CHCF’s Smith Discusses Role of Internet in Consumers’ Health Decisions
With more than 22,000 ehealth Web sites available, the Internet is "clearly playing a key and growing role in consumers health care decision making processes," California HealthCare Foundation President and CEO Mark Smith said Friday at the First National Health Policy Conference in Washington, D.C. The Internet has lead to the "democratization" of health information, Smith said. More people are logging on shortly after receiving diagnoses in an "instant-reflex" reaction to find health information. And most importantly, Smith noted, people are incorporating what they learn from these ehealth sites into their every day lives. Smith said, "[People] urge their family members to see a doctor based on their reading about a symptom. They alter their own habits or behaviors. They make a treatment decision or they ask a doctor about a specific diagnosis."
To find appropriate ehealth sites, many people rely on suggestions from family and friends, other online sources and links or recommendations from health care providers. Smith said that consumers tend to trust sites that have been recommended by providers, particularly physicians, that clearly separate editorial and sponsored content and that are sponsored by "known and trusted" health care organizations. To assess the accuracy and accessibility of online health information, Smith said that the RAND Corp., with a grant from CHCF, is conducting the "first-ever examination" of 19 English-language and seven Spanish-language sites "to see what they say" on four common conditions: breast cancer, depression, obesity and childhood asthma.
Noting that there was "justifiable concern" about the "so-called digital divide," Smith said that lack of access to the Internet for the underserved is "not nearly as big a problem as we might have thought." He noted that in some surveys, African-American ehealth users were "even more satisfied with ... ehealth sites than whites." Smith said that "foreseeing a world in which most people have access to this technology is not decades away, it's more like months or perhaps a few years away." However, he added that providers' lack of Internet access remains a large problem. Smith pointed to Cedars Sinai Medical Center, which now offers physicians wireless modems so they can "carry laptops around, sit in a conference room and download clinical data in real time -- no wires." Noting that Cedars Sinai is "in some ways an unusual hospital," Smith said that certain technical advances, while beneficial, will "probably come to the Cedars Sinais of the world before they come to the Los Angeles Counties of the world."
Researching quality information about providers online is another potential use for the Internet, but Smith noted that "the problem is not lack of science but lack of data." The availability of digital health care information varies widely, Smith said, adding that "pharmacy data is now almost universally available in digital format, lab data nearly so, hospital data less so and physicians for the most part" continue to rely on paper records. Smith said that the most pressing questions, such as "how good is my doctor or my surgical team?" cannot be answered electronically yet. Smith said that such outcome data is still stored using "19th century technology."
Confidentiality and security of online medical information are important issues and are clearly "important to consumers and ... providers," Smith said, adding, "When you read ... a sensationalistic headline about an HMO that had 5,000 patient records online erroneously for a few hours or a university medical center that had posted a hundred thousand patient records in plain view on the Internet, it raises all those problems about 'who is going to hack in?' and 'where is my data going?' and 'who is buying my data and selling it?'" CHCF, along with its partners, has documented that consumers' fears are not unwarranted, Smith said, pointing to a report that found that a "number of health Web sites that had policies on privacy were clearly, unambiguously and deliberately violating those policies." While some of the sites profiled have changed their policies, Smith said, "[I]t's not enough just to know that technology exists to protect security, it also has got to be implemented" (Melissa Keefe, California Healthline, 2/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.