Mobile Advantage: Context and Immediacy in Health Information Seeking

Lisa Gualtieri, PhD, ScMAssistant Professor

Dept. of Public Health and Community MedicineTufts University School of Medicine

Email: lisa.gualtieri@tufts.eduTwitter: @lisagualtieri

Health search is everywhere• Last night, in J.K. Rowling’s The

Casual Vacancy, I read…– “She navigated away from the

Parish Council message board and dropped into her favorite medical website, where she painstakingly entered the words "brain" and "death" in the search box.The suggestions were endless. Shirley scrolled through the possibilities…”

3

Agenda

• Past• Present

– Focus on what mobile devices provide health seekers

• Future

4

Distant past: Literature, family, friends

Past: Look it up at work or at home

Present: Look it up on mobile device in waiting room, elevator, car, walking, etc.

Future?

Past, present, and future of health information seeking behavior

Democratization of medical information

“Democratization of location”

?

Before looking at mobile health search, need to ask if people use mobile devices

• 321.7M wireless subscribers in US at end of 2011– Penetration of 101%

• Smartphones now outnumber feature phones for the first time in the US

• 1 in 8 internet page views are on smartphone or tablet, doubling in just a year– Comscore 9/12

• Almost impossible to focus only on laptops and desktops when considering health information seeking

Not only are mobile devices used but they may eradicate the “digital divide”

• Smartphone ownership in US– 49% of Hispanics– 47% of African Americans– 42% of whites– Pew Internet & American Life Project 9/12

Some people are only using mobile devices

• 34% of US household are wireless only– Stephen J. Blumberg, Julian V. Luke, Wireless

Substitution: Early release of estimates from the National Health Interview Survey, July-December 2011, National Center for Health Statistics, 2012, http://www.cdc.gov/nchs/data/nhsr/nhsr061.pdf

• But one device or many?

Some people are using lots of mobile devices

• 40% of US households have 3 or more mobile devices in addition to their PCs & TVs

• Differences in – Where mobile phones and tablets are used– Frequency of use

Church or place of worship

Bank

Library

School

Train/subway/bus

Other

Home office

Events

Airport/airplane

Bathroom

Hotel

Kitchen

Other room in my house

Restaurant/coffee shop

Stores

Car

Outdoors

Work

Bedroom

Living room

6%

6%

16%

15%

15%

9%

35%

14%

41%

30%

44%

51%

32%

32%

12%

29%

31%

35%

79%

88%

6%

13%

15%

17%

18%

18%

26%

28%

29%

30%

34%

36%

39%

41%

42%

45%

48%

49%

53%

56%

mobile

tablet*

Base: 2,116 US online adults who own a mobile phone; Base: 549 US online adults who own a tablet

Source: North American Technographics Telecom And Devices Online Recontact Survey, Q3 2011 (US)

Where are mobile phones and tablets used? Note that doctor’s office isn’t listed!

Tablets are used more frequently than smartphones with the exception of daily health content users

Daily 5-6x per Week

2-4x per Week

Once a week

Less than 1x per week

0%

5%

10%

15%

20%

25%

16%

5%

13%

6%8%

13%

9%

24%

11%

8%

SmartphoneTablet

Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033How often do you use your device for health purposes?

What do mobile devices provide health seekers?

• Immediacy and access• Affinity• Multiple methods of input/output• Context

Immediacy and access• 85% of respondents had cell phones

– 53% of these, or 45% of US adults, had smartphones– Cell phone owners

• 31% look for health or medical information• 11% have health apps• 9% receive text updates or alerts from doctor or pharmacist

– Pew 9/12 via Susannah Fox• Mobile devices may be used immediately after leaving

doctor’s office, especially with a new diagnosis or prescription– Impact on health literacy especially recall and retention– Impact on patient-physician communication

• Could patients listen or ask questions differently due to reliance on search?

What do mobile devices provide health seekers?

• Immediacy and access• Affinity• Multiple methods of input/output• Context

More lovable when they’re cute and little

Affinity

• People relate to computers differently than people– What about smartphones? Tablets?

• Mobile users have an ongoing intimate and personalized relationship with their “digital appendage” or “cognitive prosthetic device”

• Do people seek information differently?– Searches on mobile devices tend to be about private/sensitive

conditions: sexually transmitted diseases, mental health• How is use changing?

– Greater online community use

Top 10 health searches 2011Web• 1. Cancer• 2. Diabetes• 3. Symptom• 4. Pain• 5. Weight• 6. Infection• 7. Virus• 8. Diet• 9. Thyroid• 10. Sleep

• Healthline Networks

Mobile • 1. Chlamydia• 2. Bipolar disorder• 3. Depression• 4. Smoking/quit smoking• 5. Herpes• 6. Gout• 7. Scabies• 8. Multiple Sclerosis• 9. Pregnancy• 10. Vitamin A

Online research is up in every category with the greatest growth in community support

General information about a condition

Symptom/diagnosis information

Treatment options

Side effects

Specific information about a medication/drug

Preventative measures

Community support/experiences from others

Interactive tools

64%

55%

47%45%

41%

33%

14%

10%

65% 64%

54% 53% 52%

39%

32%

22%

2010 2012 Largest shift: more people were seeking online

communities!

Source: comScore Custom Research – Jan/Feb 2010 Total n=1191 and Jan 2012 Total n=1033What types of health-related information have you looked for online in the last 6 months?

What do mobile devices provide health seekers?

• Immediacy and access• Affinity• Multiple methods of input/output• Context

Methods of input/output• Input: less typing, fewer spelling mistakes

– Text: Autocomplete, word suggestions, etc.– Voice: “Siri, what is…”– QR codes

• Search: many types of mobile search: app and browser– In mobile browser– On mobile website– In app store– In an app

• Output: limitations are screen size and location/privacy– Text– Images– Video

Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 -

2,000

4,000

6,000

8,000

10,000

12,000

14,000 More Mobile Health Access through Browser than App

Accessed health information [Application] Accessed health information [Browser ]

Thou

sand

s

52%

59%

SOURCE: COMSCORE MOBIL LENS, 3 MOS ENDING MARCH 2012

Number of search results viewed on smartphone versus computer

What do mobile devices provide health seekers?

• Immediacy and access• Affinity• Multiple methods of input/output• Context

Context• People are exposed to a wealth of contextual

information: what they see, hear, feel, remember– How do people act on it using their mobile device?

• Multiple devices monitor and record contextual information, including sensors and GPS– How do weather, location, time of day, blood

pressure, etc. impact personalization and tailoring?• Big data and predictive analytics

Sometimes asking questions leads to more questions: fighting the Hydra

Some of my questions…• Do people conduct health searches differently

– On smartphones or tablets?– In mobile browsers or mobile websites or app stores or apps?– Using text or voice?– Based on location?

• Are people more or less easily able to locate “helpful” information?

• Are there different indicators of quality or reliability?• How can mobile health search better help people to seek

information and achieve their health goals?

Near future

• Design for mobile first instead of retrofitting health websites into mobile format

• Make smarter smartphones and better integrate sensor data

• Learn from strategies used by well-funded retail– Use of big data and predictive analytics to provide

accurate and timely health information

Future• From digital appendages to… Google glasses• The ultimate in seamless mobile health search?• Stay in touch

– Email: lisa.gualtieri@tufts.edu– Twitter: @lisagualtieri