The Rise of the e-Patient - looooker.com · PewInternet.org The Rise of the e-Patient Understanding...
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PewInternet.org
The Rise of the e-Patient Understanding Social Networks and Online Health
Information Seeking
Lee Rainie, Director, Pew Internet Project
1.12.12
Providence St. Joseph Medical Center, Burbank
Email: [email protected]
Twitter: @Lrainie
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The story of e-patients (and netweavers) Trudy and Peter Johnson-Lenz
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New social operating system: Networked Individualism
• Social networks are more important
• Social networks are differently composed
• Social networks perform different functions
• Social networks are more vivid and tied to creation of information/media
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Implications of networking individualism for health care
• Social networks (and the internet) provide “second opinions” – and can be sources of misinformation
• Providers are necessarily “nodes” in people’s social networks
• Social networks are allies and complements for care delivery
• Those in acute care use their networks differently from those with chronic conditions
• Providers are assessed and judged in more public ways
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0%
10%
20%
30%
40%
50%
60%
70%
80%
June 2000
April 2001
March 2002
March 2003
April 2004
March 2005
March 2006
March 2007
April 2008
April 2009
May 2010
May 2011
August 2011
Jan 2012
Home broadband Home dial-up
Digital Revolution 1 Internet (83%) and Broadband at home (67%)
71%
67%
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Networked creators among internet users
• 65% are social networking site users
• 55% share photos
• 33% create content tags
• 32% contribute rankings and ratings
• 30% share personal creations
• 26% post comments on sites and blogs
• 15% have personal website
• 15% are content remixers
• 14% are bloggers
• 13% use Twitter
• 6% location services – 9% allow location awareness from social media – 23% maps etc.
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55% of adults own laptops –
up from 30% in 2006
45% of adults own MP3 players –
up from 11% in 2005
50% of adults own DVRs –
up from 3% in 2002
42% of adults own game consoles
18% of adults own e-book readers - Kindle
20% of adults own tablet computer – iPad,
Kindle Fire - doubled in 1 month
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• Empowered and engaged – 61% of all adults get health info online (80% of internet users)
• Participatory e-patients – 60% consume social media; 29% have contributed content
• Crowd-sourced via e-patients: 19% consult rankings/reviews of providers (5% post them); 18% consult reviews of hospitals (4% post them)
Impact on health
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Anti-Hippocratic Age
I SWEAR … I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine,
but to none others.
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AMA press release December 20, 2001
6. Remember that the Internet cannot replace a physician’s expertise and training …. If you have questions, trust your physician, not a chat room
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Demographic factors correlated w/ broadband adoption
Positive correlation (in order of importance)
Negative correlation (in order of importance)
Household income of $75,000 or more per year
Having high school degree or less
College degree Senior citizen (age 65+)
Parent with minor child at home Rural resident
Married or living with partner Disabled
Employed full time African-American
Source: Pew Internet Project, August, 2011 tracking survey 10/5/2010 13 Trends in Home Broadband Adoption
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By the numbers: Who’s not online?
17% …of American adults are not online
34% of them have some past or current contact w/ internet
10% of them want to use the internet in the future
61% of them would need assistance getting online
Source: Pew Internet Project, May 2010 tracking survey
10/5/2010 14 Trends in Home Broadband Adoption
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Relevance & digital literacy are primary factors for not going online
Relevance
48%
Price 21%
Usability 18%
Availability 6%
Other 7%
Source: Pew Internet Project, May 2010 tracking survey
10/5/2010 15 Trends in Home Broadband Adoption
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Digital Revolution 2 Mobile – 84%
327.6 Total U.S. population: 315.5 million
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Mobile internet connectors – 63% adults
37
43
54 55
57 59
63
30
35
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45
50
55
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65
Nov-08 May-09 Nov-09 May-10 Nov-10 May-11
Wireless internet user - % of adults
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The rise of apps culture - 50% of adults
22% 29*
38 43
38* 43*
50*
-20%
0%
20%
40%
60%
Download apps to their phone
Have preloaded apps on their phone
Total who have apps on phone
Sept 2009 May 2010 August 2011
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Mobile health apps
20%
32%*
28%*
20%
29%*
33%*
29%
50+ (n=145)
30-49 (n=276)
18-29 (n=224)
Rural (n=100)
Suburban (n=322)
Urban (n=203)
All (n=658)
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• Real-time – 35+% use mobile phone for health info; 29% have health apps on handhelds
• Place-less and time-less
• Over-represented among young, minorities, urban residents, upper SES
• NO FEMALE/MALE DIFFERENCES
Impact on health
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Digital Revolution 3 Social networking – 50% of all adults
9%
49%
67%
76%
86%
83%
85%
7%
8%
25%
48%
61% 70% 71%
6% 4%
11%
25%
47% 51%
52%
1%
7%
13%
26% 33%
35%
0%
20%
40%
60%
80%
100%
2005 2006 2007 2008 2009 2010 2011 2012
18-29 30-49 50-64 65+
% of internet users
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• “Last search”: 48% for others; 36% for self; 11% for both
• Read others’ commentaries: 34%
• Find others who have same condition: 18%
• Get info from social networking site: 11% SNS users
• Get info from Twitter: 8% of Twitter users
Impact on health
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How people make medical decisions
• Mindset – general approach to medicine
• Data/Numbers – and how they are presented
• Stories
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June 25, 2010 24
What technology has done to social networks and the role providers can play in them
• Made it possible for experts to become “nodes” in people’s networks that can help them solve problems, make decisions
• Allowed for immediate, spontaneous creation of networks that can include professionals
• Given people a sense that there are more “friends” in their networks like professionals whom they can access when they have needs
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How online searches affect decisions (1)
• 60% of e-patients say the information found online affected a decision about how to treat an illness or condition.
• 56% say it changed their overall approach to maintaining their health or the health of someone they help take care of.
• 53% say it lead them to ask a doctor new questions, or to get a second opinion from another doctor.
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• 49% say it changed the way they think about diet, exercise, or stress management.
• 38% say it affected a decision about whether to see a doctor.
• 38% say it changed the way they cope with a chronic condition or manage pain.
How online searches affect decisions (2)
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The networked world of e-patients
What providers are good for
• Diagnosis / treatments
• Prescriptions
• Recommendation for specialist
• Recommendation for hospital
• Info on alternative treatments
What others are good for
• Emotional support
• Practical advice for day-to-day coping
• Recommendation for quick remedy for everyday issue
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What’s a doctor to do about e-patients?
• Minimum engagement – “Tell me what you’re thinking” - Groopman
– Ask about patients’ internet use, exposure on social networking, what they post and read
• Medium engagement – Ask if patients would be willing to be let you/staff
be a node on social media
• Heavy engagement – Do it yourself
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What social networks do for patients: Why physicians can be “nodes”
• Attention – act as sentries – alerts, social media interventions, pathways
through new influencers
• Assessment – act as trusted, wise companion – help assess the accuracy of info, timeliness of info,
transparency and rigor of info
• Action – act as helpful producers/enablers – help give people outlets for expression,
interpretation of their creations
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Health outcomes payoff • Monitoring
• Interventions and reinforcement
• Skills training – meds/devices
• Emotional and social support among peers
• “Information prescriptions”
• Amateur research contributions – online recruitment, communities and clinical trials
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Health outcomes payoff Have you or has anyone you know been HELPED by following medical advice or health information found on the internet?
• Major help – 10%
• Moderate help – 20%
• Minor help – 11%
• No help – 50%
• Don’t know – 4%
Have you or has anyone you know been HARMED by following medical advice or health information found on the internet?
• Major harm – 1%
• Moderate harm – 1%
• Minor harm – 1%
• No harm – 94%
• Don’t know – 3%
41% 3%
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Be not afraid