The Online Health Care Revolution

Fifty-two million American adults, or 55% of those with Internet access, have used the Web to get health or medical information. We call them “health seekers” and a majority of them go online at least once a month for health information. A great many health seekers say the resources they find on the Web have a direct effect on the decisions they make about their health care and on their interactions with doctors.

48% of these health seekers say the advice they found on the Web has improved the way they take care of themselves; and 55% say access to the Internet has improved the way they get medical and health information.
92% of health seekers say the information they found during their last online search was useful; 81% said they learned something new.
47% of those who sought health information for themselves during their last online search say the material affected their decisions about treatments and care. Half of these health seekers say the information influenced the way they eat and exercise.
36% of those who sought health information for someone else during their last online search say the material affected their decisions on behalf of that loved one.

The specific impact

For the 21 million health seekers who say they were swayed by what they read online the last time they sought health information, the impact was as follows:

70% said the Web information influenced their decision about how to treat an illness or condition.
50% said the Web information led them to ask a doctor new questions or get a second opinion from another doctor.
28% said the Web information affected their decision about whether or not to visit a doctor.

For illness, including mental illness, more than for fitness

The Internet is a tool for the sick more than it is an educational resource for those who want to stay well.

91% of health seekers have looked for material related to a physical illness.
26% have looked for mental health information.
13% have sought information about fitness and nutrition, 11% have sought basic news about health care, and 9% have sought information about specific doctors, hospitals, or medicines.

For research, more than interaction with providers

Most users go to health sites for research and reference purposes. Few use it to communicate with their caregivers or to buy medicine. Most health seekers have been able to get the information they need without making any significant trade-offs by giving up personal information. Thus, it is not clear whether most Internet users will embrace a full range of health-care activities online, such as filling prescriptions, filing claims, participating in support groups, and emailing doctors.

9% of health seekers have communicated with a doctor online.
10% have purchased medicine or vitamins online.
10% have described a medical condition or problem in order to get advice from an online doctor.
21% have provided their email address to a health Web site; 17% have provided their name or other personal information.

A tool for family members seeking help for ailing loved ones and friends

A great many are using the Web to gather information on behalf of family and friends. Those who are in excellent health often seek material to help someone else; those who are in less-than-excellent health are more likely to be hunting for information for themselves.

54% of health seekers say they were searching for information on behalf of someone else, including their children, their parents, and other relatives, during the most recent time they went online for health information.
43% of health seekers were looking for information for themselves during that most recent visit.

Accessing the Web: A way to get a second opinion

When it comes to the most recent time they used the Internet to get health information, most health seekers focused on getting information about an immediate medical problem. And the majority got information in conjunction with a doctor’s visit.

70% of health seekers said they went online for information about a specific illness or condition the last time they consulted the Web for health information; 11% were checking out news related to health care, 9% were seeking information about specific doctors, hospitals, or medicines.
61% of those who sought information for themselves and 73% of those who sought information for others turned to Web resources in connection with a visit to the doctor.

More often than not, health seekers consult Web resources after they had been to a doctor, and, presumably after a diagnosis has been given. But the timing of the Web search also depends on the person who is sick. If a health seeker is looking for information on behalf of a loved one, she is very likely to go online after a doctor’s visit, perhaps to get more information related to the diagnosis. If she is looking on behalf of herself, she relatively likely to go online before the doctor’s visit, perhaps to see what the diagnosis might be. Only a small percentage of health seekers use the Web in lieu of a doctor’s visit.

Why health seekers like the Internet

They appreciate the convenience of being able to seek information at any hour, the fact that they can get a wealth of information online, and the fact that they can do research anonymously.

93% of health seekers say it is important they can get health information when it is convenient for them.
83% of health seekers say it is important to them that they can get more health information online than they can get from other sources.
80% of health seekers say it is important to them that they can get this information anonymously, without having to talk to anyone; 16% of health seekers said they had used the Web to get information about a sensitive health topic that is difficult to talk about

Health seekers fear privacy violations

Health seekers are very anxious to have their privacy protected. They are afraid of Web sites selling or giving away information about them, about insurance companies learning what they have done online and making coverage decisions based on that, and about their employers learning what they have done. Among the most sensitive to privacy violations are African-Americans, parents, and Internet newcomers (those who first came online less than six months ago).

89% of health seekers are concerned that a health-related Web site might sell or give away information about what they did online; 71% are “very concerned” about such privacy violations.
85% of health seekers are concerned that an insurance company might raise their rates or deny them coverage because of the health sites they have visited; 72% are “very concerned” about this possibility.
52% of health seekers are concerned that their employer might find out what health sites they have visited. This ranks comparatively low in part because most health seekers are getting their information online from home.
63% of health seekers and 60% all Internet users think that putting medical records online is a bad thing, even if the records are on a secure, password-protected site, because they worry about other people seeing their personal information. The rest think it’s a good thing because they and their doctors would have easy access to patients’ medical records.

Privacy policy issues

Despite these public sentiments, the health-information privacy regulations soon to be released by the Clinton Administration will probably not cover the majority of the nation’s more than 17,000 health-related Web sites. Analysis by the Health Privacy Project suggests that many Web sites do not clearly fall into the three categories of organizations that are covered by the regulations – health care providers, insurance companies, and health data clearinghouses (the organizations that process and transmit insurance-claim data). Many of the most common features of health Web sites will not be covered: health assessments, applications for clinical trials, chat rooms and bulletin boards, and personal management tools such as online disease management and patient-generated “medical records.” In the future, health seekers want protection and the right to punish companies that violate their privacy policies.

81% of health seekers think people should be able to sue a health or medical company if it gave away or sold information about its Web site users after saying that it would not.

Health seekers also fear getting inaccurate information

The credibility of health information and health advice on the Internet is also a concern. One major reason is that most health seekers are doing general Internet searches for the material they need, rather than relying on recommendations about Web sites from health providers or friends. Compared to other Internet users, health seekers show greater vigilance in checking the source of online information. Health seekers are pretty evenly divided about whether the information they get online is credible.

86% of health seekers users are concerned about getting health information from an unreliable source online.
81% of health seekers found the information they wanted through an Internet search, rather than being directed by someone. And 64% of health seekers say they had never heard about the Web sites they ended up consulting before they began the search. 30% of health seekers checked out four or more Web sites during their most recent search.
58% of health seekers checked to see who was providing the information at the Web sites they visited the last time then went online for health-related material.
52% of users who have visited health sites think that “almost all” or “most” health information they see on the Internet is credible; 44% think that they can believe only “some” online health information.

How women and men differ

Women are much more likely than men to seek online health information. Women are more likely to register strong feelings about the benefits of online searches, especially those related to the wealth of information online and the convenience of online searches. And women are more likely to worry about getting unreliable information from the Web. Asked about their most recent search for medical and health information, women were more likely than men to be seeking material related to a specific illness, to be hunting for material related to symptoms, and to be conducting the search after a doctor’s visit. Women are twice as likely as men to be seeking material for a child. However, men and women were equally likely to be seeking information on behalf of a parent or other relative.

When men look for information about a specific illness, they are more likely than women to look for material about their own condition and they are more likely to report that their Web search affected their decisions about how to treat the illness. Men are more likely to be seeking material about what happens to someone during an illness and when certain treatments or drugs are administered. They are also more likely than women to have used the Web information they gathered to ask follow-up questions of a medical professional. Men’s and women’s attitudes about privacy are very similar. However, compared to women, men are slightly more privacy-conscious; they are more likely to have read a Web site’s policy. And men are somewhat more eager to take advantage of the fact that they feel anonymous online; they are more likely to have used the Web to search for information about sensitive health issues.