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2014 “What’s Reasonable?” StudyPatient Expectations of Online vs.

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Conducted by:

2014 “What’s Reasonable” Study

Catalyst Healthcare Research is a national specialist in meeting the research needs of

health providers, health plans, and suppliers to the healthcare industry. Drawing on a

range of traditional and new research methods, we specialize in helping organizations

understand, measure, and leverage the customer experience in order to achieve

Confident Change®.

200 31st Avenue North #200

Nashville, TN 37203

Toll Free: 888.297.6535

Phone: 615.297.6535

Fax: 615.292.0262

CatalystHealthcareResearch.com

3

Dan Prince

President

dan.prince@catalysthcr.com

Simon Lynn

Research Manager

simon.lynn@catalysthcr.com

Abby Shields

Marketing Manager

abby.shields@catalysthcr.com

Background & Purpose

4

In 2012, Catalyst Healthcare Research conducted its first “What’s Reasonable?”

study, focused on what behaviors Baby Boomer consumers expect and prefer

when it comes to communication with a doctor. Results are available at

www.catalysthcr.com/resources/chr-white-papers/

Catalyst Healthcare Research undertook this 2014 national study to measure

consumer preferences for communication with doctors and other health care

providers and institutions.

These questions were of particular interest:

How many consumers want online access to doctors and healthcare information?

Does this preference vary by age cohort and, if so, how?

Does this preference vary according to other factors, like smartphone ownership?

If there is a preference for online healthcare communication, does it extend to

patient satisfaction surveys?

Methods & Sample

5

In total, 433 individuals responded to the online survey between December 20,

2013 and February 19, 2014.

The sample is representative of the US population (age 21 and up) with regard

to age and gender distribution.

The margin of error for the full sample is ±4.7%, and between generations is

approximately ±10% (at 95% confidence level).

Respondents were segmented into four generations for comparison by age.

18%

34%

23%

25%

0% 10% 20% 30% 40%

68+ (Silent Generation)

49-67 (Baby Boomers)

34-48 (Gen. X)

21-33 (Gen. Y)

Percent Respondent by Age / Generation

Male52%

Female48%

Percent Respondent by Gender

n=107

n=101

n=149

n=76

Respondent Profile

6

4%

12%

12%

22%

22%

28%

0% 5% 10% 15% 20% 25% 30%

Decline to respond

$100,000 or more

$70,000 - $99,999

$50,000 - $69,999

$30,000 - $49,999

Less than $30,000

Percent Respondent by Annual Household Income

0%

2%

22%

27%

15%

24%

10%

0% 5% 10% 15% 20% 25% 30%

Decline to answer

Less than High School

High School / GED

Some College

2-year College Degree

4-year College Degree

Graduate Degree (Masters or…

Percent Respondent by Educational Attainment

0%

1%

0%

1%

4%

4%

10%

79%

0% 20% 40% 60% 80% 100%

Other

Decline to answer

Pacific Islander

Native American

Asian

Hispanic / Latino

African American

White / Caucasian

Percent Respondent by Race or Ethnicity

1%

1%

2%

10%

11%

11%

25%

38%

0% 10% 20% 30% 40% 50%

Decline to answer

Seasonal / Temporary /…

Student

Part-time

Homemaker / Parent

Unemployed

Retired

Full-time

Percent Respondent by Employment

Q29 Which answer best describes your current employment? Q31 What is the highest level of education you have completed?

Q32 Which answer best describes your annual household income? Q30 Which answer best describes your race or ethnicity?

Respondent Profile

7

1%

5%

2%

4%

6%

7%

11%

12%

18%

34%

0% 10% 20% 30% 40%

Decline to answer

8 or more

7

6

5

4

3

2

1

0

Number of Prescription Meds

0%

3%

48%

48%

0% 10% 20% 30% 40% 50% 60%

Decline to answer

Don't know

None

1 or more

Chronic Medical Conditions

2%

22%

31%

17%

23%

5%

0% 20% 40%

Decline to answer

More than 30 pounds over your…

10-30 pounds over your ideal weight

Less than 10 pounds over your ideal…

Right at your ideal weight

Under your ideal weight

Current Weight

Q26 Relative to your ideal weight (what you would like to weigh), would you say that right now you are...

Q24 Do you have one or more chronic medical conditions?

Q25 How many prescription medications do you take on a regular basis?

Communications ToolsHow consumers connect with the world

8

Communication Devices Owned by Age Group

Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Smartphone 74% 66% 42% 20% 52%

Home Telephone 29% 42% 55% 67% 48%

Basic Cell Phone 9% 26% 44% 59% 34%

Laptop Computer 80% 77% 69% 47% 70%

Desktop Computer 55% 66% 68% 83% 67%

Tablet 50% 45% 35% 26% 39%

Q27 Select the devices you own or use regularly at home.

Implication: The adoption of mobile devices extends across the

generational groups.

Internet UseHow consumers use the Internet to meet non-healthcare needs

9

Percent Doing Internet Activity by Age

Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Banking or Bill Pay 82% 89% 78% 79% 82%

Buy Clothes or Shoes 79% 81% 65% 53% 70%

Make Travel

Arrangements69% 61% 52% 53% 59%

Buy Tickets to an Event 57% 50% 40% 24% 44%

Buy Recorded Music 56% 58% 36% 20% 43%

Q22 In the past two years, have you used the Internet to do any of the following (at least once)?

Implication: Many consumers seem ready to engage in “self serve”

transactions in the healthcare world!

Internet UseHow consumers use the Internet to meet health-related needs

10

Health Related Internet Activity by Age Group

Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Find info about a medical condition or drug 77% 79% 84% 78% 80%

Find info about doctors 62% 51% 44% 34% 48%

Visit a website to see personal health info 37% 30% 27% 22% 29%

Find how much a medical procedure may cost 41% 22% 23% 13% 25%

Visit a website to request a prescription refill 30% 23% 18% 16% 22%

Q22 In the past two years, have you used the Internet to do any of the following (at least once)?

Implication: Quest for information about quality and cost is evident

as healthcare consumers act like retail customers.

11

Internet UseHow consumers use the Internet to meet health-related needs

Percent Doing Internet Activity by Age

Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Find info about a medical condition or drug 77% 79% 84% 78% 80%

Find info about doctors 62% 51% 44% 34% 48%

Visit a website to see personal health info 37% 30% 27% 22% 29%

Find how much a medical procedure may cost 41% 22% 23% 13% 25%

Visit a website to request a prescription refill 30% 23% 18% 16% 22%

Q22 In the past two years, have you used the Internet to do any of the following (at least once)?

Infographic Source: Pew 2012

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

12

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Review / Pay medical bill

Mail 34% 38% 50% 64% 46%

Online 55% 55% 38% 26% 44%

Phone 11% 7% 11% 9% 10%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Q: How do you prefer to communicate with a doctor or healthcare provider?

For each situation below, select the action you would most prefer, assuming that

all options are available to you and provided at no additional cost.

-Pay a medical bill

Visit the doctor's website to review your bill and make payment

Call to the doctor's office to review your bill and make payment

Receive, review and pay your bill by mail

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

13

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Receive lab results

Mail 23% 29% 33% 30% 29%

Online 42% 46% 29% 30% 36%

Phone 35% 26% 38% 39% 35%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Q: How do you prefer to communicate with a doctor or healthcare provider?

For each situation below, select the action you would most prefer, assuming that

all options are available to you and provided at no additional cost.

-Receive your lab results after a visit to the doctor

Visit the doctor's website and log in to see the results

Call the doctor's office to be told your results

Have the lab results mailed to you

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

14

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Set future appointment

Visit Office 8% 5% 5% 4% 6%

Online 33% 37% 19% 21% 27%

Phone 59% 58% 76% 75% 67%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Q: How do you prefer to communicate with a doctor or healthcare provider?

For each situation below, select the action you would most prefer, assuming that

all options are available to you and provided at no additional cost.

-Schedule a future (routine) appointment with a doctor

Visit the doctor's website and choose among available times

Call the doctor's office to arrange an appointment time

Go to the doctor's office to arrange an appointment time

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

15

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

After hours advice from

doctor

Phone (with call back) 55% 44% 58% 74% 57%

Online 18% 19% 13% 3% 14%

Phone (24-hour number) 27% 38% 29% 24% 30%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Q: How do you prefer to communicate with a doctor or healthcare provider?

For each situation below, select the action you would most prefer, assuming that

all options are available to you and provided at no additional cost.

-Get medical advice from a doctor during the evening hours

Use Internet video chat (like Skype) to speak with a doctor on duty at that time

Call a toll-free number to talk with a doctor on duty at that time

Call your doctor's office to have the on-call doctor call you back

Teladoc

MD LIVE

American

Well

16

Impact of Telemedicine

2013:

400,000 “visits”2012:

200,000 “visits”

Source: American Telemedicine Association & Wall Street Journal

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

17

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Take an experience survey

Mail 14% 15% 17% 21% 17%

Online 82% 83% 77% 70% 79%

Phone 4% 2% 5% 9% 5%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Q: How do you prefer to communicate with a doctor or healthcare provider?

For each situation below, select the action you would most prefer, assuming that

all options are available to you and provided at no additional cost.

-Take a survey about your experience with a doctor and his/her office

Take an online survey

Take the survey over the phone

Complete and return a printed survey sent to you in the mail

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

18

Percent Preferring Mode by Age

Mode Gen. Y Gen. X

Baby

Boomers

Silent

Gen. All

21-33 34-48 49-67 68+ 21+

Take an experience survey

Mail 14% 15% 17% 21% 17%

Online 82% 83% 77% 70% 79%

Phone 4% 2% 5% 9% 5%

Review / Pay medical bill

Mail 34% 38% 50% 64% 46%

Online 55% 55% 38% 26% 44%

Phone 11% 7% 11% 9% 10%

Receive lab results

Mail 23% 29% 33% 30% 29%

Online 42% 46% 29% 30% 36%

Phone 35% 26% 38% 39% 35%

Set future appointment

Visit Office 8% 5% 5% 4% 6%

Online 33% 37% 19% 21% 27%

Phone 59% 58% 76% 75% 67%

After hours advice from doctor

Phone (with call back) 55% 44% 58% 74% 57%

Online 18% 19% 13% 3% 14%

Phone (24-hour number) 27% 38% 29% 24% 30%

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Healthcare Communication PreferencesHow consumers want to communicate to meet health-related needs

19

In the 68+ age group, smartphone

owners were…

• 74% more likely to prefer online bill pay

with their doctor as non-smartphone

owners.

• 78% more likely to prefer online access

to lab results as non-smartphone

owners.

Q36 How do you prefer to communicate with a doctor or healthcare provider? For each situation below, select the action you would most prefer,

assuming that all options are available to you and provided at no additional cost.

Healthcare Communication PreferencesDesire to have email communication with a doctor

20

Scenario:

Q11 Assume your doctor recommends that you see a specialist and gives you the names of two doctors who specialize in what you need. If you were

considering these two specialists, both with a good reputation, similar training and credentials, and both located in the same office building, which

one would you be most likely to choose?

Assume your doctor recommends that you see a specialist and gives you the names

of two doctors who specialize in what you need. If you were considering these two

specialists, both with a good reputation, similar training and credentials, and both

located in the same office building, which one would you be most likely to choose?

Specialist A offers you the opportunity to email him/her with questions you

might have, after you have been seen by him/her, at no additional cost to you.

Specialist B does not offer email communication as an option (and there are no

additional costs involved).

Healthcare Communication PreferencesDesire to have email communication with a doctor

21

Q11 Assume your doctor recommends that you see a specialist and gives you the names of two doctors who specialize in what you need. If you were

considering these two specialists, both with a good reputation, similar training and credentials, and both located in the same office building, which

one would you be most likely to choose?

Assume your doctor recommends that you see a specialist and gives you the names

of two doctors who specialize in what you need. If you were considering these two

specialists, both with a good reputation, similar training and credentials, and both

located in the same office building, which one would you be most likely to choose?

Specialist A offers you the opportunity to email him/her with questions you

might have, after you have been seen by him/her, at no additional cost to you.

Specialist B does not offer email communication as an option (and there are no

additional costs involved).

Decision 1:Specialist A offers email;

Specialist B does not. 7%

93%

0%20%40%60%80%100%

Specialist B

Specialist A

Decision 1: Percent Respondent by Specialist

If Specialist A chosen in D1…

Decision 2: Now, assume the situation is the same, except Specialist A charges $25

for email contact following a visit and Specialist B does not offer email

communication as an option. Which would you be most likely to choose?

Specialist A

Specialist B

Healthcare Communication PreferencesDesire to have email communication with a doctor

22

Decision 1:Specialist A offers email;

Specialist B does not.

Q11 Assume your doctor recommends that you see a specialist and gives you the names of two doctors who specialize in what you need. If you were

considering these two specialists, both with a good reputation, similar training and credentials, and both located in the same office building, which

one would you be most likely to choose?

7%

93%

0%20%40%60%80%100%

Specialist B

Specialist A

Decision 1: Percent Respondent by Specialist

If Specialist A chosen in D1…

Decision 2: Now, assume the situation is the same, except Specialist A charges $25

for email contact following a visit and Specialist B does not offer email

communication as an option. Which would you be most likely to choose?

Specialist A

Specialist B

Healthcare Communication PreferencesDesire to have email communication with a doctor

23

Decision 1:Specialist A offers email;

Specialist B does not. 7%

93%

0%20%40%60%80%100%

Specialist B

Specialist A

Decision 1: Percent Respondent by Specialist

Q11 Assume your doctor recommends that you see a specialist and gives you the names of two doctors who specialize in what you need. If you were

considering these two specialists, both with a good reputation, similar training and credentials, and both located in the same office building, which

one would you be most likely to choose?

75%

25%

0%20%40%60%80%100%

Specialist B

Specialist A

Decision 2: Percent Respondent by Specialist

Decision 2:Specialist A offers email for a $25 fee;

Specialist B does not offer email.

24

Access: The One Medical Example

$199/year buys you…

Email communication with your doctor

Preferred access for same-day appointments

Digital access to your medical record

Digital access to your lab and test results

Digital Rx refills

Digital communication for treatment (common issues)

Healthcare FeedbackWillingness of consumers to provide feedback

25

No8%

Yes92%

Don't rememb

er6%

No, 71% Yes

23%

Don't remem

ber4%

No, 11%

Yes85%

Have you been to a doctor in

the last two years?If yes…

Were you asked to

complete a patient

satisfaction survey?

If yes… Did you take the survey?

Q18 In the past two years, have you been to see a doctor (of any type, at any type of location)?

Q19 After your visit, were you asked to complete a patient satisfaction survey of some kind?

Q20 Did you take the survey?

Don’t

remember

6%

Don’t

remember

4%

In Summary

26

In general, the younger the age group, the more interested they are in online

access to relevant healthcare information and services.

Practices pursuing Meaningful Use have some “ramp up time,” since older

consumers tended to prefer more traditional vs. online methods of

communication.

A significant subset of consumers are willing to pay for online access, as

evidenced both by our study and by the commercial examples we cited.

Healthcare-related activities similar to ones people already do online, like bill

pay and scheduling, will be adopted ahead of less-familiar activities, such as

using video chat to connect to a doctor.

We suggest that providers move aggressively to collect patient and consumer

emails, in order to establish the “digital channel” and to use online surveying

to measure patient satisfaction.

27

Thank you for attending

today’s webinar!

Questions?

Dan Prince

dan.prince@catalysthcr.com

Simon Lynn

simon.lynn@catalysthcr.com

Abby Shields

abby.shields@catalysthcr.com