Internet has an impact on patients but how on earth do you reach them?

Rochester 09 July 2001Although the Internet is increasing its influence on how patients approach their health care, strategies borrowed from consumer sites fail to reach them, according to Harris Interactive Health Care News, which focuses on new research, conducted by Harris Interactive, recently released by The Boston Consulting Group (BCG). The study found that shifts in how people search for health care information present industry players with new opportunities to engage and capture patients on-line.


Deborah Lovich, a BCG vice president and co-leader of the firm's e-health initiative noted that two contradictory findings have surfaced. "On one hand, patients who use the Internet to explore health issues report that the information they find on-line has a real impact on how they manage their overall care and comply with prescribed treatments. This makes the Web an important lever for companies seeking to get patients more involved in care decisions", Ms. Lovich stated. "Yet, typical on-line traffic-building strategies don't seem to work, since usage patterns in e-health bear little resemblance to those in e-commerce."

This research shows that the more patients use the Web for health, the stronger their response to the call to action issued by health care companies. Indeed, those who use the Internet frequently are two to three times more likely than infrequent users to take action which affects their diagnosis and treatment. For example, the data patients find on-line result in their asking physicians more questions and in greater detail. But more importantly, when patients who frequently use the Internet for health consult with the doctor, about 36 percent suggest the specific illnesses that they are suffering from and 45 percent request specific treatments. In comparison, among those who hardly ever venture on-line to find health information, only 16 percent and 19 percent of patients respectively exhibit the same active involvement.

Harnessing the power of the Internet will be daunting for health care companies, since reaching patients on-line is difficult. Indeed, the research reveals two key dissimilarities between the searching behaviours of patients and consumers. First, unlike consumers seeking other information on-line, patients do not explore health topics on the Web at their leisure or for fun. In fact, the vast majority of 77 percent use the Internet for health issues only when they have specific questions.

Second, the same Internet users who might visit and return to Amazon to purchase books typically do not turn to health sites directly when they search for health information. To answer their health queries on the Web, 65 percent of patients usually start with general search engines such as Yahoo, Ask Jeeves, and Alta Vista. Only 24 percent make health portals such as WebMD and InteliHealth their first stop; a mere 11 percent start with disease-specific Web sites such as or MSWatch. And even those who favour specific health-related sites report that they initially found them through general search engines.

"These findings hold promise for all health care companies that benefit from influencing patient behaviour, such as pharmaceutical companies which stimulate new therapies and managed care players which promote patient compliance with disease-management initiatives. The new struggle will be figuring out how to reach them, particularly since where patients will end up when they log on for answers to health care questions remains highly unpredictable", commented Ms. Lovich. However, she noted that emerging shifts in patient behaviour suggest that health care companies can home in effectively on the patient segments that they wish to target on-line.

In a report released earlier this year, titled "Vital Signs: The Impact of E-Health on Patients and Physicians", BCG segmented patients based on the severity of their condition and their attitude toward physicians. The four patient segments are:

  • Accepting or 8 percent of patients rely entirely on doctors for health information and decisions.
  • Informed or 55 percent rely on doctors to make health decisions but typically go on-line after an office visit to learn more about a diagnosis or prescribed treatment without, in their view, wasting the doctor's time with questions.
  • Involved or 28 percent view themselves as partners with their physicians in making care decisions and seek information on-line both before and after visits to discuss with their doctor. However, they still rely on their clinician to make the ultimate decision regarding care.
  • In control or 9 percent feel best suited to determine their care; use on-line information to diagnose themselves before visits to determine which treatments they want and to convince their doctor to treat them accordingly.

The new research shows that while 46 percent of in-control patients and 30 percent of involved patients often use the Web for health, only 14 percent of the informed and 3 percent of the accepting segments use it in that way. Although their overall size is relatively small, the more active involved and in-control segments account for a significant portion of health care expenditures. These patients tend to suffer from the most severe conditions and thus are likely to be the heaviest consumers of health care. They are also more likely to be women, with their frequent role as family caregiver causing them to take responsibility for the diagnosis and treatment of their children, spouses, and parents.

Because these different segments of patients use e-health differently and for different reasons, some patients are easier to find, and therefore easier to influence on-line. Two important behaviours of these groups have emerged. Patients have already begun to migrate to more active segments over the past year. This suggests that greater patient access to on-line information is leading to greater patient involvement. Ultimately, if these shifts continue, the more active patients could well become the largest portion of the health care market.

Patients taking an active role in their care are starting to "stick" to sites. These patients are more likely than patients in other segments to visit health and disease-specific sites in particular. Only 28 percent of patients in the accepting segment visit health-related portals and disease-specific Web sites, compared with 42 percent of the in-control group. With roughly the same percentage, namely 23 percent to 27 percent, of each segment visiting health care portals, the differences in behaviour are fuelled by visits to disease-specific sites. This suggests that disease-specific sites are an attractive pull for return visits among the most active and valuable segments in health care.

"If, as the data suggest, patients continue to become more active and therefore more likely to visit disease-specific sites, we can expect a shift to deep, narrow health sites. Consequently, understanding the disease- and segment-specific offerings that attract and retain patients will be an essential element for health care companies to build a future presence on-line. For the time being, however, search engines remain the most dominant vehicle for reaching patients on-line", concluded Ms. Lovich.

A research bulletin, titled "Vital Signs Update: The E-Health Patient Paradox", highlights the key findings of BCG's latest analysis of e-health and explores their implications for health care companies. Both the findings and the implications are based on a research arrangement with Harris Interactive, using their on-line research capabilities which include the "Chronic Illness Panel" of more than three million patients. Currently, BCG is conducting research to further investigate the role of physicians in e-health. A printable PDF version of the Harris Interactive Health Care News issue with the e-health study is available.

Leslie Versweyveld

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