I like what e-Patient Dave says: “Note that none of the above in any way diminishes the value of authoritative medical knowledge, nor the value of professional medical judgment.” This is important. Patients want their providers’ help and expertise. Taking the steps discussed here will enhance providers’ ability to give their patients guidance on their area of expertise, which is the practice of medicine, while at the same time receiving guidance from their patients on THEIR area of expertise, which is the daily experience of their health and health care in the full context of their lives.

The number who HAVEN’T sought health info online dropped from 75% to 39% - again about half.

The number who DON’T have broadband dropped from 95% to 43%.

The writing on the wall is pretty clear: duh, people are going online pretty darn quickly. And mobile? Remember that the iPhone has changed the world and was introduced just 29 months ago. It’s not a mass-market “appliance,” by far, but the behavior the leading edge is clear and the trickle-down is predictable, IMO.

The thing is, as people keep hearing stories of people who won when the docs were stumped, a person in trouble will (you bet your BUTT) go online. Example stories: “Moms, do not give up” (ABC News), or CNN’s Teen diagnoses her own disease in science class.

Increasingly my two mantras are “Patients can help” and “Give us our data.” They’re both in the slides and video of my remarks at the NeHC board meeting last week.

Note that none of the above in any way diminishes the value of authoritative medical knowledge, nor the value of professional medical judgment. The teen who spotted the granuloma on her tissue slide called her teacher over; the teacher verified it as much as she could (on the internet!); and they took the idea to the doctors. Same with the mother who figured out what her son had.

And as for “what difference does it make,” it makes a ton of difference: it means policy people should think ahead, and write policies today that will serve us well ten years from now.

At the CDT meeting where you and I sat together, people talked at length about how HIPAA was written when the Web was brand new and nobody had a clue what today’s world would be like. Let’s not make that mistake again: it’s pretty clear what direction the public is heading … more and more and more online. (I said plan for 2020; Bob Coffield’s testimony to NCVHS said to plan for 20 and even 50 years out.)

In the foreseeable future, the life or well-being of someone you care about will be impacted by the regulations we’re writing now. Let’s enable participation, not inhibit it.

Alan’s points about iPhone & laptop culture return us to one of what Susannah called the “big winners” (according to the new Pew data): Mobile apps. I think laptops (particularly with air cards, etc.) probably count there. I also think you might be right about the parallels with other industries, though Pew has consistently found higher dependence on professional in health care (Susannah’s “will not budge” adapted from the book on “Social Life of Information”) than in other industries.

What can we learn from other industries to answer the IMPACT question, and what is different?

You asked, Susannah, for theories on Why the big jump in two years in people who know someone helped by the health internet?

I see truth in each of the hypotheses put forward by you, Josh, and Gilles. Two further thoughts:

1) The iPhone. Fullstop.
And iTouch (where web use has been growing even faster). And WAN cards. And other handheld or netbook hardware. Their growth in the last two years makes always-on access more availalbe at both the moment and location where you have a question.

2) The change in laptop culture. When I visited potential colleges to attend with my now-22-year-old, a few students had laptops open during some lectures. When I did the college visit thing with my now-20-year old, about half of the students had laptops open during class. But when I visited colleges with my 18-year-old daughter this year, almost every student in every class had laptops open and were online taking notes, checking email, instant messaging, reading the news — and searching on whatever came to mind. Big change. Fast.

Josh, the Google searches aren’t just falling in forests (love that image!), they’re falling in lecture halls — and restaurants, parks, plazas, trains, cars, coffee shops, and other venues where they weren’t as common two years ago. And desktop computers are starting to become a bit like landline telephones.

The tone of the public/press/media reporting has definitely changed with more and more positive reporting of the Internet effect. That should ease members of the public willingness to talk (positively) about their own experience.

Well, the last time I was in France, my accent was so bad that the Parisians thought that I was Italian.

RE: Your question about what has made the difference — I think you’re definitely right about “always on” broadband being part of the answer. Here are a few other hypotheses:

1. Clinician acceptance — A decade ago, when I talked to practicing docs, I often heard the, “I hate it when my patients bring out a stack of printed info from the Web!” I just don’t hear that as much anymore. That also begs a “why?” question,” which brings us to…

2. Consumer expectation changing — As your Pew focus groups from a couple of years ago proved, when told by docs to stop going online, consumers either switch physicians or (in your words) “go underground.” At some point, clinicians realize that’s bad for both them and their patients.

3. Web information may be getting better — I don’t have any empirical evidence to suggest that’s true, but info quality certainly could have improved since my own dissertation research, which dates back almost as long as Pew’s first health surveys (Yikes! We e-health researchers ARE getting old!).

4. Consumers are better e-learners now — Again, no empirical evidence, but as comfort & experience has increased, consumers are better at sifting through info and triangulating answers from multiple sources.

5. More Ix being prescribed — (Of course, I have to say this, and you know we’d love to see that in future Pew surveys.) Increased proactive delivery of information and shared decision making facilitates more participatory medicine and renders the info found on the Web more useful for decision making.

Lots more answer are out there, I’m sure. Others, please join in the discussion.

Josh

Are you like me and dusting off your French to get ready for Health 2.0 2010 in Paris? There is indeed a “plus ca change” trendline in the findings — I called it “comfort food” data over on e-patients.net.

I love your image of a Google search falling in the forest. It is a key question: What difference does all this make? I was surprised by that jump from 31% to 60% of e-patients who say say they or someone they know has been helped by following medical advice or health information found on the internet.

I’d love to hear theories about what has made the difference in the past two years.

My theories run toward the increasing roll-out of “always on” broadband connections which encourage people to use the internet as an information appliance, plus an increase in the percentage of people who have sharpened their search & retrieval skills, maybe in other contexts, and then they use those tools when a health question crops up.

In any case, thanks for the thoughtful commentary!