Webchutney Digital Healthcare Report 2011

Webchutney works with leading companies in India by developing awardwinning and memorable experiences for brands to connect, engage withand build sustained relationships with their consumers online.Our clients include Airtel, Microsoft, Unilever, Marico, Titan, Samsung,MasterCard, Barclays, Nokia and Canon among others. We work with Catching the e-Healthcarethem in areas of online advertising, website design, mobile marketingand social media. BugRanked as India’s Number 1 Digital Agency two years in a row (BrandEquity Agency Reckoner, The Economic Times, 2008 & 2009),Webchutney is committed to leading the interactive marketing industry.We are a team of over 200 digital marketing professionals across NewDelhi, Mumbai and Bangalore.Visit us at www.webchutney.com for more information.Follow us on www.twitter.com/webchutneyJoin us on www.facebook.com/webchutneyDelhi 7, Keher Singh Estate, Ground Floor, Westend Marg, Lane 2, Said-ul-Ajaib, New Delhi - 110030 Phone +91 11 32572301 - 04 Fax +91 11 29534136Mumbai Abhishek G, 2nd Floor, Juhu Versova Link Road, Andheri (W), Mumbai - 400053 Webchutney Phone +91 22 26365364, 26365380, 26365391 Fax +91 22 26364068Bangalore NewBridge Business Center, 777/D, 100 Feet Road, Indiranagar, Bangalore - 560038 Digital Healthcare Report 2011 Phone +91 9845096692 Fax +91 80 25211515©2010 Webchutney Studio Pvt. Ltd. All rights reserved.

ContentsForeword ................................................................................................ 2Introduction ............................................................................................ 4A NEW BREED OF HEALTHCARE INFORMATION SEEKERS .............. 6Surge in Online Healthcare Information Research ................................ 7Demographic Profile of the Healthcare Information Seeker .................. 9Substantial Experience with Internet Usage .......................................... 10Time Spent on Online Vs Offline Media ................................................. 11High Frequency of Internet Usage ......................................................... 12Maximum Time Spent on Search Engines ............................................ 13E-Mail, Chat/IM Most Popular Online Activities ...................................... 14SHIFTING LANDSCAPE OF INDIAN HEALTHCAREINFORMATION CONSUMPTION ............................................................ 16Internet Supplements Traditional Sources of Healthcare Information ... 17Health Hunt Online is Diverse ................................................................ 19Search Engines Facilitate Maximum Healthcare Research ................... 22Online Healthcare Information Research Heading Mainstream ............ 23Positive Impact on 9 out of 10 Healthcare Information Seekers ........... 24‘SOCIAL’ HEALTHCARE RESEARCH CASTS A WIDE NET ................... 25The Widening Circle of Online Healthcare Research ............................ 26Social Networks Influence Health Related Opinions ............................. 28Healthy Exchange of Information among Social Groups Online ........... 29Healthcare Activity on Social Networks is the New Currency ................ 30FUTURE OF MOBILITY IN INDIAN HEALTHCARE ................................. 32The Next Frontier in Health: Mobile Healthcare Applications ................ 33Substantial Interest in Location Based Healthcare Services ................. 35Building Relevant Mobile Healthcare Strategies ................................... 36THE FINAL DIAGNOSIS ......................................................................... 37Takeaways for Healthcare and Pharmaceutical Marketers ................... 38Methodology .......................................................................................... 40About the Authors .................................................................................. 42

Foreword Among the 80 million Indians online, there is a silent revolution brewing Healthcare brands need to harness the power of paid, owned and that will knock down conventional barriers dividing the role of consumers earned media online effectively to ensure maximum outreach and and providers as they are perceived today. engagement with consumers wherever they thrive. From blogs, wikis, social networks and communities to branded and promotional websites The web has opened up new paradigms in dynamic and participative and ads including SEO/SEM/SMM, they need to be present and communication, which takes place in real-time. As access to information accessible to consumers who evangelize the medium and will promote becomes democratized and the network of discerning, wired individuals positive buzz in return. They need to weave digital into the fabric of grows in India, we are beginning to witness an increasing number of their marketing strategy, by placing it at the heart of integrated healthcare consumers and patients empowering themselves with ‘self- communication strategies. And this will just be the beginning of a diagnosis’, proactively looking for cures, remedies and information on sustained commitment to stay connected with the rapidly evolving medical composition while sharing their findings with peers and large digital genes of consumers that grows more complex with developments social networks online. This is evident in the fact that 72% of respondents in interactive technologies. in our digital healthcare survey admit to searching for health related information online, and 8 out of 10 of them are looking for information ‘Catching the e-Healthcare Bug’ presents a comprehensive analysis of for themselves as well as others. current trends in the Indian consumers usage and attitude towards Internet as well as their online health information research and This spells a unique challenge for all stakeholders in the healthcare preferences, with relevant insights to help healthcare product and marketing ecosystem, who run the risk of alienating themselves from this service providers leverage this powerful medium and prepare for a emerging network of collective intelligence among healthcare consumers revolution in traditional marketing strategies ahead. online. 70% respondents from our survey trust Internet over friends and family and other traditional advertising channels, while making optimum use of search engines like Google, and curating personalized Shweta Bhandari content/information from medical journals and company websites found Lead Analyst online, which is not too far behind from the 77% who still impose unconditional trust in doctors and medical experts for medical help and well being. Majority of them (65%) seek information on specific disease or medical conditions, while others hunt for tips and suggestions on diet, fitness and overall well-being. And a substantial chunk expressed interest in using relevant mobile applications (47%) and location based mobile healthcare services (67%). Needless to say, this illustrates the massive change required in traditional healthcare marketing strategies which must embrace digital delivery and communication mechanisms that promote community building and spark dialogues, not monologues, in an increasingly complex professional healthcare marketing system.2 3

Introduction With robust development witnessed in this sector, it is equally interesting to note a rise in preventive along with curative measures of healthcare among Indians. The traditional top-down model of healthcare information The Indian healthcare market has remained immune to challenges posed by dissemination which pushes marketing messages to consumers is slowly global recession and has become one of the worlds most lucrative being challenged by more literate, evolving, knowledgeable and healthcare markets today. With a steady growth of 12% recorded in the empowered healthcare consumers. New-age communication channels like last four years, this industry is set to make giant strides with an increased Internet have become a significant source of healthcare information, contribution of 6-7% to the countrys GDP by 2012. The healthcare services gradually gaining importance equivalent to conventionally trusted sources sector is predicted to hit the $77 billion mark by 2012, the pharmaceutical like doctors and healthcare professionals/experts. market is expected to grow to $20 billion by 20151, and the medical health insurance industry is set to reach $3 billion by 20122, which is an evidence The Indian healthcare consumer typically imposes unconditional trust in of sustained and lucrative growth opportunities before key national and his/her doctor/healthcare professional for diagnosis, tests, prescription and international players in the healthcare sector. treatment. However, with growing awareness and easy access to valuable information about health and well being on the world wide web, At the time of Indias independence, just about 8% of all qualified modern consumers are proactively making an effort to look for, gather and curate medical care was provided by the private sector. Today private spending in health related content from a variety of trusted information sources online, healthcare is around 80%, while relatively cost-effective public healthcare regardless of their medical conditions i.e. from chronic, terminally-ill services comprise a modest 12%2. With spike in income levels and exposure patients to individuals seeking preventive healthcare. Armed with relevant to world-class standards of healthcare products and services, along with knowledge, it is likely that the decision to purchase or consume branded rising population and shifting disease patterns, the demand for quality healthcare products/services will be made on the basis of information healthcare is bound to increase further. accessed online. With its ability to offer uninterrupted consumer-initiated research, Internet Shifting Landscape of Indian Ailments is slowly becoming one of the major drivers in influencing consumer choices and preferences for various brands/products much before they 100% Pain/Analgesics, actually visit an outlet for final purchase. A similar trend is witnessed in the 9% 20% 21% Gynaeclogical & 10% Dermatology healthcare segment as well, with Internet becoming home to healthcare 80% 12% 9% 9% Respiratory content spread across a host of online platforms including healthcare 14% 11% 11% Gastrointestinal websites, communities, blogs, pages on social networking sites, organic 60% 9% 8% Vitamins/Minerals search results etc. It is critical for marketers to hone their understanding of 24% 18% 17% Anti-infectives the medium to service healthcare demands of a teeming online populace 40% Neuro/CNS better and use it optimally to promote product/service sales while garnering 5% 5% 6% 8% 10% 10% Cardiovascular deep-rooted consumer confidence to their advantage. 20% 3% 4% 5% Antidiabetic 15% Others Our report ‘Catching the e-Healthcare Bug’ highlights the impact of the 13% 13% 0% Internet on discerning healthcare consumers and changing trends in 2001-02 2006-07 2011-12 consumption of healthcare information. It clearly identifies the need for Source: Global Pharma Looks to India, PWC Report healthcare product and service providers to cater to this demand by supplying accurate health related information and direction while creating4 1 McKinsey: India Pharma 2015 Report 2 greater visibility for their brands through unique, intuitive and direct 5 Assocham-Yes Bank Report customer engagement.

Surge in Online Healthcare Information Research Survey findings indicate that a whopping 72% respondents use Internet to research health related information. We refer to these respondents as Healthcare Information Seekers in our report. With growing literacy and increasing penetration of the digital medium across the country, it is not too surprising to witness the shift from traditional sources of information towards Internet for procuring healthcare related information. % Respondents who have searched for Healthcare Information online Yes No 28% A New Breed of 72% Healthcare Base: 2244 Information 72% respondents use Internet to access Seekers* healthcare related information. With shift from curative to preventive healthcare *The term ‘Healthcare Information Seekers’ denotes measures, consumers are more aware andrespondents in the Webchutney Healthcare Survey who claim to knowledgeable about healthy living and search for healthcare information online. wellness than ever before, thanks to easy access to vast resources available online. 7

Several reasons could be attributed to preference for Internet as a valuable source of health related information today. With volumes of in-depth Demographic Profile of information available free of cost at the click of a mouse from around the world, coupled with personal interactions sparked and exchanged among the Healthcare Information Seeker peers, strangers, care-givers and experts online, Internets innate ability to Based on demographic details of our respondents, maximum healthcare deliver all this, along with rising awareness about strengths of the information seekers are male (85%), fall in the age group of 25-35 years interactive medium, propel its usage among healthcare information seekers. (44%), are salaried (65%) and fall in the monthly income bracket (MIB) of Another significant development in the evolution of the healthcare Rs 25,000 – 40,000 (24%). consumption process and rise of Internet as a trusted source of information Age Gender is the shift in prevalence of diseases from chronic to lifestyle related ones. There is also an increased focus on preventive rather than conventional 19-24 yrs 25-35 yrs 36-45 yrs Male Female curative measures of healthcare. Urban consumers have the propensity to 46-55 yrs Above 55 yrs detect malaise affecting health, inducing preventive action much before the 7% 8% actual onset of the disease through information exchange across a wide 15% range of online resources. There is ample content available online across a 13% variety of remedies, ranging from local, home-based solutions to ayurvedic, allopathic and other forms of treatments, coupled with listings of doctors, hospitals, diagnostic labs and insurance schemes. While searching for and 44% 28% 85% sharing health related information, online users have become savvy and more involved in their well-being than ever before. The boom in the Indian healthcare landscape, from medical insurance and medical technology/ procedures and pharmaceuticals to hospitals and other healthcare products/services is a function of the massive surge in demand Monthly Income Bracket (MIB) Occupation among the discerning, intelligent and affluent healthcare consumers. Less than Rs. 6,250 Rs 6,250-12,500 Housewife Student Interactive mediums like Internet and mobile have become significant Rs. 12,500-25,000 Rs 25,000-40,000 Self Employeed Salaried sources of valuable information for such consumers, and offer marketers Rs. 40,000-80,000 Rs. 80,000-1,00,000 Other better opportunities to engage in direct conversation with existing and More than Rs 1,00,000 prospective consumers while increasing recall, awareness and visibility for 4% 3% 3% brands across healthcare products and services. 10% 6% 12% 18% 9% 65% 23% 23% 24%8 Base: 1626 9

Substantial Experience with Time spent on Internet Usage Online Vs Offline Media 84% respondents indicate they have been online for more than 5 years, With Internet being the single global platform for information seekers and making them aware, educated and knowledgeable about various aspects of providers, it is not surprising to witness a stronger preference for it over the Internet. This experience empowers them with expertise in research and traditional media amongst online users. An impressive 80% healthcare helps them engage in a variety of useful online activities. The high level of information seekers claim to spend more than 5 hours online during engagement opportunities online enable healthcare information seekers to weekdays, whereas just 37% watch Television for 1-2 hours during search for doctors, treatments, remedies and share personal details to track weekdays, 33% spend time reading newspaper for about 30-60 minutes, healthcare conditions/solutions not just for themselves, but for others as well. and most spend less than 30 minutes on Magazines and Radio. Years of Experience with Internet Usage Online vs. Offline Media Usage (Weekdays) 3% 3% 3% More than 5 hours 12% 80% 2% 84% respondents have 2% 4% 2-5 hours 28% 7% 5% 56% 11% been online for 5 years or more, indicating experience 1-2 hours 37% 15% 12% 9% 27% 9% and maturity in usage of various online platforms. 3 30-60 minutes 25% 33% 19% 14% 10% 75% out of 4 respondents who Less than 30 minutes 9% 21% 32% 35% 2% Base: 2244 have been online for more than 6 years look for health TV Newspaper Magazine Upto 1 year 1-2 years Radio Internet related information online 2-5 years 5-6 years 6 years and above Base: 1626 Of the 75% respondents who have spent 6 or more years on the web, 3 out of 4 look for healthcare related information online. Armed with better Internet is the predominant medium of use for search abilities, their quest for healthcare solutions covers a host of healthcare information seekers on weekdays. The products and services to increase awareness and improve their health or opportunity for interaction and engagement on this medical condition(s). Mass communication needs to be slowly replaced medium adds much more value than any other with a more personalized approach in healthcare, as consumers become medium in health-related information exchange and self-reliant by proactively searching for health-related content online, giving research among online consumers across the world marketers a tremendous opportunity to create greater awareness for their10 11 products and services online with a more consumer-focused approach.

High Frequency of Internet Usage Maximum Time Spent on Search Engines Survey results indicate that a whopping 96% healthcare information seekers log onto the net at least once daily. This is indicative of the The time spent online by healthcare information seekers is divided extent to which this medium has become an integral part of their lives. across a variety of Internet platforms including blogs, online 52% of these online healthcare seekers claimed to log onto the net as communities, social networking sites, company/brand websites and many as 5 times a day, indicating the immersive and engaging nature search engines. of this medium. Search engines like Google, Yahoo, Bing etc. emerge as the most popular tools for sourcing, accessing useful and accurate information available from around the world, and are a valuable source for Frequency of Internet Usage learning and entertainment online. Over 5 times a day 2-5 times a day Once daily Once in 2-3 days Time Spent Across Various Online Platforms Once a week Blogs Online Communities Social Networking Sites 3% 1% Company/Brand Website Search Engine More than 5 hours 7% 11% 20% 12% 50% 17% 2-5 hours 5%8% 23% 17% 46% 52% 1-2 hours 8% 14% 22% 20% 36% 27% Base: 1626 30-60 minutes 13% 20% 22% 23% 22% Less than 30 minutes 29% 23% 18% 19% 10% Base: 1626 96% respondents seeking healthcare information online, log on to the net at least once a day or more. Of the Social networking websites like Facebook, Orkut, LinkedIn and Twitter 52% respondents who access Internet over 5 times a day, have amassed tremendous popularity amongst online Indians, as well maximum fall in prime age group of 25-35 years. as Internet users worldwide, in a particularly short span of less than a decade. It is estimated that Facebook in India alone has a massive user base of 20.9 million3 (July 2010) and the country ranks 8th in the list of top 20 countries by user-base on Facebook. The most active age group on this social networking site is 20-29 years3. It is therefore, not surprising to note social networking websites follow search engines as the second most popular platform online among healthcare information seekers.12 13 3 Facebook.com

E-Mail, Chat/IM Most Popular Online Activities Internet offers a truly immersive experience in comparison with other Maximum healthcare seekers online spend 2-4 hours in a day media, and keeps users absorbed and engaged with a range of individual connecting/socializing with friends, peers, family and even strangers on or group activities. Survey results indicate that online healthcare seekers e-mail and chat/instant messaging forums like Google Talk, Yahoo and pursue a variety of activities on the web ranging from basic and very simple MSN Messenger among others online. They spend around 1-2 hours on ones to complicated and interactive activities. social networking websites like Facebook, Orkut etc., along with searching for product/service related information and spend upto 30 Time Spent on Online Activities minutes watching videos online in a day. Tweeting is a popular activity 40% with up to 15 minutes spent on it daily along with a similar amount of time being spent on downloading music, wall papers etc and visiting/joining online communities. 30% 20% 10% 0% Chat/IM Email Social Networking Watch Videos Download Music Visit/Join Online Communities Tweet Download Other Search Products/ Services 2-4 hours or more 1-2 hours 30 minutes - 1 hour 15-30 minutes Upto15 minutes Base: 1626 Healthcare information seekers spend maximum time online interacting with friends, peers, family and even strangers through e-mail and chat/instant messaging forums.14 15

Internet Supplements Traditional Sources of Healthcare Information 77% respondents indicated doctors/healthcare professionals as their most trusted information source for healthcare. Clearly, this trust emanates from meeting the doctor in person, discussing the problem threadbare before seeking a personalized diagnosis followed by treatment/medication to address a medical condition. With 70% respondents voting for Internet as their next most trusted source of information, it indicates how the medium has assumed importance much more than other conventional sources like friends and family and traditional/offline media including TV, radio and print, showing a paradigm shift in the way consumers research and manage their healthcare needs today. Most Trusted Source for Health Related Information Shifting Doctor/Healthcare Experts 77% Landscape of Internet Friends & family 48% 70%Indian Healthcare Newspaper Magazines 40% 47% Information TV Published Journal/Newsletters Health/Medical Insurance Co. 13% 27% 38% Consumption Radio Ad hoardings (OOH) 6% 8% Other 1% None of these 1% Base: 2244 With 7 out of 10 respondents imposing trust in Internet as a source of healthcare related information, it is clear that significance of e-Healthcare has grown manifold 17

Moreover, while the convention was to seek opinions/advice from friends and family for healthcare issues, now the same social circle has moved Health Hunt Online is Diverse online. Owing to paucity of time and convenience of communicating through the net, the same opinions are now being sought through the web, Empowered healthcare information seekers use multiple online particularly with social networking sites and online forums enabling rapid platforms to search, curate and collate healthcare information on a information dissemination and exchange across social circuits. wide variety of topics. As consumers deepen their level of engagement with the cyber world and 65% healthcare information seekers indicate that they search for access vital information about disease prevention, restorative cures, and to information on a specific disease or medical problem online which is enhance overall well-being, a new trend is gaining critical mass. Increased also a primary reason for patients to visit a doctor. This suggests that adoption of wireless and digital modes of communication among Indians online healthcare consumers are actively breaking away from traditional has already set the pace for a massive change in consumption of healthcare norms and curating healthcare information on the web. Among other information, which must be acknowledged by marketers in time to prepare important topics, information on exercise and fitness (62%), medical for the road ahead. treatments and procedures (52%) and tips for general well-being (51%) emerge as primary health content being sought by healthcare information seekers online. Amongst 25-35 year olds, which is the largest age group engaged in online health research, information about hospitals/clinics/nursing homes and doctors/healthcare professionals is most sought after. Healthcare information seekers in the monthly income bracket of Rs 25,000-40,000 search most for information on Health Insurance and Alternative Treatments/Home remedies. Moreover, the salaried class researches information on health insurance (73%) and hospitals/clinics/nursing homes along with weight loss/exercises (66%) related information in that order. Popular healthcare topics searched online amongst men are Health insurance and Hospitals/Clinics/Nursing Homes (68%), and amongst women it is information about curative measures and weight loss which is indicative of their growing interest in adopting healthier lifestyles, managing their diet, seeking fitness, wellness and overall greater command over their own and their familys health.18 19

Type of Health related Information searched Online Demographic Category-wise Top 3 Online Health Research Topics Specific disease or medical problem 65% Age Group Online Research Topics % Exercise/Fitness Related 62% 25-35 years Hospitals/Clinics/Nursing Homes 51% Medical treatment or procedure 52% Tips for general well being 51% Doctors/healthcare professionals 51% Alternative treatments/Home Remedies 45% 36-45 years Alternative treatments/home remedies 49% Preventive Remedies 39% Prescription or over-the-counter (OTC) medicines 31% Benefits/side effects of medicines 37% Monthly Income Bracket Weight loss/control 33% Hospitals/Clinics/Nursing Home related info 30% Rs 25,000-40,000 Health Insurance 27% Health Insurance 26% Alternative Treatments/Home remedies 26% Related to doctors/healthcare professionals 25% Rs 40,000-Rs 80,000 Benefits/Side effects of Medicines 26% Curative Measures 24% Tips for General Well Being 26% Components of medicines 18% Information about healthcare equipment 16% Gender Depression/anxiety/stress management 14% Male Health insurance 90% Prescription or over-the-counter (OTC) medicines 14% Hospitals/Clinics/Nursing Homes 86% Other 1% Base: 1626 Female Curative Measures 22% Weight Loss/Control 22% Occupation From searching for information about specific ailments or Salaried Health Insurance 72% medical condition, to tips for general well-being and remedies, healthcare information seekers are actively Hospitals/Clinics/Nursing Home 66% breaking away from traditional norms and curating health Self Employed Curative Measures 28% content from the web Information about healthcare equipment such as Blood pressure machine, digital thermometer etc. 27%20 21

Search Engines Facilitate Online Healthcare Information Research Maximum Healthcare Research Heading Mainstream 64% healthcare information seekers facilitate their quest for health related Survey findings indicate that a majority 51% healthcare seekers online look research via search engines. Amongst these, 74% fall in the age group of for healthcare related information frequently, ranging from several times a 25-45 years. day to once every few weeks. Search engines offer the unique ability to source information from a wide range of platforms such as websites, discussion forums, published Frequency of looking for documents and journals etc. Healthcare marketers have a huge opportunity Healthcare Related Information Online to create greater visibility and awareness using search engine optimization 5% and marketing tactics to effectively capture a large discerning consumer 51% online base online. About once a day 22% 13% healthcare seekers A substantial chunk of healthcare information seekers also search for health Several times a day research health information across newsletters, publications, journals and company websites, offering healthcare marketers unparalleled branding opportunities Once a week related topics on the 11% to increase recall value of their products and services while drawing Every few weeks net as frequently as attention of large audiences towards themselves. As and when required 49% several times a day to every few weeks Online Platform most used for Base: 1626 accessing Health related Information Search Engine 64% Newsletter, Medical Journals 54% How would you rate your Health? Company Website 38% Online Communities 26% With majority 77% healthcare information Poor Blogs 23% seekers indicating the current status of their 1% Health Insurer’s website 19% health as Good, it is not surprising to witness Social Networking Sites 17% 49% healthcare information seekers logging onto the net to procure healthcare related Average None of these 2% 22% information as and when they require it. Other 1% Base: 1626 Discerning healthcare information seekers are no longer reactive but proactive in their approach Good towards sourcing health related content online 77% 74% healthcare information seekers using search for greater well-being, and have the option to engines fall in age group 25-45 years. frequent online platforms as they desire,22 wherever possible. 23 Base: 1626

Positive Impact on 9 out of 10 Healthcare Information Seekers The perceived utility of online healthcare related information is a function of its impact on improving a healthcare seekers medical condition. Survey findings indicate that 90% healthcare information seekers are of the opinion that health related information found online was of use to them. While 6 out of 10 healthcare information seekers agreed that healthcare information they found online gave them directions/changed the way they cope with a chronic medical condition, 57% were of the view that it helped them manage their diet/exercise/stress better. Evidently, one of the greatest advantage of online healthcare information is the knowledge with which it empowers people to manage their medical condition better or adopt better treatment or medication towards taking care of their health. ‘Social’ 14% healthcare information seekers claim they changed the decision to visit a doctor after researching healthcare information online. This Healthcare indicates the potential influence of this information on healthcare information seekers, warranting a change in conventional/traditional forms Research Casts of health information consumption. a Wide Net Impact of Healthcare Related Information found Online Gave directions/changed the way I cope with a chronic condition or manage pain 60% Helped me manage diet/exercise/stress/better 57% Led me to ask a doctor new questions/ get a second opinion from another doctor 48% It changed my overall approach towards maintaining my/someone else’s health 36% Affected my decision about treating an 33% illness/medical condition Changed my decision about visiting a doctor 14% Other 1%24 Base: 1626

The Widening Circle of Online for healthcare consumers where they find expert solutions and advice for greater well-being from various online quarters. Healthcare Research Survey results indicate 51% healthcare information seekers read comments/reviews about health related information making it one of the most pursued activity in healthcare research online, followed by posting 8 out of 10 healthcare information seekers look for health-related content comment/review/information in an online community/group and posting not just for themselves but for others too. Amongst them, majority 43% are comments about health on a blog. in the age group of 25-35 years, 25% fall in the monthly income bracket of Rs 40,000-80,000 and 65% are salaried. When I search for healthcare related Various Healthcare Related Activities Pursued Online information online, it is for? Read comments/reviews about 51% healthcare related information online Posted comment/review/information in an online group or forum 17% Posted comments about health on a blog 16% 15% 81% 3% Posted review of a doctor/hospital 15% Shared/viewed photos, videos, audio files or heard podcasts on medical issues 15% Consulted/shared rankings of doctors/ healthcare professionals/hospitals 15% Someone Else Myself Other 2% Base: 1626 Both Base: 1626 With 81% healthcare information seekers looking for Healthcare related information is sourced from a vast health related information online for themselves as array of online sources including news, communities, well as others, Internet has become a vital network of groups, forums, blogs etc., to pursue a variety of healthcare consumers online. healthcare related activities across them It is clear that healthcare seekers online peruse and pursue a variety of Social platforms online help users connect and share personalized and healthcare related activities online. While not everyone present on the web valuable opinions, insights, experiences and perspectives that are easy to creates health related content or contributes to a topic, however, the relate with from around the world today. With most respondents number of people following such views/reviews/experiences with keen indicating a positive impact of information found online, which is useful to interest is substantial and growing. This spells a great opportunity for everybody they research information for, Internet is becoming a social hub healthcare marketers to provide relevant information among networks26 27 where most healthcare information flock to and dwell online.

Social Networks Influence Health Healthy Exchange of Information Related Opinions among Social Groups Online 6 in 10 healthcare information seekers have been influenced by health With 5 in 10 healthcare information seekers recommending healthcare related commentary/views/experiences they encountered on the web. 73% products/services to their network of friends and peers online, the offline of these are in the age group of 25 to 45 years. trend of promoting and spreading useful/relevant information to influence Social platforms across the web such as blogs, microblogs, social perception and outlook towards brands through word-of-mouth, is fast networking platforms, podcasts, social content sharing websites and other gaining momentum online. communities/forums, keep healthcare users engaged in meaningful health 74% healthcare information seekers recommending their peer group about related conversation with each other. They seek health advice, support each healthcare products/services online fall in age group 25-45 years. other on patient communities and share their medical condition and Considering the increasing popularity of social networking and content experiences on the web, thus spreading greater awareness among each sharing amongst youth, it is not surprising that maximum healthcare related other. It is safe to say that today, healthcare information seekers have information is shared by people in this age group. become the social currency that healthcare marketers must leverage upon instead of focusing their efforts solely on traditional media vehicles. Have you recommended a Healthcare product/service online? Influence of Healthcare related Experiences seen/read Online Health related recommendations from trusted sources online are the new social currency that marketers must leverage to create deeper 51% 43% engagement and meaningful 49% No Yes No relationships with consumers, while Yes 57% promoting positive word-of-mouth for their products and services. Base: 1626 A multiplier or viral effect can be witnessed among online social networks as Exchange of information and health related recommendations float in abundance. Healthcare information seekers active experiences online influences healthcare on such networks act as a social currency for healthcare marketers, with the information seekers who prefer to rely on power to influence a positive or negative brand image for healthcare experiences shared by someone with a just like products and services. With increasing social mobility and communication my medical condition facilitated via Internet, healthcare marketers can seize this opportunity to increase consideration, awareness and preference for their products and28 services by leveraging on the power of online social networks. 29

Healthcare Activity on Social Networks is the New Currency With a subscriber base of 20.9 million Indians on Facebook and 19.9 It is safe to say that there is a notable surge in user-generated healthcare million on Orkut (ComScore, August 2010), it is clear that online Indians content and exchange of such information online in India. Most healthcare are tapping into social networks online. Microblogging and social information seekers in the age group of 25-35 years use social media networking sites are emerging as the new ‘information dissemination actively for accessing healthcare related information. Moreover, popular media’, which are quicker, faster and much more engaging compared to online social networking activities amongst them include joining a traditional media. Social content sharing websites such as YouTube are hospital/doctors community/page/group (55%), joining a pharmaceutical also making their presence felt strongly with a recent report indicating 7 companys blog (52%), followed by following friends & posting ones out of 10 online Indians watch online videos in a month (ComScore, health related experiences online (50%). January 2011) across a variety of online platforms including social With rise in awareness about health, well-being and healthcare networking sites like Facebook. products/services on increasingly popular social networking websites, Survey findings indicate that 66% healthcare information seekers, using marketers must envision applications directed towards health social networks, actively search for health related information on them. consciousness, fitness, diet and a disease-free existence/lifestyle to engage 4 out of 10 of them follow or track their friends personal health consumers proactively. They can use the online medium effectively to experiences/updates, while 34% share their own health status on empower healthcare information seekers to take better medical decisions, social networks. lend support and advice on treatments/cures that enable them to take greater charge of their health, spread awareness on securing their health Healthcare Activities Pursued on Social Networking Websites and related emergencies in the future and much more. Search for health related information 66% Follow a friend’s personal health experience/updates 45% Share/post my own health related comments 34% Join a hospital/doctor’s community/page/group 27% Join a pharma company’s health related community/page/group 17% Other 1% Base: 95230 With increasing popularity of social networking and content sharing websites, social media is being used increasingly for health related updates, queries and comments f f 31

The Next Frontier in Health: Mobile Healthcare Applications 47% respondents expressed interest in mobile applications on general healthcare/fitness/well being, while 33% indicated preference for mobile applications on specific or chronic diseases. While the mobile platform is still in nascent stages of being explored as a potential medium for healthcare information delivery in India, survey results indicate a substantial demand that exists for diagnostic and treatment support, remote disease monitoring, health awareness and communication. With rise in mobile Internet usage and greater adoption of smartphones, we will witness a gradual increase in healthcare marketers taking proactive measures in building relevant applications for consumers to cater to this demand. Interest in Accessing Healthcare Applications through Mobile Phones General Healthcare/ Fitness/Wellbeing 47% Future of Mobility Chronic Disease/Illness/Condition Interactive fun applications 33%in Indian Healthcare to calculate Weight, BMI, Diet Plan, Calories etc 22% Base: 1297 The future of mobile healthcare applications is bright with surge in demand for information on general well-being, chronic diseases and interactive applications on diet plans, calorie control etc. sought through mobile phones 33

Survey findings also indicate that 78% of those interested in mobile healthcare applications fall in the Rs 25,000-40,000 monthly income Substantial Interest in Location bracket. Moreover, 45% healthcare information seekers confirmed their interest in joining mobile operable healthcare communities. Rise in mobile Based Healthcare Services healthcare communication is imminent with increasing levels of awareness 7 in 10 respondents indicated interest in using their mobile phones for and consciousness about health, fitness, diet and lifestyle. When patients locating healthcare products/services nearby, indicating a massive with similar medical condition exchange information on a common opportunity for healthcare product/service providers in ensuring greater platform amongst themselves, the collective wisdom gathered as a result visibility and accessibility among consumers. can yield clinical insights that are well beyond and much better than the understanding of any doctor/physician. The intersection between location based services and healthcare is yet to take off in full swing in India, but a massive interest in such services is a Today, discerning healthcare consumers are in greater charge of their healthy beginning. In a country like India, innovative services such as these health, using interactive digital mediums creatively and actively to would be useful among urban consumers, as well as in rural areas, giving challenge commonly accepted healthcare practices and norms while them a stronger base for inclusion in the process of growth. staying abreast with latest trends and innovations in the sector. Innovative mobile applications will empower healthcare consumers further to gain Equipped with the ability to search and locate the best and most suitable greater control over their well-being. hospitals, dispensaries, medical stores, healthcare centers, health insurance providers, health care equipment providers etc. conveniently with wireless technological platforms and friendly user interfaces, the wave of location based services seems to provide a promising future in the development of healthcare communications and services. Interest in using Mobile Phone for Locating Healthcare Products/Services While the key advantage of cell phones remains their mobility, 67% healthcare 33% No seekers online expressing interest in accessing location based services (LBS) to 67% access healthcare related content is a sign of Yes the increasingly important role to be played by mobile technologies in the future of healthcare Base: 2244 Location based mobile services are a huge enabler, capable of bridging the gap between healthcare information seekers and healthcare product/service providers looking for customers to target and expand their consumer base. Anointed as a powerful tool, mobile LBS has the potential of turning the game in favor of healthcare product/service providers by servicing needs of healthcare consumer online much better. This requires uninterrupted support34 from the industry, government and regulatory authorities amongst others. 35

Building Relevant Mobile Healthcare Strategies Healthcare content disseminated online offers healthcare marketers unparalleled reach, considering today there are more wireless mobile devices than televisions and computers combined. Clearly, today mobile phones have become an integral and totally indispensable and inseparable part of consumers lives, becoming the third screen, often overriding the impact of the other two screens. Mobile operable healthcare content online primarily enables healthcare information seekers to check/ascertain status of their health on a regular basis, which helps them be in greater command of their health versus those relying on doctors alone. Moreover, preventive healthcare practices have ushered an era of new-age practices of taking greater responsibility of The Final ones well being, which is where the concept of health on-the-go becomes relevant. It is time for healthcare marketers to realize that a new generation of health products and services, based on wireless and mobile technology, Diagnosis put diagnosis and treatment management into patients’ hands, offering them solutions and empowering them to take care of themselves and their acquaintances better.36

Takeaways for Healthcare and Dawning the age of participatory medicine, faith in healthcare information online emanates from its ability to enable access to volumes of medical and Pharmaceutical Marketers scientific information and arrive at the doctors armed with better information about therapies and treatments, which explains why healthcare information online is perceived to have strategic importance. Online Healthcare Research is Gaining Significance Social Networks online offer direct connectivity with consumers 72% respondents search the web for healthcare related information. Of the 75% respondents with more than 6 years experience on the net, 3 out While social media is increasingly becoming popular amongst online of 4 are looking for healthcare related information. Captivated by the ease Indians, brand marketers are also hopping onto the social bandwagon to and comfort of procuring healthcare information on the web, coupled capture this online audience. 57% healthcare seekers online are influenced with Internets ability to offer in-depth healthcare information collated by health related commentary/views/experiences they read on the net, from numerous credible sources and increasing awareness amongst widening the scope of opportunities that exist before healthcare marketers consumers making them more proactive towards their health, the Internet to expand their scale of activities and become more visible via these networks. is fast transforming into a hotbed of healthcare information The ‘how are you’s’ of the bygone era have today moved online, which sourcing/collection process. explains why 45% healthcare seekers online follow their friends, relatives Internet Follows Doctors, Beats Friends & Family as the most and acquaintances personal health updates online, while 34% share their own healthcare related comments. Thanks to the popularity of social trusted Source of Healthcare Information networking in the country, healthcare marketers are presented with the While 77% healthcare information seekers indicate doctors as their most opportunity of increasing their visibility and using them to cater to the trusted source of healthcare information, a whopping 70% trust Internet demand for healthcare online. for the same. Multichannel Healthcare Marketing is the way forward Their trust in the Internet for healthcare information exceeds that in their friends and family (48%). While conventionally Indians preferred to consult As consumers are increasingly becoming more sophisticated and mature their social circuit for healthcare related information, ability of Internet to with their use of Internet, the locus of control in healthcare is shifting from provide credible healthcare information can be attributed to its rise as a healthcare product/service provider to the consumer. With increase in reliable source for procuring healthcare content. Online beats friends and consumers reliance on the web for procuring healthcare information familys knowledge on healthcare which could be limited to their personal online, the move from consumers reactive to proactive approach towards experiences alone and scores on account of its expansive reach and ability healthcare becomes evident, signaling the dawn of consumer driven to cut across vast populations in rendering healthcare solutions. This healthcare marketing. As opposed to the traditional marketer-fed model of displacement signifies the beginning of a paradigm shift in the traditional healthcare awareness, today marketers must realize that different model of healthcare information research. audiences consume information in different ways, which is why it is imperative to build a continuum of ways for people to engage and interact Immense utility value of online healthcare information with brands. As interaction opportunities offered by digital media remain unparalleled, marketers must realize that whilst waging the battle for an 9 out of 10 healthcare information seekers perceive health information on increased market share, leveraging online and mobile platforms to connect the net to be useful and believe it has a significant impact on their lives. with consumers better, would result in substantial cumulative benefits. While 60% healthcare information seekers feel that information on the net Better information dissemination facilitating ‘connect’ with consumers empowered them to cope with a chronic condition/manage pain better, would go a long way in improving healthcare consumer conversion rates.38 48% learnt to pose more questions/seek second opinion from doctors. 39

Methodology ‘Catching the e-healthcare Bug’ scopes the usage and attitude of online Occupation wise break up Indian healthcare consumers. The primary purpose of our study was to understand and analyze online Indians healthcare information research 5% 6% 3% behavior and the impact of Internet in influencing and driving their Student healthcare choices. Salaried To this effect, a sample of 2244 respondents was taken from a panel 23% Self Employed of consumers belonging to different demographics - age groups, socio-economic classes, locations etc. Primary data was collected by 64% Housewife means of a questionnaire. The period of the study was December 2010 Other to February 2011. Furthermore, credible secondary data sources were used to compile all facts and figures used in the study. Demographics (Base: 2244) Our respondent base was classified into five age groups, namely, 19-24 years, 25-35 years, 35-45 years, 46-55 years and above 55 years. 87% of Income wise break up the respondents were males and 13% were females. More than Rs 1,00,000 11% Gender wise break up Age wise break up Rs. 80,000 - 1,00,000 8% Female Above 55 Yrs Age 8% Rs 40,000 - 80,000 21% 7% 19-24 Yrs 13% Age Rs 25,000 - 40,000 24% 46-55 Yrs 13% Rs 12,500 - 25,000 20% 87% Age 28% 44% Rs 6,250 - 12,500 11% 36-45 Yrs Less than Rs 6,250 5% Male Age 25-35 Yrs40 41

About the Authors Shweta Bhandari Shweta Bhandari leads the research team at Webchutney, which publishes thought provoking reports on the state of online in India. She carries a diverse business profile including blue-chip companies like American Express and GE. At Webchutney, she has contributed in writing several research publications such as The Digital Vote Bank, Viral Marketing, Digital Media Outlook 2009 & 2010 and Vertical Digital Marketing Reports in the Automotive, Consumer Durable Goods, Mobile Handset and Healthcare sectors. Her passion for discovery and engaging in new challenges lends immense scope and dimension to this field. She can be reached at shweta.bhandari@webchutney.net A special thanks to Sushil Kumar for conceptualising and executing the report design. Ankita Kapoor He can be reached at sushil.kumar@webchutney.net Ankita Kapoor is a Research Analyst at Webchutney. She has completed her MBA in Marketing from ICFAI Business School, Hyderabad. Prior to this, she graduated in Journalism from Lady Shri Ram College, Delhi University. She has interned with ‘HPCL-Mittal Energy’ (HMEL) and ‘Business Standard’ during her post graduation and graduation respectively. Her strong analytical and communication skills and deep interest in the field have lent new perspectives to various research publications such as the Vertical Digital Marketing Reports in the Automotive, Consumer Durable Goods, Mobile Handset and Healthcare sectors at Webchutney.42 She can be reached at ankita.kapoor@webchutney.net

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Webchutney Digital Healthcare Report 2011

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