2001 AMIA Symposium -- A Medical Odyssey: Visions of the Future and Lessons from the Past

Ronnie S. Stangler, MD

Disclosures

March 28, 2002

In This Article

The Internet and Healthcare

The Internet and its continuing impact on healthcare and the public were explored by keynote panelists Susannah Fox, Lee Rainie, and Tom Ferguson, MD, of the Pew Internet and American Life Project.[3] They updated findings from their 2000 project: "The Online Health Care Revolution: How the Web Helps Americans Take Better Care of Themselves."[4]

The Internet has become an invaluable source of healthcare information for a substantial number of Internet users. The Pew associates defines such users as "health seekers" because most are in pursuit of information to assist them when they or their loved ones are ill.

With the duration of a typical physician visit shrinking to 12 minutes, many patients leave their physicians' offices with unanswered questions. One 1999 Pew survey found that more than half of Americans are not satisfied with the availability of their physicians or the duration of their meetings together. Not surprisingly, many have turned to the Internet for medical advice.

By the beginning of 2001, Pew estimated that well more than 52 million American adults or 55% of those with Internet access had used the Web to access health or medical information. Each day 7 million patients search the Internet, whereas 2.5 million consult a physician. It is now predicted that by 2010, 10 to 20 times more patients will use the Internet for health issues in a single day than will visit their physicians' offices.

The key demographic affecting Internet use in the Pew studies is health status. The healthy tend to use the Web for primarily preventive and health maintenance activities or to assist others who are ill. Those who are ill tend to use the Web in ways specifically related to their particular illness. In contrast, healthy individuals constitute 60% of the entire health seekers population but about 10% of the Web traffic, compared with patients with newly diagnosed conditions, who represented 5% of the health seeker population but 40% of the traffic. Chronically ill individuals made up 35% of the health seeker population and 50% of the traffic.

Typically, users' research was unguided, with 86% browsing multiple sites. Most searches were initiated with general search engines rather than from specific medical sites.

The most significant findings from the Pew research indicate how greatly health decisions are influenced by the health and medical information found on the Web. Forty-one percent reported that the material they found during their last online search affected their decisions about whether they should go to the physician, how to treat an illness, or how to question their physician. Most health seekers (92%) reported that the information they found during their last online search was useful, and 81% said they learned something new.

Nearly half (48%) of health seekers reported that the advice they found on the Web had improved the way they take care of themselves, and 55% indicated that access to the Internet had improved how they get medical and health information. Almost half (47%) of those who sought health information for themselves during their last online search reported that the material affected their decisions about treatment and care.

Health seekers are very anxious about privacy, according to the Pew research. They fear the sale of their personal health information and the potential for insurance companies and employers to misuse such information.

The credibility of health information and health advice on the Internet is also a concern. Compared with other Internet users, health seekers show greater vigilance in checking information sources. Despite their reservations, 52% believed that "almost all" or "most" health information they see on the Internet is credible.

The basic medical model of the 20th century is shifting dramatically. Although the Internet is not the sole factor, it plays a significant part. The role of the "patient" is changing to one of an "end-user," one who is more independent of his other physician and less reliant on information from a single source. The public wants to be more knowledgeable about their health, and the educated clinician will encourage and assist them in their quest. Patients deserve the best possible information and a credible road map to effective and humane care. With this goal in mind, physicians should work toward a new system that is geared toward providing the greatest benefit to the patient, the ultimate "end user."

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