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May 15, 2010 Reining in online influencers: the emerging role of strangers in life and death decisions

Reining in online influencers

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Presented by Capstrat President, Karen Albritton at the first-ever HealthCampRDU on May 14, 2010.

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Page 1: Reining in online influencers

May 15, 2010

Reining in online influencers: the emerging role of strangersin life and death decisions

Page 2: Reining in online influencers

The Patient Perspective

“The Web is great. By the time I got to the ER, a Google search told me the numbness was either Bells Palsy or a stroke.

I used WebMD in the ER waiting room figuring out what to ask the doctor.”

Page 3: Reining in online influencers

The Physician’s Perspective

“The Web is changing patient/doctor interactions. About 25% of patients come in with research prior to their appointment.

Misinformation on the Internet makes it harder and more challenging to deal with a patient who has developed preconceived notions.”

Page 4: Reining in online influencers

The Web and Health Care

Page 5: Reining in online influencers

Patients use the Web for a variety of reasons

80% of adults access health information online to:

o Learn about specific diseases or conditions

o Determine whether professional medical care is needed

o Self-diagnose

o Learn about treatment options

o Look for peer support with similar conditions

Pew Internet & American Life Project: Online Health Search, 2006.The Doctor as the second opinion and the Internet as the first. Lisa Neal Gualtieri, 2009.

Page 6: Reining in online influencers

Insurance Website

Online Forum

Advocacy Group

Pharmacist

Nurse

Google

Family/Friends

Doctor

Think back to the last time you needed information on a health issue. Which of the following sources did you use?

52%

45%

38%

37%

29%

18%

12%

6%

Capstrat Poll: April, 2010.

Page 7: Reining in online influencers

What’s the single most influential source when you need to make a health decision?

Capstrat Poll: April 2010.

Insurance Website1%

Pharmacist2%

Family/Friends2%

Online forum4%

Advocacy group

8%

Nurse

8%Not sure

9%

Google

22%

Doctor

44%

Page 8: Reining in online influencers

Online information is changing the way patients behave.

58%

55%

54%

39%

35%

0 10 20 30 40 50 60 70 80 90 100

Information affected a decisionabout how to treat a condition

Information changed theiroverall approach to maintaining

their health

Information led them to ask adoctor a new question/get asecond opinion from doctor

Information changed the waythey coped with a chronic

condition

Information affected a decisionabout whether to see a doctor

Pew Internet & American Life Project: Online Health Search, 2006.

Page 9: Reining in online influencers

What about physicians?

86% of physicians access health information online

o Gather health, medical or prescription information

o 92% access the Internet from their office

o 21% search for information while a patient is in the room

o 88% search for information at home

o 71% start their research with a search engine

o 92% of these use Google

o 50% of doctors turn to Wikipedia for medical information

American Medical News: Pamela Dolan, Posted January 4, 2010.Manhattan Research: April 2009.

Page 10: Reining in online influencers

Physicians react to patient challenges

o Physicians cite increased frustration.

o Physicians are feeling the need to justify and defend their own diagnosis and treatment recommendations.

o When challenged, some physicians felt at risk of “losing face” and/or being “put on the spot.”

o Some physicians discuss strategies of “firing” the patient, referring patients to specialists or charging for extra time.

Journal of Medical Internet Research: Are Physicians ready for patients with Internet-based health information?, Ahmad, Fara, Hudak, Pamela, et al., 2006.

Page 11: Reining in online influencers

o How do you think the Web affects the physician/patient relationship?

o How do online health information sources establish themselves as credible?

o How do online health information sources establish themselves as credible?

Discussion:

Page 12: Reining in online influencers

Next stop: Social media

Page 13: Reining in online influencers

• Health information is ripe for social channels.

o The majority of American adults surfing the Internet are looking for user-generated content written by others with similar conditions.

o Two-thirds of e-patients talk with someone else about what they find online, most often a friend or a spouse.

o 41% of e-patients have read someone else’s commentary or experience about health issues on a website or blog.

o People with chronic conditions are more likely to blog or participate in online discussions about health problems.

Pew Internet & American Life Project: The social life of health information, 2009.

Page 14: Reining in online influencers
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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Insurance Website

Family/Friends

Online Forum

Google

Pharmacist

Advocacy Group

Nurse

Doctor

Not reliable

Neutral

Reliable

When assessing a personal health care issue, how reliable do you consider the results of the following?:

74%11%15%

16% 19% 65%

71%14%15%

12% 19% 70%

59%20%21%

39% 24% 37%

36%38%26%

46% 32% 23%

Capstrat Poll: April 2010.

Page 17: Reining in online influencers

More than Facebook and Twitter

Total monthly visits

2,135,440

1,881,748

1,702,685

428,660

236,583

214,042

209,052

39,298

0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000

alliancehealth.com

healthcentral.com

diabeticconnect.com

inspire.com

askapatient.com

disaboom.com

patientslikeme.com

imedix.com

The New York Times: Social networks a lifeline for the chronically ill. Claire Miller; March 24, 2010.The New York Times: Social networking for patients. Claire Miller, October 24, 2010.

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Anonymity or privacy

Information beingavailable 24/7

Input from others withsimilar symptoms as yourown

Community membershaving no commercialinterest in particularproducts/servicesDo not consult onlinehealth communities

• What do you consider the single most appealing factor about health communities?

Capstrat Poll: April, 2010.

10%

43%

12%

7%

27%

Page 23: Reining in online influencers

• The rise of the fPatient

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• What is significant about Sara Baker?

o Her Facebook profile is fake.

o She is a faux patient representing health care consumers who are ready to experience the next wave of e-health.

o Sara is a marketing tactic from a health care technology company – Medseek.

Page 26: Reining in online influencers

Discussion:o What are the right uses for social media in health care?

o What are the implications of this new faux patient concept?

o What do you think this means for the future of health care?

o What are the implications for obtaining misinformation from health social networks?

Page 27: Reining in online influencers

What’s next?

Page 28: Reining in online influencers

• The changing landscape of health information on the Web

o Online community support groups will continue to rise.

o Use of the Internet and email by health care professionals will proceed more slowly than consumer-oriented applications.

o Health care organizations will use the Internet as a replacement for or a complement to existing information systems, communications infrastructures and transaction services.

The Future of the Internet. Mary Cain and Robert Mittman, 2001.

Page 29: Reining in online influencers

Discussion:

o How do changing demos affect the use of online sources?

o What are your thoughts around electronic medical records and electronic communication channels with physicians?

o Should physicians diagnose patients who “friend” them on social networks? Can doctors be held liable?

o Is it OK for physicians to tweet while doing surgeries?

Page 30: Reining in online influencers

Thank you

Page 31: Reining in online influencers

Search engines are the first stop for two-thirds of Internet health

Search engine like Google orYahoo

Specific health website likeWebMD

Some other way

Don't know

Pew Internet & American Life Project: October 2006.

5%

66%

27%

3%