When it comes to looking for health information online, consumers have had fairly consistent behaviors over the past 12 years. A new report, Online Health 2013, from The Pew Research Center's Internet & American Life Project found that of the 81 percent of US adults who use the internet, 72 percent have gone online to look for health information in the past year. Some 59 percent of that online health information seeker group went online to specifically try to figure out what medical condition they or someone they know has. Pew calls this group "online diagnosers" and it includes about 35 percent of all US adults.
By a two to one margin, these online diagnosers found that the internet is often correct, too. While many of those who sought a self-diagnosis with the help of the internet never ended up going to visit a clinician to double-check, some 41 percent said that a clinician confirmed their diagnosis and 2 percent said a medical professional partially confirmed it. About 18 percent said a medical professional either did not agree or -- assumedly to be less confrontational --offered a different diagnosis instead. What kinds of conditions and which sources were best, of course, remain a bit of a mystery based on the Pew data alone.
Pew Associate Director Susannah Fox told MobiHealthNews that one of the questions asked in the survey may benefit from a mobile component in the future:
"The last time you went online to look for health information... How did you begin looking? Did you start... at a search engine such as Google, Bing, or Yahoo; at a site that specializes in health information, like WebMD; at a more general site, like Wikipedia that contains information on all types of topics; at a social network site like Facebook?"
"That question is an adaptation of one that we asked way back in the year 2000 when only 46 percent of American adults had access to the internet," Fox said. "We got the same results in 2013 essentially. About 8 out of 10 health inquiries online start at a search engine. That was true in the year 2000 and it is true now. I'm not sure I'm going to be able ask this question in the same way in 2014, which is when I think we are going to be at a stage of ubiquitous mobile access. Some of the apps that have been introduced, diagnostic and health information apps -- will it be that the marketshare for those will challenge search? That is a question I have and I don't have data on it yet."
Fox said that she and her team are thinking through the implications of mobile now even before health apps have really captured the market. When possible, Pew researchers try to write questions that are platform agnostic, which is sometimes successful and sometimes not, Fox said. She said it was difficult in the past, for example, to measure the impact of Twitter without using the site's actual name. I wonder whether respondents who used their mobiles to look up health information via apps or via their mobile's browser answered Pew's questions based only on their desktop usage. More data next year hopefully.
MobiHealthNews writer Jonah Comstock wondered whether voice-enabled apps like Siri, which can help Apple device users to look up any kind of information via the Wolfram Alpha search engine, would have registered among those surveyed as using a search engine to look up health information or as something else entirely. Same goes for the Android-based Google Now predictive search offering. Slowly, the criteria that defines a search engine is changing.
Surprisingly, Pew found that one category of online health services appears to be languishing. Few consumers consulted online sources for information that would help them compare drugs or medical treatments. In 2010 Pew found that some 24 percent of respondents who sought any kind of health information online, used sites that helped them compare drugs and treatments. In 2012 that group dropped to 16 percent of online health seekers. Fox noted in the report that overall review sites online are popular -- some 8 out of 10 internet users visit some kind of review site. Seems to me that those working in the online reviews business for drugs and medical treatments might want to consider a pivot.
Considering the ongoing national discussion around public access to scientific journals, Pew's question about consumers' experience with health sites and paywalls was a particularly timely one. Fox said she believes it is the first attempt at measuring the public impact of keeping scientific and medical journals behind subscription paywalls: "I don't think anyone else has asked this question before in a national survey," she said.
Some 26 percent of online health seekers said they had encountered a paywall. Of that group, only 2 percent ended up paying to gain access to the information, while 83 percent of that group tried to find that same information elsewhere, assumedly for free. The important metric, however, was that 13 percent of that group decided to give up and end their search then and there. It would be fascinating to know what happened next: Did any of those who encountered that paywall become sicker as a result?
"This has been a question of principle so far," Fox said. "The conversation has not really penetrated the public sphere as much as the elite sphere and yet this has impacted quite a few people who were just trying to get some medical information to make a good decision. That is what the Internet is really for, and it dovetails with all our other findings that the internet is a de facto second opinion."
Fox said that her favorite question was about who you turned to the last time you had a serious medical issue.
"We get a much clearer picture that, of course, so much of healthcare is hands-on and in-person," Fox said. "Seventy percent of people got information, care or support from a clinician; 60 percent got information, care, or support from friends or family; 24 percent got information, care or support from others who have the same condition," she said. "So much of it was offline. The internet is a very important supplement, especially for younger adults and people with high levels of education, but let's just keep this in perspective."