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Opportunities and Challenges: Opportunities and Challenges: Using the Internet for PreventionUsing the Internet for Prevention
Susannah FoxNovember 17, 2003
Hypothesis:Industrial Age medicine is dead…
medical science
PHYSICIAN
patient
non-MD staff
NET-SAVVYPATIENT my other
health experts
otherself-helpers
my searchengine
my onlinesupportgroups
my primarydoc
my favoritehealth sites
my specialistdoc
my onlinepatient-helpers
my onlinedocsqualityware
& communityware
Hypothesis: …Information Age medicine is here
Methodology
Telephone surveys of the U.S. population, including callback surveys of e-patients (2000, 2001, & 2002)
Online survey of e-patients, with an over-sample of chronically ill and caregivers (2002)
Findings in a nutshell
More Americans look for health info online than see a doctor on a typical day
Search engines are the starting point, not specialized sites
Email is used for advice and support, esp. for chronically ill & caregivers
Few verify information quality, but many use what they find
Who are health seekers?Who are health seekers?
Half of American adults have looked Half of American adults have looked online for health information (esp. women, online for health information (esp. women, 30-49 year-olds, highly educated)30-49 year-olds, highly educated)
Half of Internet “health seekers” say they Half of Internet “health seekers” say they will turn will turn firstfirst to the Internet for their next to the Internet for their next health questionhealth question
Yet 1 in 4 American adults are cut off from Yet 1 in 4 American adults are cut off from the Internet (esp. older, rural, lower the Internet (esp. older, rural, lower income) income)
Low-income: CaliforniaLow-income: California
45% of low-income CA residents has 45% of low-income CA residents has Internet access, compared to 36% of low-Internet access, compared to 36% of low-income residents in other statesincome residents in other states
84% of low-income CA Internet users have 84% of low-income CA Internet users have searched for health topics, compared to searched for health topics, compared to 77% of low-income users in other states77% of low-income users in other states
Lesson: lower income and education Lesson: lower income and education levels do not automatically preclude levels do not automatically preclude Internet health searchesInternet health searches
Latino: CaliforniaLatino: California
58% of California’s English-speaking 58% of California’s English-speaking Latinos have access to the Internet Latinos have access to the Internet
78% have researched at least one topic 78% have researched at least one topic online, which is just below the average for online, which is just below the average for all Californian Internet users (83%). all Californian Internet users (83%).
But a national study found that Spanish-But a national study found that Spanish-speaking Latinos are half as likely to speaking Latinos are half as likely to search online for health information.search online for health information.
Health status
The well Newly diagnosed Chronically ill(Institute for the Future study, 2001)
Where e-patients go
Most e-patients start at a search engine like Yahoo or a general site like AOL – not a medical site – and visit two to five sites
Few have one favorite health site
How e-patients gather info
Most: Scattershot searches in response to a diagnosis
Some: Targeted email health news or medical updates
Few: Online support groups or email lists for people concerned about a particular health or medical issue
What they look forWhat they look for
80% of Internet users have searched for 80% of Internet users have searched for at least one topic:at least one topic:
– 63% for specific disease63% for specific disease– 47% for a certain treatment47% for a certain treatment– 44% for diet, nutrition, vitamins44% for diet, nutrition, vitamins– 36% for fitness36% for fitness– 34% for drugs34% for drugs– Plus 10 other topicsPlus 10 other topics
Success
Eight in ten health seekers find the information they look for online at least most of the time
More than half of search engine users found information within the first three sites they visited
Most health seekers say they had never heard about the Web sites they ended up consulting before they began the search
Many take it to heart
61% of health seekers say information they found on the Web has improved the way they take care of themselves
68% said that their last online search affected their decisions about:
- how to treat an illness
- whether to visit a doctor
- whether to ask new questions or get a second opinion
Bad information is dangerous
RAND/CHCF: Online advice is incomplete and hard to understand – esp. for Spanish readers
NEJM: Americans receive about half of recommended medical care
How e-patients check quality
Most trust the familiar Most distrust commercialism 2 in 5 check the source 1 in 3 check it out with a medical
professional
Three types of e-patients
Vigilant: 25% “always” check the source, date, and privacy policy of a health Web site
Concerned: 25% check “most of the time”
Unconcerned: 50% “only sometimes,” “hardly ever,” or “never” check
Conclusion
More Americans look for health info online than see a doctor on a typical day
Search engines are the starting point, not specialized sites
Email is used for advice and support, esp. for chronically ill & caregivers
Few verify information quality, but many use what they find
