Patients are still turning to Dr. Google to answer their health questions in the days before their condition takes a turn for the worse, according a study recently published in BMJ Open.
However, that same online behavior could be an opportunity to anticipate and improve care, with the study’s authors noting that a substantial number of ED patients with a Google account are open to their search histories and EHR data being combined and analyzed by researchers.
Of 411 approached ED patients who reported having a Google account, 49 percent shared their search and EHR data with the researchers.
Among the 103 for whom these data could be collected and analyzed, 6 percent of 591,421 total unique search queries were related to health. This proportion increased to 15 percent when limiting the analysis to searches within seven days of an ED visit, more than half of which were for content that directly related to their chief complaint when presenting. Among these seven-day searches, 56 percent were on symptoms, 53 percent hospital information, 23 percent about disease treatment or management.
Taken together, these data suggest a potential new stream of behavioral data that can be analyzed to improve care, as well as an interest among patients for more information about their conditions and care.
“At a time when diagnosis increasingly occurs at the molecular level and when precision medicine aims to tailor treatments based on largely genetic characteristics, this study adds to our understanding of the health relevance of individuals’ search histories and other digital resources,” the researchers wrote.
How it was done
Researchers approached 703 patients seeking acute care in the ED of a single large academic health system between March 2016 and March 2017. All potential participants were aged 18 years or older, and were incentivized to share their prior search history and EHR data with a lottery drawing of a $40 gift card.
The content of the search data was evaluated by two coders who gauged whether a terms was or was not related to health, with another coding conducted by two independent physicians to judge whether a term was related to the patient’s chief complaint.
What’s the history
While the researchers claim that their investigation is the first study to pair internet search data and EHR data at an individual level, the healthcare industry has long been aware of patients’ proclivity toward online search engines. With the accuracy of search results in question, several digital triage and health education services have sprung up as an alternative to less reliable online services, and many of these integrate symptom descriptions inputted by the user directly in the patient’s health record to improve their care.
On the record
"Even though we're in the early stages of this research, we've learned a lot about the questions patients ask before making the decision to visit an emergency department (ED), as well as questions they have about their care after their visit," Jeremy Asch, an innovation strategist in the Penn Medicine Center for digital health and the study’s lead author, said in a statement. "Knowing what patients look for before visiting an ED can help us anticipate their needs and direct them to the best sources of care. And knowing what they search for afterward tells us how we can communicate better and help patients on their paths."