Online Health Information Seeking

Online Health Seeking: How Social Networks Can Be Healing Communities

http://www.pewinternet.org/2010/10/25/online-health-seeking-how-social-networks-can-be-healing-communities/

1.      Internet

Adult: 61% get health info online (80% are internet users)

E-Patients: 60% consume social consume social media; 29% have contributed content; 19% consult rankings of providers (5% post them); 18% consult reviews of hospitals (4% post them)

2.      Mobile

17% use mobile phone for health info (7% have health apps)

Over-represented among young, minorities, urban residents, upper SES (Socioeconomic Status)

No female/ male differences

3.      Social Network

Read other’s commentaries 34%

Find others who have same condition 18%

Get info from SNS 11% of SNS users

Get info from Twitter 8% of Twitter users

4.      Other Data

60% of e-patients say the info found online affected a decision about how to treat an illness or condition.

53% say it lead them to ask a doctor new questions, or to get a second opinion from another doctor.

38% say it affected a decision about whether to see a doctor.

In this report, the author mentioned about having librarian serving as nodes between patients and health care. This nodes idea could also be helpful for the self-service tool, providing trusted information for patients.

Peer-to-Peer Health

http://www.pewinternet.org/2011/02/28/peer-to-peer-health-care-2/

Internet serves as pathway to find and help each other.

Social tools deepen people’s connections groups they joined offline.

18% People went online to find others who might have health concerns similar to others.

People going through a medical crisis are voracious information consumers: 85% say they look online for health information, compared with 77% of internet users who have not had that experience in the past year

When finding recommendation for a doctor or a specialty, 52% of adult say they think health professionals are more helpful than peer sources when it comes to getting a recommendation for a doctor or specialist, 27% of adults prefer to ask friends family and fellow patients for this type of advice. Order adults are much more likely than younger ones to say health professionals’ opinions are more helpful. Generation X internet users (34-45) are the most likely age group to look online for information about health professionals.

When finding recommendation for a hospital or medical facilitates, 62% of adult say they think health professionals are more helpful than peer sources when it comes to getting a recommendation for a doctor or specialist, 27% of adults prefer to ask friends family and fellow patients for this type of advice. Older adults are considerably more likely than younger adults to turn to health professionals for this type of information

Characteristics of online and offline health information seekers and factors that discriminate between them 

http://www.sciencedirect.com/science/article/pii/S0277953604000796

1.      Main Differences

Relate to traditional inequality levels in education, age, and income. Individuals who are older, have lower incomes, and are less educated are less likely to be in the group that uses online health information.

Age was a key factor that discriminated between online and offline health information seeking. As these results indicated, the mean age for the non-Internet health information-seeking group was 11-years older than that for the Internet health information seeking group.

2.      Information Sources

Seeking health information from doctors and nurses is highest among both groups. About 80% of each group report using this source.

Among the offline group, health magazines, friends or relatives, and television or radio are the next most often cited sources of health information. For the online group, friends and relatives are most often cited, following health care professionals. 55% of the online group report seeking health information once or twice via the Internet during the past year. 45% of this group report using these medium three or more times during the past year.

Health care professionals were cited more often than other sources for health information by both the online and offline groups. However, significant segments of both groups relied upon additional sources for health information

3.      Other results

The results of this study suggest that online health information seekers are healthier (self-reported data) than the offline group.

A study of web usability for older adults seeking online health resources

http://dl.acm.org/citation.cfm?id=1035578

Improvements to Web design are needed in order to accommodate vision, cognition, and motor skills of older adult users. Small font size, requiring mouse (might be problem for users with unsteady hands), and not providing help or site map support were main results found.

In order to promote the design of senior-friendly sites, future research needs to enhance the existing NIA/NLM guideline (http://www.nlm.nih.gov/pubs/checklist.pdf).

Since older people is an important group of users seeking health care information, it might be interesting to consider the idea about make to tool responsive to older adult users.

 

 

Health information-seeking behavior in adolescence: the place of the internet

http://www.ncbi.nlm.nih.gov/pubmed/15652680

“Perceived credibility of the internet varied because expertise and trustworthiness were sometimes difficult to determine, and empathy could be facilitated through online communities but the individual could control disclosure. The internet combines positive features of traditional lay and professional, personal and impersonal sources. Although it is unlikely to supplant the role of trusted peers and adults, the internet has found an important place among adolescents' repertory of health information sources.”

Affordable Care Act: Obamacare

https://www.youtube.com/watch?v=JZkk6ueZt-U

• about half of Americans will get insurance through their jobs like today → Not a lot will change for these people. Only some advantages will be added. The GOV will require companies with 50 or more employees to cover full time workers
• Third will get covered by the Gov through medicaid and medicaid
• One in ten will buy insurance themselves→ a new ways to buy health insurance→ health insurance marketplaces→ you will be able to pick how much coverage you want and how much you will pay for it
• Just under one in ten will still have no health insurance

Based on the discussion with Permira, we will probably be focusing on those who are starting to buy their insurance through insurance marketplaces.

http://obamacarefacts.com/insurance-exchange/health-insurance-marketplace.php

https://www.coveroregon.com/get-coverage/online

https://www.wahealthplanfinder.org/

• Insurance marketplaces are open once a year “ObamaCare's Health Insurance Marketplace was open until March 31st, 2014. You won't be able to purchase marketplace insurance again until November 15th.”
• Insurance marketplaces are the only places where Americans can apply for premium health care tax credits
• Each State has its own health insurance marketplace and each marketplace provide a different user experience
• The different stages required to apply for insurance under the new Obamacare in Washington:

How do patients choose physicians

Jung - How do patients choose physicians? (national survey of enrollees in employment-related health plans, 2003 --> link)

• patients rely heavily on family/friend referrals rather than online data when searching for or choosing physicians. However, this pattern may be changing as the availability of information to evaluate physicians is increasing and becoming more available. This is likely the case, especially since this finding was published in 2003.
• while the elderly are at the greatest risk for using health care services, they exhibit the least independent judgement related to consumerist behavior and attitudes when making physician decisions. 
• people generally have a high level of trust in their regular doctor, familiarity carries a lot of weight in the patient experience.
• consumers sometimes fail to understand the organization and delivery of care, often rely more on "understandable measures", such as interpersonal skills. This means that the presentation of information regarding analysis of care measures must be very clear and understandable so that it can be used effectively by consumers.
• consumers don't trust other consumer's judgments of technical aspects of care but DO trust their judgement about subjective aspects.
• The perceived preference for "informal sources of quality information" appears to be driven by a lack of understanding of process-based measures.
• while people express interest in performance-based measures, they often base their health care decisions on interpersonal ("art of care") considerations because they feel they lack the ability to understand or use if effectively.
• better understood measures are weighted more heavily in consumer's decisions
• those who have been in the hospital recently are more likely to use individual doctors as a source of information for choosing a physician and less likely to use formal sources of information.
• minorities are more active consumers of physician information, study is unclear why.
• consumer activism (use of "formal information sources" to make individual decisions) is likely to increase as the access to relevant information to compare physician grows

(Doctor review websites study, 2014 --> link)

• 20% of patients say physician's ratings are "very important", 40% say the websites are "somewhat important"
• online ratings can be frustrating to some physicians who feel that information can be out of date, and they don't have a way to refute the information
• patients pick their primary care physicians based on:
•  whether they accept their health insurance (59%)
• years of experience (46%)
• practice reputation (44%)
• word of mouth (38%)
• physician referral (34%)
• **all of these ranked higher in importance than website ratings

(Complexity, Public Reporting, and Choice of Doctors, 2014 --> link)

• Studies indicate that quality of physician choice erodes as choice set grows and becomes more complex
• four ways that an abundance of comparative information can impair choice quality
• cognitive overload (data reduction strategies are not ideal)
• consumers may respond to an overload of information by constraining their choice sets in ways that help the decision process but may not lead to optimal choices.
• reduced coherence (inconsistent ranking across multiple dimensions)
• loss of perspective (diving into detailed data leads to "tunneling")
• emotional heuristics (regret avoidance leads to emotionally resonant measures)
• They conducted an experiment in which they created a fake website tool for finding doctors. They modeled the information presented about physicians after real website information, and in different conditions increased the complexity and amount of information presented, as well as the number of physicians (options).
• they found that consumers have different decision styles. More specifically, some consumers are able to process more complex decisions more effectively than others.
• few consumers probed past the roll-up scores to their component measures. This could have been because they didn't think the extra detail would be helpful, but it may have made those consumers miss out on vital information.
• patient comments/reviews of physicians are more engaging and draw consumer's attention. We need to be careful to design the information visualization such that the qualitative information does not take away from the quantitative.

Process Blog by 10/19/2014

What we have done so far:

• We have created a Google document that will be used to collect the secondary research findings that we are executing. 
• We have also distributed duties among the team members by giving each one of us a research topic.