Healthcare in the age of Dr. Google

Healthcare in the age of Dr. Google: the 2014 digital patient journey is sponsored by Fathom Healthcare, a healthcare marketing company.

Ask any medical professional what has changed about patient behavior the last few years, and she is sure to talk about a physician who never was accepted to med school … the ubiquitous “Dr. Google.”

When patients start to notice something doesn’t feel quite right, they google their symptoms and make a preliminary diagnosis. In fact, 86 percent of patients conduct a health-related search before scheduling a doctor’s appointment. 90 percent of adults ages 18-24 say they would trust medical information shared by others in their social networks. Forty-one percent say social media impacts their choice of healthcare providers.

These self-diagnosers find a physician with some expertise in their condition and check Google Maps to see who is convenient to their homes or offices. They assume they will end up with a specialist, so they read the local specialist reviews on Vitals and Healthgrade. Think advertising doesn’t matter? Think again: More than 80 percent of health information-seekers will click on a relevant ad.

And the searching continues throughout treatment, with 43 percent of all visits to hospital websites coming from search engines and most patients visiting the sites of two or more hospitals during their investigations.

In the waiting room, they post iPad updates on their situations to Twitter and Facebook. Maybe they do some last-minute research; 53 percent of people say that information they found online led them to ask a doctor new questions.

After the doctor visit, they research side effects of prescribed medications. Sixty percent of patients say they research their prescriptions to understand them better—and even decide whether to fill them. They subscribe to a blog on the topic of their condition.

They set up accounts in the physician’s EHR. Then they change social-network profile icons to show support for a cure.

And don’t think “Dr. Google” is only about reaching young patients:

• 67 percent of seniors say that access to their health information is important;
• 70 percent say they want to be able to request prescription refills electronically;
• 67 percent want to make online appointments;
• 58 percent want to email their healthcare providers;
• and 15 percent want to use a mobile device to manage appointments.

Welcome to the digital patient journey.

The fact is patients are more involved in their own healthcare than ever before, and the consumption process is now as transparent as car shopping. Seventy-five percent of Americans have conducted a search related to personal health in the last year and more than a third use social media to research health conditions. Half of all patients who use the Internet to self-diagnose ultimately schedule a doctor’s appointment.

What about the doctors?

Seventy-eight percent of US doctors are using digital tools to gather research; 70 percent prefer online training to classroom training; and nearly 40 percent communicate with patients online.  This is the future of healthcare.

Today’s patients are educated, empowered and active. The marketers’ role is to meet them halfway, ensure access to quality information, and use the new tools to improve the access to and quality of healthcare.

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Editor’s response…

Bullish on Health Care

Dr. Google – The Internet and Google are two of the many reasons that I’m so bullish on the Future of Health Care, and another big one is Health Reform, as in Obamacare and possibly Medicare-for-All. Let me explain.

Room for Improvement is Immense. At about $3 trillion/year [now over $4 trillion/year], our nation spends twice as much as other industrialized nations for outcomes that are ranked worse in almost every category, including Life Expectancy, which isn’t even in the top 50. We’re even behind Guam, but I see progress toward Fixing Health Care already.

High Awareness. Documentary after documentary, and expose after expose, have awakened the American public to the systemic problems in our sick care system, which focuses more on disease management than wellness and prevention. That’s because physicians have been paid a fee for each visit or procedure. Modern Health Talk has reviewed many important articles and documentaries, including:

• Bitter Pill: Why High Medical Bills are Killing Us (Steven Brill’s TIME magazine special report)
• Escape Fire: The Fight to Rescue America’s Healthcare (an Inconvenient Truth for the healthcare debate)
• The Weight of the Nation (HBO’s look at the Obesity epidemic)
• The Waiting Room (about different health care for the poor)
• A Place at the Table (about hunger and poverty)
• The Line (stories of people living at or below the poverty line)

Changing Payer Incentives. I’ve always said that the key to health reform is getting the incentives right, and Obamacare is already doing that. I’ve been critical of insurance companies, saying that they add nothing to health care but costs, but even that is changing. They can no longer cherry-pick the healthiest patients and deny care for the most expensive ones. They can’t charge more for women or because you have a preexisting condition. And 80% of insurance premiums must actually go toward health care and not marketing, overhead, or profits. So how are they responding? They’re investing in wellness programs and prevention to keep clients healthy, and some are even paying for home healthcare, telehealth video consultations, and medical tourism when the cost is less and outcomes better. It’s the bottom line they’re responding to, but now in a good way.

Powerful Provider Incentives. Doctors and hospitals are becoming more competitive as well, as they must now compete with new delivery models that include telehealth and medical tourism. The Patient-Centered Medical Home (PCMH) model is a new approach that seeks to enhance care coordination by putting the patient at the center of care. It’s a model that rewards doctors for keeping their patients healthy and incentivizes them to monitor their patient’s health not just in the office, but at home too. Maybe it’s this new focus on coordinated care, but I’ve seen a recent trend to embrace Eastern medicine, which was once called “alternative” medicine (as in competition). Now things like acupuncture and sleep wellness are being collectively called “integrative” medicine, and I see that as a big game changer. It’s one reason why Modern Health Talk is expanding its own mission to support the emerging sleep wellness market.

New Consumer Incentives. Insurers, who once complained that consumers had no skin in the game or incentive to seek the lowest cost of care, have responded with high-deductible policies with much lower premiums and overall lower costs. Because consumers must now pay out-of-pocket for more of their care, they’re starting to comparison shop, and the insurers are enabling that by pressuring hospitals to disclose their once secret charges up front.

Online Ratings. Digital consumers are accustomed to using Yelp, Trip Advisor, and Angie’s List to rate services, so it was just a matter of time before systems appeared to rate doctors and hospitals. Vitals and Healthgrades both allow consumers to rate health providers, and this will pressure the providers to clean up their acts.

Tort Reform. I’m not a fan of tort reform as an artificial way to prevent legitimate lawsuits and access to the court system for dispute resolution, and I’ve long believed that the insurance industry is responsible for promoting fear of frivolous lawsuits so they could sell malpractice insurance. But from the stats I’ve seen, we don’t have a lawsuit problem; we have a medical errors problem. The new online ratings systems could go a long way toward rewarding the best practitioners and weeding out problem ones, all without the need for tort reform.

Cutting through the Clutter. With over 40,000 health & fitness apps for the Apple iPhone alone, how are consumers to cut through the clutter and find the ones that best fit their need? Two years ago I wrote about some of the tools to help you discover new mobile apps. One of them, Happtique, uses strict certification standards and performance requirements, and reviews by specific healthcare practitioners, to help consumers and healthcare providers identify the most credible apps.

Not everyone is an e-Patient. Dave deBronkart popularized the term, e-patient, as he struggled to get access to his own medical data. Realizing they have a greater stake in the game than their physician (it’s their life), e-patients regularly engage in online conversations using social media or search online websites like WebMD, PatientsLikeMe and mHealthTalk for healthcare information. But not everyone is an e-Patient with access to Dr. Google. Too many Americans still don’t have broadband Internet access, including those in rural communities, poor and underserved inner-city neighborhoods, and the “real” seniors. Market researchers like Pew Internet typically describe “seniors” as anyone over age 65, but that market segmentation ignores the real seniors 75+ or 85+.

Big Data Analytics. Google and IBM are kissing cousins (actually more like mortal competitors) in the world of big data and analytics. Both companies have large healthcare investments. IBM’s Watson, for example, is helping doctors diagnose illness and tailor medical treatment to every patient’s situation in a time when the amount of medical information is doubling every five years.

Miniaturization Approaching Molecular Scale. Just as the supercomputers keep getting bigger and more powerful to collect and analyze petabytes and exabytes of medical information, microprocessors and sensors keep getting smaller, even to the point of being implanted or injected into the body. Moore’s Law and the Future of Healthcare describes my own 40-year journey through tech innovation as applied to healthcare and paves the way for another article, Ageing and Brain Science, which is based on my interview with Dr. Metin Akay, Founding Chairman of the Biomedical Engineering Department at the University of Houston. Akay is working on the convergence of biology, neuroscience, nano-science, and information science and envisions cell-sized processors that communicate directly with individual neurons in the brain.

The Economic Effect. To close out this article, let’s circle back to Obamacare and its objective of helping more people afford healthcare on their own, without relying on their employer, and look at its economic impact. The ability to go online and compare dozens of insurance plans for the first time helps to cut the cord between worker and employers. Companies like Home Depot and IBM are starting to give workers a lump sum for health care and access to private exchanges that offer more insurance options at less cost. As a retired IBMer, I was one of the first in that trend, choosing a policy through ExtendHealth that was significantly less expensive than what I was paying before. The impact of this trend is more than lowering care costs. It will means that workers will no longer be stuck in dead-end jobs just to get insurance for a loved one with a preexisting condition. And because they can now seek better employment options elsewhere, or even start their own businesses, the employers will need to offer more competitive compensation. Theoretically, this should help to raise wages for all.