Mobile Advantage: Context and Immediacy in Health Information Seeking            Lisa Gualtieri, PhD, ScM               As...
Health search is everywhere• Last night, in J.K. Rowling’s The  Casual Vacancy, I read…  – “She navigated away from the   ...
Agenda• Past• Present  – Focus on what    mobile devices    provide health    seekers• Future                     3
Past, present, and future of health         information seeking behavior                                     ?            ...
Before looking at mobile health search,need to ask if people use mobile devices• 321.7M wireless subscribers in US at end ...
Not only are mobile devices used butthey may eradicate the “digital divide”• Smartphone ownership in US  – 49% of Hispanic...
Some people are only using mobile devices • 34% of US household are wireless only    – Stephen J. Blumberg, Julian V. Luke...
Some people are using         lots of mobile devices• 40% of US households have 3 or more mobile  devices in addition to t...
Where are mobile phones and tablets used?           Note that doctor’s office isn’t listed!                               ...
Tablets are used more frequently than smartphones with the exception of                            daily health content us...
What do mobile devices          provide health seekers?•   Immediacy and access•   Affinity•   Multiple methods of input/o...
Immediacy and access• 85% of respondents had cell phones   – 53% of these, or 45% of US adults, had smartphones   – Cell p...
What do mobile devices          provide health seekers?•   Immediacy and access•   Affinity•   Multiple methods of input/o...
Affinity• People relate to computers differently than people   – What about smartphones? Tablets?• Mobile users have an on...
Top 10 health searches 2011Web                     Mobile•   1. Cancer           •   1. Chlamydia•   2. Diabetes         •...
Online research is up in every category with the greatest growth                       in community support               ...
What do mobile devices          provide health seekers?•   Immediacy and access•   Affinity•   Multiple methods of input/o...
Methods of input/output• Input: less typing, fewer spelling mistakes   – Text: Autocomplete, word suggestions, etc.   – Vo...
14,000                     More Mobile Health Access                                                                      ...
Number of search results viewed on  smartphone versus computer
What do mobile devices          provide health seekers?•   Immediacy and access•   Affinity•   Multiple methods of input/o...
Context• People are exposed to a wealth of contextual  information: what they see, hear, feel, remember  – How do people a...
Sometimes asking questions leads to more questions: fighting the Hydra
Some of my questions…• Do people conduct health searches differently   –   On smartphones or tablets?   –   In mobile brow...
Near future• Design for mobile first instead of retrofitting  health websites into mobile format• Make smarter smartphones...
Future• From digital appendages to… Google glasses• The ultimate in seamless mobile health search?• Stay in touch  – Email...
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Mobile Health Search Lisa Gualtieri APHA12

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One of the most fascinating things about health apps is the process of selecting them: defining the need, determining how to search and which search terms to use, deciding which to consider, and deciding which to try. Having thought a lot about health app search, I was thrilled to have an opportunity to talk about the broader issue of mobile health search in a session at APHA12 on health information seeking. My presentation first argued that it is almost impossible to focus only on laptops and desktops when considering health information seeking given the preponderance of mobile devices. I then talked about what mobile devices provide health seekers: immediacy and access; affinity; multiple methods of input/output; and context. For instance, I spoke about the role of the contextual information people see, hear, feel, and remember and how that impacts search; and external information and data from sensors, such as weather, location, time of day, and blood pressure, impact personalization and tailoring. I also talked about how the impact could be huge if public health had the resources of retail for the use of big data and predictive analytics.

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  • Monday, October 29, 2012 : 9:10 AM - 9:30 AMMobile devices are changing health search because of the immediacy they provide and their integration of context. With the infiltration of mobile devices into populations who were traditionally less likely to have internet access, increased reach is possible. However, health literacy skills remain an issue as does privacy. Beyond browser-based health searches, mobile devices open a new set of challenges: how consumers locate health apps, learn about the credibility of apps, and if apps incorporate evidence-based guidelines. The talk will address these topics and will place an emphasis on the discussion of how these tools have changed how and when people seek health information.Learning Objectives: 1. Discuss the potential of mobile devices to reach healthcare consumers 2. Explain how context and immediacy offer advantages to healthcare consumers 3. Define the issues in how consumers search for credible and reliable health apps
  • Beyond individual use
  • Immediacy
  • http://www.ctia.org/advocacy/research/index.cfm/aid/10323Country with largest number of subscribers
  • Digital divide of disparities
  • Digital divide of disparities
  • Digital divide of disparities
  • Mobile users have an ongoing intimate and personalized relationship with their digital appendage and, through it, with otherspeople are more likely to share tablets
  • http://mobihealthnews.com/15325/top-10-health-searches-from-mobile-devices-in-2011/
  • Digital divide of disparities
  • Digital divide of disparities
  • Digital divide of disparities
  • Whenever your smartphone does something “smart” it is acting on contextual informationDigital divide of disparitiessmartphones that are smart and better integrated into daily lifeIn the small and in the large
  • Fighting the Hydra
  • Charles Duhigg: How Companies Learn your Secrets
  • Mobile Health Search Lisa Gualtieri APHA12

    1. 1. Mobile Advantage: Context and Immediacy in Health Information Seeking Lisa Gualtieri, PhD, ScM Assistant ProfessorDept. of Public Health and Community Medicine Tufts University School of Medicine Email: l.gualtieri@tufts.edu Twitter: @lisagualtieri
    2. 2. Health search is everywhere• Last night, in J.K. Rowling’s The Casual Vacancy, I read… – “She navigated away from the Parish Council message board and dropped into her favorite medical website, where she painstakingly entered the words "brain" and "death" in the search box. The suggestions were endless. Shirley scrolled through the possibilities…”
    3. 3. Agenda• Past• Present – Focus on what mobile devices provide health seekers• Future 3
    4. 4. Past, present, and future of health information seeking behavior ? “Democratization of location” Future?Democratizationof medical Present: Look itinformation up on mobile Past: Look device in waiting it up at room, elevator, work or at car, walking, etc. Distant past: home Literature, family, friends 4
    5. 5. Before looking at mobile health search,need to ask if people use mobile devices• 321.7M wireless subscribers in US at end of 2011 – Penetration of 101%• Smartphones now outnumber feature phones for the first time in the US• 1 in 8 internet page views are on smartphone or tablet, doubling in just a year – Comscore 9/12• Almost impossible to focus only on laptops and desktops when considering health information seeking
    6. 6. Not only are mobile devices used butthey may eradicate the “digital divide”• Smartphone ownership in US – 49% of Hispanics – 47% of African Americans – 42% of whites – Pew Internet & American Life Project 9/12
    7. 7. Some people are only using mobile devices • 34% of US household are wireless only – Stephen J. Blumberg, Julian V. Luke, Wireless Substitution: Early release of estimates from the National Health Interview Survey, July-December 2011, National Center for Health Statistics, 2012, http://www.cdc.gov/nchs/data/nhsr/nhsr061.pdf • But one device or many?
    8. 8. Some people are using lots of mobile devices• 40% of US households have 3 or more mobile devices in addition to their PCs & TVs• Differences in – Where mobile phones and tablets are used – Frequency of use
    9. 9. Where are mobile phones and tablets used? Note that doctor’s office isn’t listed! 56% Living room 88% Bedroom 53% 79% Work 49% 35% Outdoors 48% 31% Car 45% 29% Stores 42% 12% Restaurant/coffee shop 41% 32% Other room in my house 39% 32% Kitchen 36% 51% Hotel 34% 44% Bathroom 30% 30% Airport/airplane 29% 41% Events 28% mobile 14% Home office 26% tablet* 35% Other 18% 9% Train/subway/bus 18% 15% School 17% 15% Library 15% 16% Bank 13% 6% Church or place of worship 6% 6% Base: 2,116 US online adults who own a mobile phone; Base: 549 US online adults who own a tabletSource: North American Technographics Telecom And Devices Online Recontact Survey, Q3 2011 (US)
    10. 10. Tablets are used more frequently than smartphones with the exception of daily health content users 25% 24% 20% Smartphone Tablet 16% 15% 13% 13% 11% 10% 9% 8% 8% 6% 5% 5% 0% Daily 5-6x per 2-4x per Once a Less than Week Week week 1x perSource: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033 weekHow often do you use your device for health purposes?
    11. 11. What do mobile devices provide health seekers?• Immediacy and access• Affinity• Multiple methods of input/output• Context
    12. 12. Immediacy and access• 85% of respondents had cell phones – 53% of these, or 45% of US adults, had smartphones – Cell phone owners • 31% look for health or medical information • 11% have health apps • 9% receive text updates or alerts from doctor or pharmacist – Pew 9/12 via Susannah Fox• Mobile devices may be used immediately after leaving doctor’s office, especially with a new diagnosis or prescription – Impact on health literacy especially recall and retention – Impact on patient-physician communication • Could patients listen or ask questions differently due to reliance on search?
    13. 13. What do mobile devices provide health seekers?• Immediacy and access• Affinity• Multiple methods of input/output• Context More lovable when they’re cute and little
    14. 14. Affinity• People relate to computers differently than people – What about smartphones? Tablets?• Mobile users have an ongoing intimate and personalized relationship with their “digital appendage” or “cognitive prosthetic device”• Do people seek information differently? – Searches on mobile devices tend to be about private/sensitive conditions: sexually transmitted diseases, mental health• How is use changing? – Greater online community use
    15. 15. Top 10 health searches 2011Web Mobile• 1. Cancer • 1. Chlamydia• 2. Diabetes • 2. Bipolar disorder• 3. Symptom • 3. Depression• 4. Pain • 4. Smoking/quit smoking• 5. Weight • 5. Herpes• 6. Infection • 6. Gout• 7. Virus • 7. Scabies• 8. Diet • 8. Multiple Sclerosis• 9. Thyroid • 9. Pregnancy• 10. Sleep • 10. Vitamin A• Healthline Networks
    16. 16. Online research is up in every category with the greatest growth in community support 64% 65% 64% 2010 2012 Largest shift: more people were seeking online 55% 54% communities! 53% 52% 47% 45% 41% 39% 33% 32% 22% 15% 10%Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033What types of health-related information have you looked for online in the last 6 months?
    17. 17. What do mobile devices provide health seekers?• Immediacy and access• Affinity• Multiple methods of input/output• Context
    18. 18. Methods of input/output• Input: less typing, fewer spelling mistakes – Text: Autocomplete, word suggestions, etc. – Voice: “Siri, what is…” – QR codes• Search: many types of mobile search: app and browser – In mobile browser – On mobile website – In app store – In an app• Output: limitations are screen size and location/privacy – Text – Images – Video
    19. 19. 14,000 More Mobile Health Access 52% 12,000 through Browser than AppThousands 10,000 59% 8,000 6,000 4,000 2,000 - Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Accessed health information [Application] Accessed health information [Browser ]  SOURCE: COMSCORE MOBIL LENS, 3 MOS ENDING MARCH 2012
    20. 20. Number of search results viewed on smartphone versus computer
    21. 21. What do mobile devices provide health seekers?• Immediacy and access• Affinity• Multiple methods of input/output• Context
    22. 22. Context• People are exposed to a wealth of contextual information: what they see, hear, feel, remember – How do people act on it using their mobile device?• Multiple devices monitor and record contextual information, including sensors and GPS – How do weather, location, time of day, blood pressure, etc. impact personalization and tailoring?• Big data and predictive analytics
    23. 23. Sometimes asking questions leads to more questions: fighting the Hydra
    24. 24. Some of my questions…• Do people conduct health searches differently – On smartphones or tablets? – In mobile browsers or mobile websites or app stores or apps? – Using text or voice? – Based on location?• Are people more or less easily able to locate “helpful” information?• Are there different indicators of quality or reliability?• How can mobile health search better help people to seek information and achieve their health goals?
    25. 25. Near future• Design for mobile first instead of retrofitting health websites into mobile format• Make smarter smartphones and better integrate sensor data• Learn from strategies used by well-funded retail – Use of big data and predictive analytics to provide accurate and timely health information
    26. 26. Future• From digital appendages to… Google glasses• The ultimate in seamless mobile health search?• Stay in touch – Email: l.gualtieri@tufts.edu – Twitter: @lisagualtieri

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