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
Aug 23, 2014
THE RISE OF THE E-PATIENTTrends in the use of digital technologyfor health purposes
Lee RainieDirector – Pew Internet ProjectMedical LibrariansAtlantic City10.7.09
October 7, 2009 2Rise of the e-patient
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
October 7, 2009 3Rise of the e-patient
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
October 7, 2009 4Rise of the e-patient
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
October 7, 2009 5Rise of the e-patient
Media ecology – now (information age)Product Route to home Display Local storage
cable TiVo (PVR) VCRTV stations DSL TV Satellite radio playerInfo wireless/phone radio DVD“Daily me” broadcast TV PC Web-based storage content books iPod /MP3 server/ TiVo (PVR)Cable Nets broadcast radio stereo PCWeb sites satellite monitor web storage/serversLocal news mail headphones CD/CD-ROMContent from express delivery pager satellite player cell phone memory individuals iPod / storage portable gamer MP3 player / iPodPeer-to-peer subcarriers / WIFI cell phone pagers - PDAsAdvertising newspaper delivery non-electronic cable boxRadio stations camcorder/camera PDA/Palm game console
game console paperSatellite radio e-reader / Kindle storage sticks/disks
e-reader/Kindle
Adapted from Tom Wolzien, Sanford C. Bernstein & Co
Ubiquitous computing ageCloud computing
“Internet of things”
October 7, 2009 6Rise of the e-patient
Information and media ecosystem changes
1.Volume of information grows2.Variety of information increases3.Velocity of information speeds up4.The times and places to experience
media enlarge5.People’s vigilance for information
expands AND contracts
October 7, 2009 7Rise of the e-patient
Information and media ecosystem changes
6.The immersive qualities of media are more compelling
7.Relevance of information improves8.The number of information “voices”
explodes – and the voices become “louder” and more findable
9.Voting and ventilating are enabled10.Social networks are more vivid
October 7, 2009 8Rise of the e-patient
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
October 7, 2009 9Rise of the e-patient
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
October 7, 2009 10Rise of the e-patient
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– 71% of 30-49-year-olds– 59% of 50-64-year-olds– 27% of those 65 and older
• Skews upscale and educated• Parentshttp://e-patients.net/
October 7, 2009 11Rise of the e-patient
October 7, 2009 12Rise of the e-patient
October 7, 2009 13Rise of the e-patient
Information about specific disease or medical problem
36%39%
45%49%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 14Rise of the e-patient
Information about treatment or procedure procedure
27%30%
36%41%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 15Rise of the e-patient
Information about exercise and fitness
21%25%
31%
38%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 16Rise of the e-patient
Information about prescription or over-the-counter drugs
19%24% 26%
33%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 17Rise of the e-patient
Information about alternative treatments or medicine
16% 18% 19%
26%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 18Rise of the e-patient
Information about depression, anxiety, stress or mental health issues
12% 14% 15%21%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 19Rise of the e-patient
Information about experimental treatments or medicines
10%14% 13% 15%
0%
10%
20%
30%
40%
50%
60%
Dec-02 Nov-04 Aug-06 Dec-08
% o
f adu
lts
October 7, 2009 20Rise of the e-patient
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
October 7, 2009 21Rise of the e-patient
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.
October 7, 2009 22Rise of the e-patient
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.
October 7, 2009 24Rise of the e-patient
A handy tech-user typology
http://www.pewinternet.org/Reports/2009/5-The-Mobile-Difference--Typology.aspx
October 7, 2009 25Rise of the e-patient
What we measured
• Assets• Actions• Attitudes
Overall picture39% are motivated by
mobility5 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
October 7, 2009 27Rise of the e-patient
Motivated by mobility – Group 1Digital 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.
October 7, 2009 28Rise of the e-patient
Motivated by mobility – Group 1Digital collaborators (8% of population)
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
October 7, 2009 29Rise of the e-patient
Motivated by mobility – Group 1Digital collaborators (8% of population)
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
October 7, 2009 30Rise of the e-patient
Motivated by mobility – Group 2Ambivalent networkers (7% of population)
Tech lifestyle attributes
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.
October 7, 2009 31Rise of the e-patient
Motivated by mobility – Group 2Ambivalent networkers (7% of population)
Demographics• Male: 60%• Median age: 29 (youngest)• Race: Little more minority than DigCollab.• Education: 23% college +• Household income: 44% make < $50K• Employment status: 64% employed FT• Community type: 44% suburb; 45% urb.• Funky facts: 30% are students
34% are NOT email users 83% are cell texters
October 7, 2009 32Rise of the e-patient
Motivated by mobility – Group 2Ambivalent networkers (7% of population)
Important because
• They are tomorrow’s primary e-patients and library-service users and influencers
• They have seen change in libraries and liked it
October 7, 2009 33Rise of the e-patient
Motivated by mobility – Group 3Media movers (7% of population)
Tech lifestyle attributes
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.
October 7, 2009 34Rise of the e-patient
Motivated by mobility – Group 3Media movers (7% of population)
Demographics• Male: 56%• Median age: 34 (second youngest)• Race: Diverse• Education: 32% college+ (average)• Household income: 56% make > $50K• Employment status: 70% employed FT• Community type: 55% suburb; 30% urb.• Funky facts: 31% record video on cell
87% own dig. camera 90% online health seekers
October 7, 2009 35Rise of the e-patient
Motivated by mobility – Group 3Media movers (7% of population)
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
October 7, 2009 36Rise of the e-patient
Motivated by mobility – Group 4Roving nodes (9% of population)
Tech lifestyle attributes
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
October 7, 2009 37Rise of the e-patient
Motivated by mobility – Group 4Roving nodes (9% of population)
Demographics• Female: 56%• Median age: 39• Race: Diverse > Latino• Education: 44% college+ (2nd highest)• Household income: 52% make > $50K• Employment status: 68% employed FT• Community type: 48% suburb; 39% urb.• Funky facts: 100% have cell phones
heavy internet use at home and work – hard to give up
say tech gives them control
October 7, 2009 38Rise of the e-patient
Motivated by mobility – Group 4Roving nodes (9% of population)
Important because
• They are kin-keepers and caregivers
• They will appreciate you if you help them be efficient and thorough
October 7, 2009 39Rise of the e-patient
Motivated by mobility – Group 5Mobile newbies (8% of population)
Tech lifestyle attributes
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.
October 7, 2009 40Rise of the e-patient
Motivated by mobility – Group 5Mobile newbies (8% of population)
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• Employment status: 53% employed FT• Community type: 24% rural• Funky facts: just 39%=internet users
46% use computersnone create internet content
love new connectedness
October 7, 2009 41Rise of the e-patient
Motivated by mobility – Group 5Mobile newbies (8% of population)
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
October 7, 2009 42Rise of the e-patient
Stationary media majority – Group 1Desktop veterans (13% of population)
Tech lifestyle attributes
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.
October 7, 2009 43Rise of the e-patient
Stationary media majority – Group 1Desktop veterans (13% of population)
Demographics• Male: 55%• Median age: 46• Race: Skews white• Education: 41% college+ (3rd highest)• Household income: 32% make >$75K• Employment status: 56% employed FT• 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
October 7, 2009 44Rise of the e-patient
Stationary media majority – Group 1Desktop veterans (13% of population)
Important because
• They are relatively intense e-patients
• They already know about the things you do
• They are influencers, too
October 7, 2009 45Rise of the e-patient
Stationary media majority – Group 2Drifting surfers (14% of population)
Tech lifestyle attributes
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.
October 7, 2009 46Rise of the e-patient
Stationary media majority – Group 2Drifting surfers (14% of population)
Demographics• Female: 56%• Median age: 42• Race: Diverse• Education: 33% college+; 33% HS• Household income: 46% make >$50K• Employment status: 66% employed FT• 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”
October 7, 2009 47Rise of the e-patient
Stationary media majority – Group 2Drifting surfers (14% of population)
Important because
• They are not aware of the material that is available online and through other resources
• They will need you some day
October 7, 2009 48Rise of the e-patient
Stationary media majority – Group 3Information encumbered (10% of population)
Tech lifestyle attributes
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.
October 7, 2009 49Rise of the e-patient
Stationary media majority – Group 3Information encumbered (10% of population)
Demographics• Male: 67% (highest)• Median age: 53• Race: Skews white• Education: 33% college+; 37% HS• Household income: 42% make <$40K• Employment status: 40% employed FT• 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.
October 7, 2009 50Rise of the e-patient
Stationary media majority – Group 3Information encumbered (10% of population)
Important because
• They are the alienated and society functions better with their participation and involvement
October 7, 2009 51Rise of the e-patient
Stationary media majority – Group 4Tech indifferent (10% of population)
Tech lifestyle attributes
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.
October 7, 2009 52Rise of the e-patient
Stationary media majority – Group 4Tech indifferent (10% of population)
Demographics• Female: 55% • Median age: 59 (2nd oldest)• Race: Diverse (little higher Af-Am)• Education: 73% HS or less• Household income: 59% make <$50K• Employment status: 34% employed FT• Community type: 26% rural• Funky facts: just 39% are int. users
46% computer users but 86% are cell users
least likely users of everything
October 7, 2009 53Rise of the e-patient
Stationary media majority – Group 4Tech indifferent (10% of population)
Important because
• They are on the far side of the digital divide even though they have some relationship to technology
• Very few e-patients
October 7, 2009 54Rise of the e-patient
Stationary media majority – Group 5Off the net (14% of population)
Tech lifestyle attributes
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.
October 7, 2009 55Rise of the e-patient
Stationary media majority – Group 5Off the net (14% of population)
Demographics• Female: 57% (highest)• Median age: 67 (oldest)• Race: Skews to minorities• Education: 80% HS or less• Household income: 38% make <$20K• Employment status: 17% employed FT• Community type: 30% rural• Funky facts: just 16% have desktop or
laptop they see no lifestyle
improvements with technology
October 7, 2009 56Rise of the e-patient
Stationary media majority – Group 5Off the net (14% of population)
Important because
• These are often the people who most need medical information
• Their caregivers need you, too
October 7, 2009 57Rise of the e-patient
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
October 7, 2009 58Rise of the e-patient
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
October 7, 2009 59Rise of the e-patient
Thank you!
Lee RainieDirectorPew Internet & American Life Project1615 L Street NWSuite 700Washington, DC 20036Email: [email protected]: http://twitter.com/lrainie 202-419-4500