LivingBetter-Part-1

KLICK HEALTH / PROPRIETARY + CONFIDENTIAL // LIVINGBETTER 1

#LIVINGBETTER A research study from Klick Health, Google and the Digital Health Coalition, examining how digital technologies are influencing chronic care patients

KLICK HEALTH / PROPRIETARY + CONFIDENTIAL // LIVINGBETTER

Telephone Results 74% of phone respondents use the internet, which we know is low compared to US average of 87%*. Of those who do use the internet, however, their behaviors look very similar to the online sample. Devices owned tend to be less common for this group, and this reinforces that the group is older and (likely) less affluent than the online contingent. For example, 39% of telephone respondents was in the 65+ age bracket, as compared to only 13.9% of the US population in general. This represents a 2.8x over-representation for this age bracket that uses the internet less. Telephone Respondents Behave the Same Once we get past the barrier of internet use, the phone respondents look similar to the online respondents in terms of activities.

Survey Data Collection We wanted to ensure we had a representative reflection of the US diabetes patient population for our survey, so we decided to do some phone interviews to enhance the online data. The reality in the market today is that many citizens no longer respond to telephone surveys and this makes it difficult to acquire meaningful data from the channel. The online channels, which were once accused of bias, are now the more representative.

METHODOLOGY

= 2000 = 200 = 1800

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KLICK HEALTH / PROPRIETARY + CONFIDENTIAL KLICK HEALTH / // LIVINGBETTER

THE OVERALL STATE OF THE NATION ON CHRONIC CARE

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KLICK HEALTH / PROPRIETARY + CONFIDENTIAL PROPREITARY + CONFIDENTIAL KLICK HEALTH / // LIVINGBETTER

ARE THEY ONLINE?

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Number of Screens Interestingly, the different usage segments all have similar numbers of screens. Technology ownership is not a strong predictor of diabetes engagement:

Online Obviously everyone who answered the survey online had internet access. Only 74% of the telephone respondents had internet access and this was because the group that answers phone surveys skews much older than the general population.

98% have devices that connect to the Internet, across multiple devices

YES!

2.85 Daily/Weekly

2.61 Monthly

2.53 Few Times

2.20 Do Not Research

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Mobile users are not exclusive, the PC is the ubiquitous device for all users and mobile usage increases for the more active users. This means that the users most likely to be looking at your information are looking at it on multiple different screens.

93%

43% 39%

1%

93%

21% 19% 2%

92%

19% 13% 4%

29%

4% 2%

70% 72%

19% 16% 24%

0%

20%

40%

60%

80%

100%

Desktop or Laptop Tablet Smartphone Have not researched health information

Have you researched health information on the internet using the following over the past 12 months?

Daily/Weekly Monthly Few Times a Year Do Not Research All Diabetes

89%

38% 31%

1%

94%

15% 14% 1%

72%

11% 7% 23%

8% 1% 1%

91%

57%

13% 11%

38%

0%10%20%30%40%50%60%70%80%90%

100%

Desktop or Laptop Tablet Smartphone Have not researched diabetes information

Have you researched diabetes information on the internet using the following over the past 12 months?

IT’S A MULTI-SCREEN WORLD

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SURPRISING FACT #1

MORE SICK MORE SATISFIED

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One of our goals for this research was to find out if there is a correlation between digital usage and health outcomes. What we found was a complex story. The most digitally engaged users said their health was on the higher end of the spectrum; 70% were good or better. This did not extend to the users who use digital sources for diabetes monthly or less often. When measured against ER visits, the more digitally engaged users were actually MORE likely to go. A full 43% of these patients had been to an ER in the past 6 months.

13%

25%

32%

24%

7% 2%

17%

41%

31%

9%

2%

19%

40%

31%

9% 3%

23%

41%

26%

8% 4%

19%

40%

29%

9%

0%5%

10%15%20%25%30%35%40%45%

Excellent Very good Good Fair Poor

In general, would you say your health is:

Daily/Weekly Monthly Few Times a Year Do Not Research All Diabetes

57%

18% 11% 7% 8%

78%

12% 7% 2% 1% 0

83%

12% 3% 1% 1% 0

80%

13%

3% 3% 2% 0

77%

14% 5% 2% 2%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

0 1 2 3 or 4 5 or more Don't know

In the past 6 months, how many times did you go to a hospital emergency department?

IS THERE A CORRELATION?


We feel that what we’re seeing here is that digital is a lagging indicator rather than a driver. Patients are experiencing issues, disease complications, and are finding the disease impacts their lives, then this causes them to engage more digitally.

ANALYSIS

This digital engagement is in response to disease issues, and reflects the patients’ need to turn to online information sources for relief.

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SURPRISING FACT #2

CAN’T SEGMENT GROUPS BASED ON TRADITIONAL DEMOGRAPHICS

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We see a blurring of the traditional demographic patterns. Both Social and Mobile Over-index up to age 45-54. These respondents over-index on age groups up to 45-54. Interestingly, social use sees more uptake in the older age groups than mobile use.

1% 6% 10% 30% 30% 24%

5% 19% 22%

32%

16% 5% 1% 3% 7%

29% 33% 28%

0%20%40%

18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 or older

What is your current age? All Mobile EN Mobile NOT

1% 6% 10%

30% 30% 24%

3% 12% 16%

32% 24%

12% 2% 6%

29% 33% 30%

0%

20%

40%


What is your current age? All Social EN Social NOT

4% 16% 21%

28% 18%

12% 2%

7% 9%

36% 30%

17%

1% 3% 8%

32% 34%

22%

2% 6%

26% 31% 34%

1% 6%

10%

30% 30% 24%

0%10%20%30%40%


What is your current age? Daily/Weekly Monthly Few Times a Year Do Not Research All Diabetes •  44 and younger dominate

the Daily/Weekly usage segments

•  45-64 is biggest in monthly •  55-64 is biggest in few

times a year •  65+ dominates the DNR

segment

•  Socially engaged segment is 44% of the total

•  It over-indexes up to 45-54 age group

•  Mobile engaged segment is 19% of the total

•  It over-indexes up to 45-54 age group

AGE BY CHANNELS


SEGMENTS

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47% 18% 35%

SEEKERS Use digital for health daily/weekly

INTEGRATORS Use digital for health a few times a year or more

TRADITIONALISTS Don’t use digital for health


SURPRISING FACT #3

WHERE PATIENTS GO TO GET INFORMATION

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Social Media When asked about their use of social media specifically for their condition, the diabetes population over-indexes compared to the US population in general. The difference was most visible on Forums where 38% of diabetes patients engage compared to 20% of the general population.

ONLINE CHANNELS

77% 88%

58% 57%

Sites focused "on Diabetes

Health Portals Sites of a "brand of drug

Email newsletters/mailing lists

Branded Sites We were very surprised to see pharmaceutical brand sites at #3 on the list of preferred information sources. This speaks to a patient audience that is willing to accept information from the drug manufacturers.

KLICK HEALTH / PROPRIETARY + CONFIDENTIAL PROPREITARY + CONFIDENTIAL KLICK HEALTH / // LIVINGBETTER 15

WHEN DO THEY SEARCH ONLINE? INSIGHTS FROM


In waitingroom

Stumble across info

online (e.g.

Facebook)

50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%

When I’m feeling bad/looking for

help

Whenever I have free

time

Before doctor visit

START In exam room

While talking with the doctor

After doctor visit

After medication prescription

ONLY PATIENTS WITH MOBILE DEVICES CAN PARTICIPATE IN THESE TASKS

After picking up

medication

After taking the

medication

Return to the start

DIABETES PATIENT JOURNEY Daily/Weekly Monthly Few Times a Year Do not Research

DURATION: WEEKS – YEARS LESS THAN AN HOUR – HOUR HOURS – WEEKS


SO WHAT DOES THIS ALL MEAN?


We find that the more engaged respondents were digitally, the more likely they were to be engaged in real life. There is likely a strong feedback loop here:

•  Worry about the disease causes the respondent to search online more

•  Finding more condition information online provides both the impetus and the knowledge needed for behavior change

•  The goal of behavior change also causes the respondent to look to their healthcare providers for better treatments

VALUE = ACTION


CHANGE MY DIET AND NUTRITION

WHAT WAS THE RESULT?

19 KLICK HEALTH / // LIVINGBETTER


CHANGE MY EXERCISE AND FITNESS BEHAVIOR/ROUTINE




SET UP AN APPOINTMENT WITH MY PHYSICIAN TO DISCUSS DIABETES




WHAT DO THEY WANT?


The mobile engaged segment is only 19% of respondents We defined “mobile engaged” as both having the required devices, which the majority of diabetes patients have, and using said devices to look up diabetes information

INTEGRATE THEIR MOBILE DIGITAL LIFE WITH THEIR DOCTOR



Diabetic Mobile Users Lead HCPs Of mobile engaged users, a full 80% want app recommendations from their doctors, something that PwC research shows 68% of doctors would be willing to do* but that only 37% have already done** * http://www.klick.com/health/news/blog/insights/68-of-physicians-would-be-willing-to-prescribe-an-app/ ** http://www.klick.com/health/news/blog/mhealth/37-of-physicians-have-prescribed-an-app/


Diabetic Mobile Users Lead the Rest of the Population Of mobile engaged users, 78% want to share their data with their doctors. In the general US population 56% would like to share some of their health data with their providers* * http://www.klick.com/health/news/blog/insights/half-of-americans-want-health-data-sent-to-providers/


// #LIVINGBETTER

Telemedicine Can’t Come Fast Enough Of mobile engaged users, 75% want to use their devices to interact with their doctors This technology has been slow to gain traction as reimbursement plans failed to allow for it Now, however, two forces are moving doctors toward accepting telemedicine connections: 1.  Insurance plans are reimbursing the

activity 2.  The industry is moving towards payment

for outcomes rather than payment for activities, this will incent telemedicine, as it is more efficient than traditional visits

KLICK HEALTH / PROPRIETARY + CONFIDENTIAL PROPREITARY + CONFIDENTIAL KLICK HEALTH / // LIVINGBETTER

WHAT SHOULD WE BE THINKING ABOUT

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We have broken down our recommendations into four sections, each with a list of the most valuable things healthcare marketers can be thinking about to help their patients with chronic conditions.

TRACK MANAGE CONNECT SHARE


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Social listening to understand macro behaviors and sweeping trends Website metrics to identify audiences and determine preferred engagement Smartphone and wearable apps to measure and analyze individual data

TRACK MANAGE CONNECT SHARE Electronic health records to integrate with the point of care Relationship management programs to provide ongoing support Deep data analytics and reporting to provide feedback and optimization

New FDA social media draft guidance to provide prescriptive process Content creation and community management to heighten engagement Blogger influencer campaigns to build advocacy and support

Tracking data shared with peers and professionals to motivate and guide Management data shared to help diagnose, treat, and adhere Social content shared with peers to create community and share success

// #LIVINGBETTER

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www.klick.com/livingbetter

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LivingBetter-Part-1