Original title: Health 2.0 meets Ix: Susannah Fox’s presentation
Here are my prepared remarks for the “Navigating the New Health Care Delivery System” segment at the Health 2.0 meets Ix conference (with the lines I added to respond to other themes brought out during the conference in bold)
“Is Health IT the answer? Only if it helps foster relationships.” What a powerful statement about the role of technology in our lives. Ideo’s interviews uncovered trends which are reflected in the national phone surveys conducted by the Pew Internet Project.
Participatory medicine is taking hold with both citizens and health professionals.
But there are still pockets of people who lack access to the basic technology, lack the skills required to participate, lack interest in trying something new, or who may lack the sense that they are welcome.
The Pew Internet Project studies the social impact of the internet. We conduct classic telephone surveys to measure tech adoption in the U.S. and to map online social life. Our most recent survey about health and health care was conducted in December 2008 in partnership with the California HealthCare Foundation and I am writing a report which will come out in a few weeks. I am here to give you a sneak preview of those findings.
We all know that broadband enabled “always on” access. Now, mobile has created the state of being “always connected.” The consequence is that mobile is changing us, once again, as internet users.
39% of adults are what we call Motivated by Mobility. That describes most of the people in this room. You just checked your email and you are probably Twittering. We use wireless technology not as a replacement, but as a supplement to everything we do on our desktops. Mobile access creates a “continual information exchange” that feeds on itself and reinforces our collaborative behavior.
Tap into that mobile hive and you’ve got a chance to make a difference in this world.
Most Americans – 61% of adults – are what we call the Stationary Media Majority. Many are on the “have” side of the so-called digital divide. They have broadband, they have a cell phone – but they are rooted in old media.
If you’re someone who thinks that online collaboration is a good thing, you have not convinced these people. In fact, you may even be losing them. They are just not that into your hive. They are satisfied with old ways or just comfortable with a desktop experience.
Looking specifically at health, the Pew Internet Project confirms our finding that 8 in 10 internet users, or 61% of U.S. adults, have looked online for health information.
But more importantly, just as we find that mobile access creates a “continual information exchange” the Pew Internet Project finds that online health research does not replace traditional sources of health information. Participatory medicine can reinforce and supplement traditional sources of care.
The vast majority of people with a health question want to consult a health professional. The second most popular choice is friends and family. Third choice: the internet and books.
But participatory patients or e-patients are using the internet in new ways. Some are going online to connect, in fact, with what we think of as traditional sources: health professionals, friends, and family members.
Technology is not an end, but a means to accelerate the pace of discovery, widen social networks, and sharpen the questions someone might ask when they do get to talk to a health professional. Technology can enable the human connection in health care.
For example, a significant percentage of internet users look for tailored information, provided by other e-patients, seeking the “just-in-time someone like me” who can help them in a given situation:
- 41% of e-patients have read someone else’s commentary or experience about health or medical issues on an online news group, website, or blog.
- One-quarter of e-patients have consulted rankings or reviews online of doctors or other providers
- One-quarter of e-patients have consulted rankings or reviews online of hospitals or other medical facilities
I hope that the Pew Internet Project’s upcoming report can add new insights to the excellent work done in the past year by other researchers.
The Deloitte Center for Health Solutions found that “the majority of consumers want to share decision-making with their doctor; only 20% are content to let their doctor control those decisions.”
Edelman’s Health Engagement Barometer is tracking the rise of “Health Info-entials” and points out that the New Second Opinion means that “no single source of information stands out or stands alone.” It’s a network. It’s a hive.
The Center for Studying Health System Change also measures “patient activation” and finds that 41% of patients have the knowledge, skills, and confidence to manage their health.
But we have a potentially severe problem. Your “just in time someone like me” may not be online or they may not be speaking up in public forums:
- Only 5% of internet users have posted comments, queries, or information about health or medical matters in an online discussion forum
- 5% of e-patients have posted a review online of a doctor (recall that one in four have consulted such reviews)
- 4% of e-patients have posted a review online of a hospital.
We do not have full participation.
However, few people foresaw what happened when the Obama campaign first began using social technologies to motivate citizens to donate, to volunteer, and to vote. Keep your eye on mobile adoption since “always connected” citizens are likely to be at the forefront, navigating the new health care delivery system.
Mobile could be a game-changer. But only for those who get in the game.
Susannah – but what is the cost (to the user) of this additional continual information exchange? For many of us, it’s an unnecessary expense, so far. Do I really want to add another $50 a month (for additional access) plus the cost of a blackberry or similar device to my current costs? I hate to be a Luddite. But cost containment is real. Add my phone, ISP, cell phone, cable TV etc. bills together and it’s a lot of money. So… so far I don’t have a pressing need to pay the fee for being “motivated by mobility”. Saving for retirement comes first :-)
Hi Deborah,
I hope it’s clear that I am describing these groups, not praising one over the other. I agree that it may not be worth the extra cost to be “always connected.”
In fact, I came away from the Health 2.0 meets Ix conference with a deeper appreciation for how valuable established desktop applications and services can be, plus how difficult implementation of mobile health will be!
There was specific discussion of how bleeding edge the event participants were (129 Twitterers for goodness sake) and acknowledgement that we needed to remember the reality of most people’s lives. That is why I ended my talk with a line that I added last-minute: Mobile could be a game-changer but only for those who get in the game.
Over the next two weeks I am going to be writing the full report based on the Dec08 survey we conducted in partnership with the California HealthCare Foundation.
One piece of feedback I got directly after my talk was that I didn’t make it clear when I was transitioning between talking about “all adults,” “internet users,” and “e-patients.” That is incredibly important and I’ll be sure to incorporate that into the final paper.
All feedback is welcome, so fire away with questions, concerns, or critiques!
Susannah — such a great presentation. Thank you for sharing. The one stat I have a question about is the 5% of internet users who’ve posted healthcare information. That sounds reasonable for the entire population. Did you break it out for e-patients? Thanks, Judy
Hi Judy,
Great question! 6% of “online health seekers” (or “e-patients”) have posted comments, queries or information about health or medical matters in an online discussion forum, compared with 1% of internet users who say they have not looked online for any of the health topics we list. Maybe I should have featured that data point in the first place since it keeps the comparison apples to apples, if only in that section.
I should note that our survey included a whole series of questions about other “social technology” activities and whether the respondent used them for health/medical purposes: tagging, listserve participation, posting comments to news sites, listening to podcasts, sharing audio/video/photos. Stay tuned! I’m writing as fast as I can :)
Thanks, I didn’t think you were pushing for all of us to be connected all the time. I wonder what life will be like for people who are always multi-connected – I suspect that the way today’s teenagers learn and react will be different from the way people my age do (early baby boomers). I wonder if all this constant information flow is good for them – will they be able to analyze situations in a productive way? What happens in a power failure when they can’t recharge things? :-) Oh, I am showing my age!!!!
I have a twitter account but since I refuse to let it text message me all the time, it is silent. I forget how to look at it. I have to pay extra for texting… bah, humbug!
Deborah, you would be a great addition to the Twittersphere! You’ll see that our “tribe” is friendly and focused (@ePatientDave, @gfry, @TrishaTorrey, @jenmccabegorman, @tedeytan, just to name a few). Whenever you’re ready, create a new account, start fresh, and join us — but only when you want to :)
Deborah, you can easily tell Twitter not to text you. Long ago it was mainly a cell phone thing, but I’d die if I used it that way.
To look at it all you have to do is go to http://twitter.com/yourtwittername. Mine is http://twitter.com/epatientdave, Susannah is http://twitter.com/SusannahFox, etc.
Honestly the thing I like most about Twitter is that I can use it as little or as much as I want. Whole days of tweeting can go by and I don’t know what was said and don’t care. If something important happens, someone will tell me. :)
Okay, I’m in… and I just changed my twitter ID but I’m not going to post it here for fear of being deluged. I do have it set not to text me. I put several of you on my list I’m following… :-) OMG I’m changing to someone who’s more plugged in..?
Thanks, Dave and Susannah