The rise of the e-patient - Lee Rainie

THE RISE OF THE E-PATIENT Trends in the use of digital technology for health purposes Lee Rainie Director – Pew Internet Project Medical Librarians Atlantic City 10.7.09

New information ecosystem: Then and Now Industrial Age Info was: Scarce Expensive Institutionally oriented Designed for consumption Information Age Info is: Abundant Cheap Personally oriented Designed for participation

2000 46% of adults use internet 5% with broadband at home 50% own a cell phone 0% connect to internet wirelessly <10% use “cloud” = slow, stationary connections built around my computer The internet is the asteroid: Then and now 2009 77-79% of adults use internet 63% with broadband at home 85% own a cell phone 54-56% connect to internet wirelessly >two-thirds use “cloud” = fast, mobile connections built around outside servers and storage

Media ecology – then (industrial age)

Product Route to home Display Local storage

TV stations phone TV Cassette/ 8-track

broadcast TV radio

broadcast radio stereo Vinyl album

News mail

Advertising newspaper delivery phone

paper

Radio Stations non-electronic

Tom Wolzien, Sanford C. Bernstein & Co

Media ecology – now (information age)

Product Route to home Display Local storage

cable TiVo (PVR) VCR

TV stations DSL TV Satellite radio player

Info wireless/phone radio DVD

“ Daily me” broadcast TV PC Web-based storage

content books iPod /MP3 server/ TiVo (PVR)

Cable Nets broadcast radio stereo PC

Web sites satellite monitor web storage/servers

Local news mail headphones CD/CD-ROM

Content from express delivery pager satellite player cell phone memory

individuals iPod / storage portable gamer MP3 player / iPod

Peer-to-peer subcarriers / WIFI cell phone pagers - PDAs

Advertising newspaper delivery non-electronic cable box

Radio stations camcorder/camera PDA/Palm game console

game console paper

Satellite radio e-reader / Kindle storage sticks/disks e-reader/Kindle

Adapted from Tom Wolzien, Sanford C. Bernstein & Co Ubiquitous computing age Cloud computing “Internet of things”

Information and media ecosystem changes

Volume of information grows

Variety of information increases

Velocity of information speeds up

The times and places to experience media enlarge

People’s vigilance for information expands AND contracts

Information and media ecosystem changes

The immersive qualities of media are more compelling

Relevance of information improves

The number of information “voices” explodes – and the voices become “louder” and more findable

Voting and ventilating are enabled

Social networks are more vivid

Behold Networked Individuals … those with a different sense of …

Expectation about access to, availability of, and pathways to information

Place, distance, presence, intimacy – it’s all ambient

Time use

The possibilities of work, learning, and play

The scalability of conversation and community

The persistence of “digital me” and “digital you”

Personal efficacy and the payoff for personal effort

Boundaries and contexts – public and private

The rewards and challenges of networking for social, economic, political, and cultural purposes – new layers and new audiences

A new pattern of communication and influence built around social networks and participatory media

The four A’s of searching and acting

attention

acquisition

assessment

action

Networked Individuals as e-patients

61% of total population – 83% of online population

64% of women; 57% of men

65% of whites; 51% blacks; 44% Hispanics

Age

72% of 18-29-year-olds

27% of those 65 and older

Skews upscale and educated

Parents

http://e-patients.net/

Other e-patient activities

47% of adults have used the internet to get information about doctors or other health professionals

38% have gotten information about hospitals or other medical facilities

33% have gotten information about how to lose or control their weight

27% have gotten information about health insurance

12% have gotten information about how to stay healthy on an overseas trip

60% of e-patients engage with social media

41% have read someone else's commentary or experience about health or medical issues on an online news group, website, or blog.

24% have consulted rankings or reviews online of hospitals/other medical facilities.

24% have consulted rankings or reviews of docs or other providers.

19% have signed up to receive updates about health or medical issues.

13% have listened to a podcast about health or medical issues.

20% of e-patients are e-participators

6% have tagged or categorized content about health issues.

6% have posted comments about health issues in an online discussion, listserv, or other online group forum.

5% have posted comments about health on a blog.

5% have reviewed a doctor.

4% have reviewed a hospital.

4% have shared photos, videos or audio files online about health or medical issues.

A handy tech-user typology

http://www.pewinternet.org/Reports/2009/5-The-Mobile-Difference--Typology.aspx

What we measured

Assets

Actions

Attitudes

Overall picture

39% are motivated by mobility

5 groups that are being drawn into deeper use thanks to mobile connections

Wireless connections prompt them to use the internet more and feel better and better about its role in their lives

Self expression and networking matters to them, but some have mixed feelings

61% are tied to stationary media

5 groups that do not feel the pull of mobility – or anything else – drawing them deeper in the digital world

Some have lots of technology, but it is relatively peripheral in their lives

They have plateaued in internet use and enthusiasm -- or are on the outskirts of digital life

Motivated by mobility – Group 1 Digital collaborators (8% of population)

Tech lifestyle attributes

With the most tech assets, Digital Collaborators use them to work with and share their creations with others.

The lead the pack in every dimension of our analysis: assets, actions, attitudes towards technology.

Always-on broadband and always-present cell connection is key to their lives.

These veteran users are enthusiastic about how ICTs help them connect with others and confident in how to manage digital devices and information.

Demographics

Male: 56%

Median age: 39

Race: Diverse

Education: 61% college +

Household income: 53% make > $75K

Employment status: 70% employed FT

Community type: 52% suburb; 36% urb.

Funky facts: 12 years online

73% married

51% parents minor children

Important because

They are your most consistent, primary users

They are early adopters

They are most potent influentials; they are evangelists and their word of mouth really, really matters

When you want to explore new services, they will give you feedback

Motivated by mobility – Group 2 Ambivalent networkers (7% of population)

Ambivalent Networkers have folded mobile devices into how they run their social lives, whether though texting or social networking tools online.

They tie for first or take second in all assets and actions categories.

They also rely on ICTs for entertainment.

But they also express worries about connectivity; and some find that mobile devices are intrusive.

Many think it is good to take a break from online use.

Their keyword about technology might be “obligation” – can’t afford to be off the grid, even though they want to be.

Demographics

Male: 60%

Median age: 29 (youngest)

Race: Little more minority than DigCollab.

Education: 23% college +

Household income: 44% make < $50K

Funky facts: 30% are students

34% are NOT email users

83% are cell texters

Important because

They are tomorrow’s primary e-patients and library-service users and influencers

They have seen change in libraries and liked it

Motivated by mobility – Group 3 Media movers (7% of population)

Media Movers have a wide range of online and mobile habits, and they like to find or create an information nugget, such as a digital photo, and pass it on.

These social exchanges are central to this group’s use of ICTs – rather than work-related uses.

Cyberspace as a path to personal productivity or an outlet for creativity is less important.

They are not into online content creation the way Digital Collaborators are, yet they are big-time sharers.

Demographics

Male: 56%

Median age: 34 (second youngest)

Race: Diverse

Education: 32% college+ (average)

Funky facts: 31% record video on cell

87% own dig. camera

90% online health seekers

Important because

They are least intense e-patients, though lots of them have sought medical information online

They are eager social networkers who pass along your material

They add to the diversity of your audience

Motivated by mobility – Group 4 Roving nodes (9% of population)

Roving Nodes are active managers of their social and work lives using their mobile device.

They get the most out of basic applications with their assets – such as email or texting – and find them great for arranging the logistics of their lives and enhancing personal productivity.

They love email and texting, but are too busy to blog or create other content.

Think “working Little League mother”, or caregiver for aging parent when you think of Roving Nodes

Demographics

Female: 56%

Median age: 39

Race: Diverse > Latino

Education: 44% college+ (2nd highest)

Funky facts: 100% have cell phones

heavy internet use at home and work – hard to give up

say tech gives them control

Important because

They are kin-keepers and caregivers

They will appreciate you if you help them be efficient and thorough

Motivated by mobility – Group 5 Mobile newbies (8% of population)

This group rates low on tech assets, but its members really like their cell phones.

Mobile Newbies, many of whom acquired a cell in the past year, like how the device helps them be more available to others.

The act of getting a cell phone was like a conversion experience for them in the way it opened up the world.

They would be hard pressed to give up the cell phone. And they express general support for the role technology can play in people’s lives even though most do NOT use the internet.

Demographics

Female: 55%

Median age: 50 (oldest MBM group)

Race: A bit weighted to minorities

Education: 72% HS or less

Household income: 45% make <$40K

Community type: 24% rural

Funky facts: just 39%=internet users 46% use computers

none create internet content

love new connectedness

Important because

They are very unlikely to be e-patients and quite unaware of the wealth of material available online

They greatly diversify your audience

They are traditionally under-served customers

Stationary media majority – Group 1 Desktop veterans (13% of population)

This group of older, veteran online users is content to use a high-speed connection and a desktop computer to explore the internet and stay in touch with friends.

They are happy to be connected with they are stationary and sitting. So, they place their cell phone and mobile applications in the background.

For them, online life hit its zenith about 3-5 years ago when they first got broadband connections.

And their 2004 cell phone still serves its primary purpose for them – making phone calls.

Demographics

Male: 55%

Median age: 46

Race: Skews white

Education: 41% college+ (3 rd highest)

Household income: 32% make >$75K

Community type: 52% sub.; 30% urb.

Funky facts: just 77% have cells

int. user 10.5 years

heavy int. users at home and work

average content creators

Important because

They are relatively intense e-patients

They already know about the things you do

They are influencers, too

Stationary media majority – Group 2 Drifting surfers (14% of population)

Many have the requisite tech assets, such as broadband or a cell phone, but Drifting Surfers are infrequent online users.

They also are not big fans of mobile connectivity.

When they use technology, it is for basic information gathering.

It wouldn’t bother the typical Drifting Surfer to give up the internet or cell phone.

Likely to be secondary user of technology in household.

Demographics

Female: 56%

Median age: 42

Race: Diverse

Education: 33% college+; 33% HS

Household income: 46% make >$50K

Community type: 46% sub.; 35% urb.

Funky facts: 85% have home broadbd 86% have cells

below aver. tech user

tech doesn’t help much 46%=“good to take break”

Important because

They are not aware of the material that is available online and through other resources

They will need you some day

Stationary media majority – Group 3 Information encumbered (10% of population)

Most people in this group suffer from information overload and think taking time off from the internet is a good thing.

Their attitudes about the role of technology in the world have worsened since 2006 and they see no great benefits from technology in their personal lives.

The Information Encumbered are firmly rooted in old media to get information and communicate.

Demographics

Male: 67% (highest)

Median age: 53

Race: Skews white

Education: 33% college+; 37% HS

Community type: 48% urb; 20% rural

Funky facts: 99% are int. users

75% are cell users

only 52% online typ. day 52% feel overloaded

62% need help new gad.

Important because

They are the alienated and society functions better with their participation and involvement

Stationary media majority – Group 4 Tech indifferent (10% of population)

Members of this group are not heavy internet users.

Although most have cell phones, they don’t like their intrusiveness.

The Indifferent could easily do without modern gadgets and services. They are too much trouble with too little payoff.

Demographics

Female: 55%

Median age: 59 (2 nd oldest)

Race: Diverse (little higher Af-Am)

Funky facts: just 39% are int. users

46% computer users but 86% are cell users

least likely users of everything

Important because

They are on the far side of the digital divide even though they have some relationship to technology

Very few e-patients

Stationary media majority – Group 5 Off the net (14% of population)

Members of this group have neither cell phones nor online access, and tend to be older and low-income.

Some have experience with ICTs. They used to have online access and as many as one in five used to have a cell phone.

But it broke, or didn’t provide much enhancement to their worlds, so they did not return to using the technology.

Demographics

Female: 57% (highest)

Median age: 67 (oldest)

Race: Skews to minorities

Funky facts: just 16% have desktop or laptop

they see no lifestyle improvements with technology

Important because

These are often the people who most need medical information

Their caregivers need you, too

8 tips on how to be a node in a social network

Think like a friend

Remember your strengths and play to them by being an expert, a filter, and a recommender (linker)

Be aware that your audience is bigger than the available evidence provides – lurkers and future arrivals are part of the mix

Look for opportunities to provide support to users and chances to build communities with your material

8 tips on how to be a node in a social network

Help people cope with technology

Participate in the Web 2.0 world

Embrace the move towards mobility, constant connectivity, perpetual contact

This changes the realities of time and space and presence

Ask for help/feedback

Thank you!

Lee Rainie

Director

Pew Internet & American Life Project

1615 L Street NW

Suite 700

Washington, DC 20036

Email: [email_address]

Twitter: http://twitter.com/lrainie

202-419-4500

The rise of the e-patient - Lee Rainie

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