May 15, 2010 <br />Reining in online influencers: <br />the emerging role of strangers<br />in life and death decisions<br />
The Patient Perspective<br />“The Web is great. By the time I got to the ER, a Google search told me the numbness was eith...
The Physician’s Perspective<br />“The Web is changing patient/doctor interactions. About 25% of patients come in with rese...
The Web and Health Care<br />
Patients use the Web for a variety of reasons<br />80% of adults access health information online to:<br /><ul><li>Learn a...
Determine whether professional medical care is needed
Self-diagnose
Learn about treatment options
Look for peer support with similar conditions</li></ul>Pew Internet & American Life Project: Online Health Search, 2006.<b...
Think back to the last time you needed information on a health issue. Which of the following sources did you use?<br />52%...
What’s the single most influential source when you need to make a health decision?<br />Doctor<br />44%<br />Insurance Web...
Pew Internet & American Life Project: Online Health Search, 2006.<br />
What about physicians?<br />86% of physicians access health information online<br /><ul><li>Gather health, medical or pres...
92% access the Internet from their office
21% search for information while a patient is in the room
88% search for information at home
71% start their research with a search engine
92% of these use Google
50% of doctors turn to Wikipedia for medical information</li></ul>American Medical News: Pamela Dolan, Posted January 4, 2...
Physicians react to patient challenges<br /><ul><li>Physicians cite increased frustration.
Physicians are feeling the need to justify and defend their own diagnosis and treatment recommendations.
When challenged, some physicians felt at risk of “losing face” and/or being “put on the spot.”
Some physicians discuss strategies of “firing” the patient, referring patients to specialists or charging for extra time. ...
Discussion: <br /><ul><li>How do you think the Web affects the physician/patient relationship?
How do online health information sources establish themselves as credible?
How do online health information sources establish themselves as credible?</li></li></ul><li>Next stop: Social media<br />
Health information is ripe for social channels.<br /><ul><li>The majority of American adults surfing the Internet are look...
Two-thirds of e-patients talk with someone else about what they find online, most often a friend or a spouse.
41% of e-patients have read someone else’s commentary or experience about health issues on a website or blog.
People with chronic conditions are more likely to blog or participate in online discussions about health problems.</li></u...
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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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  • Patients’ use of internet changes perceptions of doctor’s advice.Internet often considered first opinionDoctor’s advice becomes second opinionSome patients don’t even mention their internet search to doctors. Don’t want to be dismissedFear of being seen as challenging “On an average about 25% of my patients come in with research prior to their appointment. It does skew more to women than men.” “10% of those that do research call me or request another visit based on more information they found on the web.” 
  • For patients who used Internet for self-misdiagnosis or self treatment, physicians described doing substantial work in justifying and, at times, even defending their own diagnosis and treatment recommendationsIn having their expertise challenged, some physicians felt they were at risk of “losing face” and/or being “put on the spot”Notably, some physicians discussed strategies of “firing” the patient, referring patients to specialists, or charging for extra time. Physicians’ lack of familiarity with popular health information sites was another source of frustration.This “reversed information gap” was cited as exerting extra pressures on the physician, leading to strain in the doctor-patient interaction
  • Meet Sara BakerShe uses the Internet to stay connected with friends, check her bank balance and make purchases. She is Web-savvy and expects her healthcare provider to be, too. She has growing expectations of her healthcare providers for 2011 and beyond. And she will be the driving force behind your healthcare organization&apos;s ePatient revenue center
  • Consumer Health Information Services.The number of health care Web sites will proliferate as established health care organizations, new Web-oriented health start-ups, and interested individuals put up their content. A number of approaches, including ratings services and trusted brands, will help consumers sort through the noise. Online purchases of both prescription drugs and over-the-counter items will increase during the forecast period.Online Support Groups for Patients and Caregivers.Online support groups for patients with a given disease and the people who care for them will continue to develop rapidly. Patients participating in the groups will feel more in control and, for many diseases, have better outcomes. There will be points of strain, however, between patients and some physicians who feel a loss of control over their patients&apos; care.Health Care Provider Information Services.Use of online information by health care professionals has become increasingly common. We don&apos;t forecast any breakthrough applications, although sites will develop that filter out most of the random content for them. Medical journals and, eventually, continuing medical education, will go to the Web.Provider-Patient E-Mail.In certain communities, consumer pressure will push physicians to overcome their fears of being overwhelmed with electronic messages, of breaches in security, and of liability. In most places, however, physicians will be reluctant to embrace e-mail with their patients. In time, despite the lack of reimbursement for e-mail communications, physicians will come to embrace it as they did the telephone in the early part of this century. Communications Infrastructure and Transaction Services.The justification for using the Internet to transmit electronic insurance claims, conduct remote telemedicine consultations, and transmit data from clinical trials or for FDA filings will be largely economic. Many other health care transactions, including eligibility, enrollment, and utilization review, will take longer to move to the Web.Electronic Medical Records.Health care providers are near the beginning of a slow transition to electronic patient records. We forecast that, although there will be a lot of activity in Web-based front ends, they won&apos;t be capable of providing the type of decision support that the eventual full electronic medical record will give to providers.
  • 1. Our research shows that more older people put their trust in doctors and pharmacists, but younger demos do not see them as a trusted source. Doctor reliable: 68% older population (65 and older) vs. 41% younger population (age 18-29) Pharmacist reliable: 62% older population vs. 25% younger population 2. As time goes by and younger generations move into medicine we can expect more sharing online of private medical procedures and records. N Newer generations are putting their life online and share everything. 3. Because so many people are going to the internet for first opinions, doctors who don’t participate in conversation online could be come marginalized. Surgeons are starting to Tweet from the operating room. Doctors are posting updates about events in their day, connecting with other healthcare workers, informing patients and documenting surgeries and procedures.Surgeons are saying that tweeting removes communication barriers. And helps make something scary much more comprehendableOthers are saying that it redirects their attention and allows them to minimize some of their nervousness around what is going on and the gives them support from a community.
  • Many searches start with a search engine like Google or Yahoo.
  • Reining in online influencers

    1. 1. May 15, 2010 <br />Reining in online influencers: <br />the emerging role of strangers<br />in life and death decisions<br />
    2. 2. The Patient Perspective<br />“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. <br />I used WebMD in the ER waiting room figuring out what to ask the doctor.” <br />
    3. 3. The Physician’s Perspective<br />“The Web is changing patient/doctor interactions. About 25% of patients come in with research prior to their appointment.<br />Misinformation on the Internet makes it harder and more challenging to deal with a patient who has developed preconceived notions.”<br />
    4. 4. The Web and Health Care<br />
    5. 5. Patients use the Web for a variety of reasons<br />80% of adults access health information online to:<br /><ul><li>Learn about specific diseases or conditions
    6. 6. Determine whether professional medical care is needed
    7. 7. Self-diagnose
    8. 8. Learn about treatment options
    9. 9. Look for peer support with similar conditions</li></ul>Pew Internet & American Life Project: Online Health Search, 2006.<br />The Doctor as the second opinion and the Internet as the first. Lisa Neal Gualtieri, 2009.<br />
    10. 10. Think back to the last time you needed information on a health issue. Which of the following sources did you use?<br />52%<br />45%<br />38%<br />37%<br />29%<br />18%<br />12%<br />6%<br />Capstrat Poll: April, 2010.<br />
    11. 11. What’s the single most influential source when you need to make a health decision?<br />Doctor<br />44%<br />Insurance Website<br />1%<br />Family/Friends<br />2%<br />Pharmacist<br />2%<br />Online forum<br />4%<br />Advocacy group<br />8%<br />Google<br />22%<br />Nurse<br />8%<br />Not sure<br />9%<br />Capstrat Poll: April 2010.<br />
    12. 12. Pew Internet & American Life Project: Online Health Search, 2006.<br />
    13. 13. What about physicians?<br />86% of physicians access health information online<br /><ul><li>Gather health, medical or prescription information
    14. 14. 92% access the Internet from their office
    15. 15. 21% search for information while a patient is in the room
    16. 16. 88% search for information at home
    17. 17. 71% start their research with a search engine
    18. 18. 92% of these use Google
    19. 19. 50% of doctors turn to Wikipedia for medical information</li></ul>American Medical News: Pamela Dolan, Posted January 4, 2010.<br />Manhattan Research: April 2009. <br />
    20. 20. Physicians react to patient challenges<br /><ul><li>Physicians cite increased frustration.
    21. 21. Physicians are feeling the need to justify and defend their own diagnosis and treatment recommendations.
    22. 22. When challenged, some physicians felt at risk of “losing face” and/or being “put on the spot.”
    23. 23. Some physicians discuss strategies of “firing” the patient, referring patients to specialists or charging for extra time. </li></ul>Journal of Medical Internet Research: Are Physicians ready for patients with Internet-based health information?, Ahmad, Fara, Hudak, Pamela, et al., 2006.<br />
    24. 24. Discussion: <br /><ul><li>How do you think the Web affects the physician/patient relationship?
    25. 25. How do online health information sources establish themselves as credible?
    26. 26. How do online health information sources establish themselves as credible?</li></li></ul><li>Next stop: Social media<br />
    27. 27. Health information is ripe for social channels.<br /><ul><li>The majority of American adults surfing the Internet are looking for user-generated content written by others with similar conditions.
    28. 28. Two-thirds of e-patients talk with someone else about what they find online, most often a friend or a spouse.
    29. 29. 41% of e-patients have read someone else’s commentary or experience about health issues on a website or blog.
    30. 30. People with chronic conditions are more likely to blog or participate in online discussions about health problems.</li></ul>Pew Internet & American Life Project: The social life of health information, 2009.<br />
    31. 31.
    32. 32.
    33. 33. When assessing a personal health care issue, how reliable do you consider the results of the following?:<br />74%<br />11%<br />15%<br />16%<br />19%<br />65%<br />71%<br />14%<br />15%<br />12%<br />19%<br />70%<br />59%<br />20%<br />21%<br />37%<br />39%<br />24%<br />36%<br />38%<br />26%<br />23%<br />32%<br />46%<br />Capstrat Poll: April 2010.<br />
    34. 34. More than Facebook and Twitter<br />The New York Times: Social networks a lifeline for the chronically ill. Claire Miller; March 24, 2010.<br />The New York Times: Social networking for patients. Claire Miller, October 24, 2010. <br />
    35. 35.
    36. 36.
    37. 37.
    38. 38.
    39. 39. What do you consider the single most appealing factor about health communities?<br />10%<br />27%<br />43%<br />7%<br />12%<br />Capstrat Poll: April, 2010.<br />
    40. 40. The rise of the fPatient<br />
    41. 41.
    42. 42. What is significant about Sara Baker?<br /><ul><li>Her Facebook profile is fake.
    43. 43. She is a faux patient representing health care consumers who are ready to experience the next wave of e-health.
    44. 44. Sara is a marketing tactic from a health care technology company – Medseek.</li></li></ul><li>Discussion:<br /><ul><li>What are the right uses for social media in health care?
    45. 45. What are the implications of this new faux patient concept?
    46. 46. What do you think this means for the future of health care?
    47. 47. What are the implications for obtaining misinformation from health social networks?</li></li></ul><li>What’s next? <br />
    48. 48. The changing landscape of health information on the Web<br /><ul><li>Online community support groups will continue to rise.
    49. 49. Use of the Internet and email by health care professionals will proceed more slowly than consumer-oriented applications.
    50. 50. Health care organizations will use the Internet as a replacement for or a complement to existing information systems, communications infrastructures and transaction services. </li></ul>The Future of the Internet. Mary Cain and Robert Mittman, 2001.<br />
    51. 51. Discussion:<br /><ul><li>How do changing demos affect the use of online sources?
    52. 52. What are your thoughts around electronic medical records and electronic communication channels with physicians?
    53. 53. Should physicians diagnose patients who “friend” them on social networks? Can doctors be held liable?
    54. 54. Is it OK for physicians to tweet while doing surgeries?</li></li></ul><li>Thank you<br />
    55. 55. 5%<br />3%<br />27%<br />66%<br />Pew Internet & American Life Project: October 2006. <br />
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