriate design, management, maintenance, positioning, as well as their evaluation become essential with the aim of ensuring that the web interface is as attractive as possible and provides the necessary information to clients (Ramos and Perna 2009). This ensures the survival and competitiveness of the organization (Assiri and Shamsudeen 2019).

This research is focused on this context. An analysis of the web presence and the level of maturity regarding the use of e-commerce in spas in Spain is conducted for two main reasons. The first one is due to the weight of the tourism industry in the Spanish economy. According to data from the Statistics on Tourist Movements at the Border (INE-FRONTUR 2022), between 2004 and 2019, Spain hosted an annual average of more than 60 million tourists, a figure which at the end of 2021 reached a record of more than 83.5 million tourists. In 2020 and 2021, these figures dropped to 18.9 and 31.2 million, respectively due to the health crisis derived from COVID-19. Likewise, according to data from the Tourism Expenditure Survey (INE-EGATUR 2022), spending by international tourists reached its record in 2019 with 92,337 million. However, in 2021, this figure decreased to 34,816 million, due to the effects of the pandemic.

Secondly, due to the importance of health and wellness tourism. The National Association of Spas (ANBAL) classifies the components of this type of tourism into hydrotherapy, thalassotherapy and marine treatments, and a health and beauty centre. In Spain, spas or health resorts are an important component of this tourist segment. According to the Global Wellness Institute (GWI 2022), the wellness sector currently represents 4.4 trillion dollars. It will grow by 5% per year until 2025, when it is expected to reach 7 trillion dollars. Spa tourism plays a leading role within wellness tourism, and it is predicted to have great potential in the future, due to the role of spas as health agents (Pinos Navarrete and Shaw 2021). In this regard, it is necessary to clearly define what is understood by thermal establishments or spas. For this purpose, we resort to the definition provided in Spain by the National Association of Thermal Resorts, “the Spa or health resort is defined as a facility that has Mineral-Medicinal waters declared of Public Utility, medical services and adequate facilities to provide the Treatments that are prescribed”. Currently, these establishments operate as businesses with a broader approach in their process of adapting to their clients´ new demands, incorporating into their main objective, treating ailments or preventing them (therapeutic approach), providing an environment in which to enjoy a health holiday (recreational approach) by incorporating relaxation and stress relief services, beauty treatments, spa treatments (massages, facial and body treatments… all aimed at general well-being). According to Bonfada et al. (2011), these establishments combine the two approaches: therapeutic and recreational. Spas are important tourism resources that provide economic activity for the tourism industry and retail trade in the territory (Bacon 1998).

For these two reasons, it is justified to carry out an investigation on the Internet presence of spas through their websites as communication and distribution tools. This study aims to achieve several objectives. In the first place, to propose a comprehensive model for assessing the online presence of spas based on the four categories of content (i.e. Information, Communication, e-Commerce and Additional Functions) and to analyse the maturity of their development of e-commerce based on the eMICA model. Secondly, to use the proposed model to analyse the websites of health resorts in Spain. And, thirdly, in order to help health resort managers in their work to manage spas efficiently, offering them recommendations and suggestions for improving their management. The results obtained will be useful to spa managers for their reflection and formulation of strategies related to the digital marketing of their businesses.

This document is divided into five sections. After the introduction in which the subject matter is contextualized, the research is justified, and the objective is stated. Section 2 describes the context and sector in which the analysis is carried out. The third section presents the methodology, followed by the results obtained in Sect. 4. Finally, in the fifth section, the conclusions, recommendations to spa managers and limitations of the research are collected.

2 Internet presence of wellness tourism

The integration of ICT in the health industry in general benefits the development of health tourism, since it enhances patients´ options and travel patterns, especially for the initial check-up and the subsequent follow-up phases (Wong and Sa'aid Hazley 2020). This benefit is more significant among the elderly and those who may have mobility problems when travelling. Digitized and connected healthcare has experienced increased investment in recent years and the widespread use of technology-based healthcare has made the idea of the “smart hospital” a reality (Moro Visconti and Morea 2020). The adoption of blockchain technology to improve the security and effective use of healthcare data in the health tourism sector has grown in recent years (Bali et al. 2023). The use of technology can relieve face-to-face appointments for health tourists, especially for follow-up sessions after returning to their home country, thus generating a more convenient and satisfying experience (Graham et al. 2020).

The development of new technologies in the spa tourism sector is a key issue, especially in their distribution and promotion through the Internet (websites and social networks) and mobile devices (Anaya-Aguilar et al. 2021a). Following Buhalis (2003), ICTs will allow spas to organize their resources better, increase productivity, communicate their offers and relevant information, and promote their alliances with their stakeholders. In this regard, there are many studies that demonstrate the importance of having a quality website to improve performance (Acharya et al. 2008; Lee and Kozar 2006), increase the chances of revisits and recommendations (Bai et al. 2008; Kim and Niehm 2009; Kuan et al. 2008; Lin 2007; Yoo and Donthu 2001), as well as the use of social networks as a marketing tool to improve performance (Tarsakoo and Charoensukmongkol 2020; Trainor et al. 2014; Wang and Kim 2017), brand loyalty (Almohaimmeed 2019; Balakrishnan et al. 2014; Bilgin 2018; Erdogmus and Cicek 2012; Hudson and Thal 2013; Sehar et al. 2019; Zahoor and Qureshi 2017), and purchase intention (Almohaimmeed 2019; Balakrishnan et al. 2014; Sehar et al. 2019).

There are several studies on the usefulness of websites in the tourism sector following different methodologies; in tourist destinations (Bastida and Huan 2014; Del Vasto-Terrientes et al. 2015; Fernández-Cavia et al. 2014; Park and Gretzel 2007), in hotels (Chung and Law 2003; Law 2019; Nguyen et al. 2020; Zafiropoulos and Vrana 2006), tourism websites (Beldona and Cai 2006; Ríos-Martín et al. 2017) or in the airline sector (Ceballos-Hernandez et al. 2020; Shchiglik and Barnes 2004). However, these investigations are very scarce in the health resort sector (Barroco et al. 2018).

If we focus on the study of the service quality provided by spa websites we can find several researches. Joukes and Gerry (2010) analysed the website effectiveness of Portuguese spas through an exploratory analysis and subsequently, Barroco et al. (2018) analysed the quality of the websites of 19 spas in the central region of Portugal. These researchers used several indicators that were grouped into nine categories: location and contact information, general information, information on health and wellness services, information on spa facilities, information on reservations, information on surroundings, customer communication, social networks, and languages. The results showed that the spas analysed did not take advantage of all the possibilities offered by the Internet as a means of communication, and that there was still plenty of room for improvement in order to attract new customers, increase customer loyalty and ultimately, increase sales. Lo et al. (2015) investigated the impact of specific dimensions of spa service quality on consumers’ emotions. Responsiveness was found to be the most important determinant of positive emotions, followed by reliability, empathy and tangibles. The results demonstrate the importance of the quality of spa services in enhancing the achievement of positive emotions by spa customers. Loncaric et al. (2013) conducted research on web content with the aim of evaluating the performance of the online presence of health resorts and hospitals in Croatia. The results showed that the websites only provided basic information and not all services were available. Toprak et al. (2014) evaluated spa websites and the perception of acceptance of hydrotherapy, and Inci and Sancar (2017) evaluated the communication effectiveness of the websites of hydrotherapy facilities in Turkey through an exploratory analysis using a set of attributes, which they grouped into seven categories: “contact information, general information, facility information, thermal/medical and wellness services information, surrounding area information, booking and external contracts information, and technical items”. Their results were very clear, the spa facilities did not manage their websites efficiently and showed that the use of the potential of this communication tool was very low. On the other hand, Anaya-Aguilar et al. (2021a: 1) conducted an analysis of the usability of Andalusian spas´ websites using an exploratory methodology. These authors observed that the use of new technologies by spas was underdeveloped, although these facilities had achieved good positions in Internet search engines thanks to the synergistic effect of official tourism websites.

The results obtained in previous research highlight the need to implement initiatives in this area, such as improving website content, as well as the use of new technologies to collect useful data on spa consumers in order to increase the competitiveness of wellness tourism destinations (Salinas Fernández 2020). An example of this are the spas in Poland, which have taken advantage of the potential of technologies to increase the value of their services (Szromek and Naramski 2019). The authors of this study found three market segments classified by sociodemographic, behavioural and psychographic factors, and stated that this knowledge is important both for tourist agents and for tourists themselves, as it provides insight into the needs and motivations of tourists in order to improve the management of destinations and tourism services. Website development has proven to be an area of innovation for spas, but it has also been shown that this sector has had difficulties in adopting ICTs. In research conducted by Anaya-Aguilar et al. (2021a, b), the usability of spa websites was analysed. The results revealed that the use of new web technologies by spas is underdeveloped, although these facilities have achieved good positions in Internet search engines due to the synergistic effect of official tourism websites. Thus, most of them give background information and detail their nature and protection of their spaces. In this way, spas use their presence on the Internet mainly as a means of communication (Antunes et al. 2022).

Other works focus on the presence of the wellness industry on mobile phones. A paper by Liew et al. (2019) stated that satisfaction was the top-rated attribute. Satisfaction refers to the user's liking, comfort and pleasure in using the mobile application. On the other hand, consumers did not rate issues such as intuitiveness, which mobile health experts considered vital. Other aspects that consumers were concerned about were internal fees and advertising (Liew et al 2019).

3 Methodology

Websites play an important role in institutional communication and are especially useful when representing a company or cultural entity (Daries et al. 2021). Together with elements such as social networks, online videos and email, among others, websites are also key instruments when designing digital communication campaigns (Mariné-Roig et al. 2019). Therefore, developing a method of defining and assessing which characteristics websites should have as ideal channels for communicating with customers has become a topic of great interest for researchers and practitioners alike. As numerous authors have pointed out, no universally accepted method of evaluating websites is currently available (Bauer and Scharl 2000; Camprubí and Coromina 2016; Gaur and Kumar 2018; Ramon-Cardona et al. 2022).

In their comprehensive review on research addressing web evaluations, some scholars determined that the most common methods of evaluation used are based on surveys, experimental evaluation and content analysis (Chiou et al. 2010). Law et al. (2010) state that the methodological approaches most commonly used in works on website measurement can be classified into five types: accounting method, automatic method, numerical computation method, user opinion method, and combined method. In our research, we used an accounting method.

Website analysis studies generally use a set of indicators divided into four large groups: technical, commercial, content-related and design-related (Benbunan 2001; Chiou et al. 2010; Cristobal-Fransi et al. 2021; Daries et al. 2021). A market-oriented approach has been chosen, in which websites are evaluated considering users as potential customers. Therefore, the evaluation focuses more on aspects related to the promotion of activities, online transactions and the characteristics of the products and services offered (Álvarez 2014).

The methodology used is Web Content Analysis together with the eMICA (Internet Commerce Adoption Model). With the aim of evaluating the level of adoption of e-commerce on the websites of Spanish spas, the variables of the eMICA model were adapted. Taking into account the different levels proposed in the model, it was also established that in order to consider that the web goes from one level to another, it has to collect a minimum number of attributes (Álvarez 2014; Cristobal-Fransi et al. 2017; Daries et al. 2018). The scale is dichotomous for all items.

To achieve the proposed objectives, the websites corresponding to all the active spas in Spain were analysed. The data were extracted from the National Association of Spas (ANBAL), the Bílbilis Foundation, the Ibero- American Association of Hydrotherapy and Wellness (AITB) and the National Observatory of Hydrotherapy and Rural Development. After discarding the spas that do not have a website, 106 websites were obtained out of a total of 118. The aim of this work is to analyse the use they make of this web presence (Fig. 1).

Fig. 1
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Design of the study’s investigation process

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3.1 Web content analysis

A model for web content analysis of spas was developed from an in-depth review of the literature on the subject (Álvarez 2014; Barroco et al. 2018; Joukes and Gerry 2010; Lee and Morrison 2010). This model is structured in four dimensions and it has the elements that a spa’s website must have in order to provide users with the necessary information and the possibility of interacting to perform e-commerce activities. It also includes the implementation of a secure platform, which meets the quality standards of a website (see Table 1). To support spas’ online presence, Web 2.0 tools, including social networks, wikis, blogs, video-hosting sites, online sales pages and podcasts, facilitate the interoperability, transmission of information and collaboration among users (O’Reilly 2005).

Table 1 Proposed model for web content analysis
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To perform the analysis, a set of elements that are considered useful or attractive for a website user were identified for each of the dimensions (Álvarez 2014; Lee and Morrison 2010; Ramon-Cardona et al. 2022). These items were selected from the literature review adding new elements to adapt them to the case of spas. We have chosen to evaluate the website from a marketing point of view.

Our web content analysis involved eight steps (Neuendorf 2018). First, to formulate research questions, we considered that the websites that had adopted e-commerce to a more advanced degree would make greater use of different web-based possibilities. Second, we identified variables related to the information, communication, e-commerce and additional functions afforded by the websites. Third, we defined categories and units of measurement for analysing all of the websites, which involved identifying the unit of analysis (i.e. Spanish wellness resorts websites) and defining the categories—that is, the different items that determine the web presence of such spas. Fourth, to create the coding scheme, we produced a code book containing the categories and how they were measured. All items were included in the four mentioned dimensions (i.e. information, communication, e-commerce and additional functions). Fifth, for sampling, we selected websites belonging to Spanish wellness resorts websites. Sixth, the code book was tested by two trained coders who evaluated the websites, and seventh, coding for the sample was performed independently with reference to the code book. Eighth and last, data were analysed by evaluating the presence or absence of certain characteristics and aggregating the data in tables and graphs.

3.2 The eMICA model

The Internet Commerce Adoption Model (MICA) developed by Burgess and Cooper (1998) proposes that companies, when implementing websites, usually start on the Internet through a simple Web page. This page become more complex over time as companies’ knowledge of the use of ICTs increases. Later in 2000, Burgess and Cooper (1998) adapted the MICA model to the particularities of the Internet and renamed it with the name of extended MICA (eMICA). This model, based on a phased evaluation, makes it possible to evaluate websites from a basic level to a more advanced level of processes, which constitutes the upper stage of a website.

Websites continually evolve, as reflected in the different stages of their development, from the beginning, through consolidation and finally into maturity. The complexity and functionality of each website are added to the model, which thus reflects its evolution from a static Internet presence to a dynamic website. That evolution occurs through increasing levels of interactivity that incorporate value chain integration and innovative applications in order to add value by way of information management and increased functionality (Burgess et al. 2011). The first stage (static website) consists of 2 levels (basic level and a level with a more enhanced degree of information), called “promotion” and corresponds to the initial stage of web development. Within this stage, basic information about the company and the products/services it offers is provided on the website. The second stage (interactive website) called “provision” or also information transmission corresponds to a consolidation stage. This stage consists of 3 levels corresponding to low, medium and high interactivity and refers to the organization of the interactivity in order to establish e-commerce. Finally, the third stage corresponds to the functional maturity of the web and is called “processing” or commercial transaction process (E-commerce), since it allows for online transactions (Table 2).

Table 2 Expanded model of e-commerce adoption
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The MICA and eMICA model has been widely applied in different areas of the tourism sector: destinations (Burgess et al. 2011; Doolin et al. 2002), gastronomy (Daries et al. 2018, 2019), snow tourism (Cristobal—Fransi et al. 2017), golf courses (Daries et al. 2021; Javaherian et al. 2022), travel agencies (Ahmed and Shaker 2021; Lin et al. 2009), accommodation (Ahmed and Shaker 2021; Ting et al. 2013; Curlin et al. 2022; Kwan Chung and Sutty Segovia 2019; Meslem and Abderrahim 2021), agrotourism (Fanelli 2022), museums (Cristobal-Fransi et al. 2021), Sport Tourism (Daries et al. 2021), ecotourism (Jaroensuk et al 2021) and even health tourism (Joukes and Gerry 2010).

Although the model based on a phased assessment allows the evaluation of websites from the promotional level to the transactional processes that constitute a website’s upper stage, it has some limitations. Schmidt et al. (2008) have reported, for example, that it tends to reduce the level of complexity of investigations and allows a website to simultaneously be at two levels of development or neither of them. Our objective, after adapting the model, was to assess the maturity of the spas’ websites. To that end, the eMICA includes the three logical dimensions that a website, as a technological platform, has: information, communication and transaction (Marimon et al. 2010).

The phases proposed in the eMICA are (Table 2):

  • First phase: Promotion (i.e. information) focuses on spas’ use of the web as a tool for communicating with the public. The phase, characterised by a low level of functionality, basic visual and informative content, has two levels.

  • Second phase: Provision (i.e. dynamic information) involves determining whether the website offers dynamic information about the spas and its environment. Occurring at three levels, provision is pivotal because spas are tourism development elements of the first magnitude (Bacon 1998, Pinos and Shaw 2020).

  • Third phase: Process (i.e. functional maturity) occurs when the spas’s Internet presence becomes a powerful means of e-commerce, one that allows the sale of products and/or services over the Internet combined with traditional channels. The process phase has a single level.

Focusing on companies in the field of health tourism in general and spas in particular, which can also become an important tourism resource for the area where they are located, it can be said that they have not always taken advantage of all the possibilities derived from ICT (Brumen et al. 2020). The results of this work indicate that the websites of spas do not take advantage of all the possibilities of their Internet presence to maintain an optimal relationship with their clients, using it mainly as a means of promotion (Zollo et al. 2015).

4 Results

This section presents the results of our study in two subsections. These subsections present the main results of the WCA and the application of eMICA according to the region in which the spas are located.

4.1 Website content analysis

4.1.1 Dimension information

The first of the dimensions analyses the mechanisms established by spas to inform about their main characteristics, facilities, surroundings, and promotions of their products. As shown in Table 3, the contents relating to Information about Spanish spas (I.1), and their facilities (I.2) are better represented than the information provided about the surroundings (I.3) and promotions (I.4). It can be observed that the dissemination of information through websites has a different development depending on the variable analysed. Elements such as images (I.1.4), rates (I.2.5), information on the facilities (I.2.1) and activities offered (I.1.9) are very present on the web.

Table 3 Information indicators (I)
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Regarding the negative aspects of the information dimension, there is little information on atmospheric conditions (I.3.5), virtual tours (I.2.3) or press area (I.4.4). There is not much visibility either regarding accesses to the thermal centre (I.3.4) or the sports and leisure facilities (I.2.3), which are elements that can be key in the management of a spa. Neither are there many resources related to interaction provided, such as webinars, podcasts, magazines, catalogues or newsletters (I.4.3).

One aspect to note is the activity of the spa as a tourism resource. Tourism-related items such as tourist information about the area (I.3.1), or information about other spas (I.3.2), or other businesses related to guided tours (I.3.3) have much room for improvement. On the other hand, a different behaviour is observed depending on the autonomous community in which they are located. Despite the fact that the results are conditioned by the number of spas in each region, the communities of Aragon, La Rioja, the Basque Country and Cantabria are the ones with a more significant orientation towards the tourism resources of the area. On the other hand, there are regions such as Andalusia or Asturias that do not have a great deal of promotional activity. Spas must reinforce these attributes of the Information dimension, since they constitute determining elements in the purchase behaviour of their services through the web (Anaya-Aguilar et al. 2021a, b; Joukes and Jerry 2010).

4.1.2 Communication dimension

The Communication dimension is made up of those tools that favour interaction with the client through the website and other digital marketing elements. It also includes the ability to offer its content in several languages and the adaptation of the content on different devices.

As shown in Table 4, the items related to communication show lower results than the previous variable, focused on information. In general, spas do not use all the possibilities provided by the web to establish a full dialogue with their users, but in some aspects, they show remarkable results. The most common means of communication for contacting users are through the traditional means of telephone and email (C.1.1). This is followed by the possibility of collecting online customer feedback (C.1.5), but at a great distance. The third element to be highlighted is the use of instant messaging (C.1.3). For the remaining elements, the level of presence is quite low. The results indicate that interaction and communication with clients through the website is an aspect to be improved by the spas analysed.

Table 4 Communication Indicators (C)
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Regarding the use of web 2.0 resources, the results show that spas make extensive use of SEM campaigns (C.2.8) and have a profile on Google My Business (C.2.3). Elements such as links to social networks (C.2.4), and the possibility of sharing content (C.2.7) are highly representative. To a lesser extent, we find the items of video on the web (C.2.2) or subscription to the newsletter (C.2.6).

In this aspect, differences can also be observed depending on the area where the spa is located. For example, in the area of interaction, spas in the autonomous communities of Asturias and Valencia are positioned above the average. Focusing on the subject of web 2.0 resources, the spas of Aragon, Asturias, Catalonia or Galicia are those with the best data. Finally, the presentation of the websites in different languages was observed. Presentation in more than one language is not a general situation in this sector, so it is considered that there is room for improvement. Only 58.5% of the websites analysed provide information about their products/services on the website in at least two different languages, with Castilla la Mancha, Valencia and Extremadura being the regions with the lowest percentage.

The importance of this item is evident, even more so if we take into account that before the pandemic, around 830 million trips were made per year within the framework of health and wellness tourism, with an estimated value of 559 million euros. Spain ranks as the second European destination and the fifth worldwide chosen for wellness reasons (Global Wellness Institute 2022). Therefore, the use of more than one language on websites is a clear competitive advantage, and not investing in this field is a mistake that is currently being made by almost 42% of the spas analysed.

4.1.3 E-commerce dimension

The e-commerce dimension includes online payment services, secure online transaction and interaction with the server. The analysis of this section shows a significant presence of payment (CE.1.1) and secure online transactions (CE.1.2), with almost three quarters of the spas having these resources available. However, this means that a quarter of them do not have an online payment system implemented. The situation is even worse if we focus on the interaction with the server (CE.1.3). In other words, the possibility of consulting the spa's customer database (access to the customer profile and possibility of modification, access to purchase records, etc.). There is much room for improvement in these aspects. These results are in line with those obtained in previous studies applied in Italy (Zollo et al. 2015), in Slovenia (Brumen et al. 2020) or in Portugal (Barroco and Amaro 2018). At the regional level, the autonomous community of Valencia stands out as the least prepared for online transactions, followed by Castilla y León (see Table 5).

Table 5 Electronic commerce (EC) indicators
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4.1.4 Dimension of additional functions (AF)

The last of the dimensions includes aspects that may be relevant to a website for an optimal web presence. This dimension is divided into three sections: information security, certifications and availability of mobile applications. This dimension shows a similar behaviour to the rest of the variables. Information security elements are very present on the websites of spas in general. In contrast, the certifications section shows a very differentiated behaviour. There is little presence of quality certifications except for the Q Certification of Tourism Quality for Spas (FA. 2.4) and other certifications (FA. 2.5). This last item includes a wide variety of elements such as awards of different kinds (international, national or regional) or simply recognitions.

Last but not least, regarding the availability of a mobile App (FA. 3.1), it is observed that none of the spas analysed provided this resource. This is of great concern, since mobile terminals have become an essential access point to e-commerce (Brumen et al. 2020; Nel and Boshoff 2020).

From the analysis of these four indicators (information, communication, e-commerce and additional functions), it can be deduced that despite the fact that spas seem to be prepared to carry out online transactions, a significant part has basic Internet presence with a mainly informative function. These results are in line with research applied to other sectors, which indicates that websites in many cases are static showcases for products and services, where the full capacity provided by the Internet and e-commerce is not used (Álvarez 2014; Daries et al. 2021).

4.1.5 eMICA model results

The information included in this section is an indicator of the maturity of spas with respect to their commercial orientation on the Internet. If we analyse the results as a whole, they show that there is still room for improvement in the adoption of e-commerce by this type of entity.

The results obtained show that the spas´ websites have a low level of functional maturity, since only 1.9% of the websites have passed phase 3 and the vast majority are in the first level of Phase 2 (more than 40% have not passed the second level of phase 2). Nevertheless, there is a certain shift from a static, purely informative perspective to a dynamic Web with increasing levels of interactivity. It should also be noted that although the results show that more than half of the websites have medium interactivity, this number is largely represented by spas that have the possibility of sharing information or subscription options, but with a lower representation of interactive web tools, as seen in the web content analysis (Tables 6, 7).

Table 6 Additional function indicators (AF)
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Table 7 Results of the evaluation by the eMICA model
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Regarding phase 3 of Processing (1.9% of Webs), the websites offer purchase processes and secure payment gateways. They also provide communication mechanisms that facilitate interaction with users.

If the level in which each spa is not considered (the analysis is progressive, i.e., if an entity does not exceed one level, the following ones are no longer analysed), it is observed that 75% of the spas allow for the complete purchase process through the Internet. This is an encouraging figure.

5 Conclusions

Information and communication technologies have a significant impact on the health tourism industry in general, and particularly on spas. Therefore, it is essential for the management and promotion of spas to adjust to this environment and to evolve in order to take advantage of the benefits provided by the Internet in all its dimensions. It is not only a matter of using the Internet as a promotional tool, but also as a means to market and establish a close relationship with customers.

The results of the investigation reveal that the spas´ websites show a high level of communication in terms of the static information about the establishment. This includes data such as location, facilities, fees and contact details. However, the level of communication is considerably lower in those indicators that offer interactive elements, such as applications for sharing content, making reviews and ratings or links to blogs, among others. This type of additional information can be extremely useful for clients, as it provides them with credibility and trust in the organization (Nilashi et al. 2018).

Considering the tourist and economic impact of spas in the territory where they are located, it can be argued that the opportunities offered by the Internet to make this resource and its potential popular have been underexploited. It has been found that many websites do not provide information in several languages, nor do they publicise the tourism resources available in the area. These aspects are essential when selecting or booking a travel destination. In addition, the lack of communication of policies related to quality, accessibility and environmental management has also been observed. These factors can be decisive for clients who are increasingly committed to sustainability or for those who have a disability and require specific information.

As a main theoretical contribution, the results of the study provide additional confirmation of the usefulness of the phased method to measure the development of commercial websites in the health tourism sector. The proposed method is formed by the extended model of the adoption of Internet Commerce (eMICA) and by the web content analysis model, based on the dimensions of Information, Communication, Electronic Commerce and Additional Functions.

In terms of management, spa managers are recommended to consider the proposed model to ensure that their websites meet the expectations of the customer profile that visits spas. Doing so will increase the number of visits, customer interaction and online bookings. In addition, it is important that they establish synergies with the managers of tourist destinations, collaborating in joint promotional campaigns. This will help the destination to position itself as a place for health and wellness tourism, since spas can become an important pole of attraction, generating a considerable tourist flow by offering complementary activities to those offered by the destination itself. Working together with the destination will reinforce the image and tourist attraction of both.

Regarding the limitations, first of all, we can point out that the study has been carried out at a specific time, and the websites of the spas can change dynamically. This means that the results may vary depending on when the study is conducted. Another important limitation was the number of websites analysed. Although they represented all the active spas in Spain, it remains necessary to expand the number of websites analysed.

As future research, it is proposed to extend the analysis to spas in other countries in order to obtain more data and be able to make comparisons. In addition, another qualitative analysis (e.g. personal interviews) could be conducted with the managers of these facilities to identify the main barriers faced when trying to implement a more advanced use of the Internet and improve interactivity. These interviews would provide useful information on the specific challenges faced by the sector in relation to the use of technology and could provide insights into possible solutions or improvements in the management of spas. In the same line we can administered a questionnaire to users to determine which elements of the websites to evaluate and to study the causes for the informative and interactive shortcomings of the sites.