Approximately 4.5% of all internet searches on the internet are for health-related information and in the US alone six million people search for health-related information on a daily basis, which exceeds the combined number of daily outpatient visits to emergency departments and physician offices. To put it in a different perspective: Fifty-two million American adults, or 55% of those with internet access, have used the web to get health or medical information. This group has been coined ‘health seekers’ and a majority of them go online at least once a month for health information.
There have been attempts within the peer-reviewed literature to better understand the profile of people who use search engines for access to health information and there are also a fair number of papers that attempt to answer how patients perceive the quality of this information, the degree to which patients share the information they find with their clinician and to examine the seasonal trends associated with health information seeking. But, in truth, we should start with a very simple question: what are health seekers fundamentally looking for? In other words, can we reveal patient priorities using search engines in relation to health seeking in order to make meaningful policy changes that impact the way health information is contextualised and retrieved.
The literature, along with richly detailed reports from organisations like The Pew Research Center and The Commonwealth Fund, shows that the vast majority of health seekers use online search engines as a starting point to gain information on a disease or illness or to seek information on the treatment options for a particular disease or illness. In fact, to no one’s surprise, Google is by far and away the most popular search engine in the US and accounts for over 85% of health-related searches and we also know that almost four out of five health seekers (77%), start an online health information search by accessing sites like Google, Bing and Yahoo with just 13% saying that they will begin at a site that specialises in health information (like WebMD) and less than 2% of health seekers will start at a social media platform like Wikipedia or Facebook. This is very intuitive and completely unsurprising but perhaps what is surprising is that these results hold true across a variety of diseases from laser vision correction to oncology to back pain and that there appears to be no difference according to age or gender. The timing of health information seeking does, however, appear to exhibit some differences in revealing health-seeking priorities: health seekers looking for information for themselves tend to do so before seeing a clinician whereas those looking on behalf of someone tend to seek information after a visit with a doctor.
Why do we even care about all this? We care because there are approximately 70,000 websites/online platforms that purport to provide health information. Additional sources show that approximately 70% of studies assessing the quality of these on-line platforms’ ability and accuracy in delivering health information, report grossly inaccurate or misleading information being found on a significant proportion of these portals.
Thus, understanding what health seekers are looking for has important implications for policy-makers in that it can help guide decisions vis-á-vis the allocation of resources to underserved or needy segments of the population and eradicate misinformation and inefficiency associated with self-diagnosis which may, in turn, lead to regulation or certification of the way in which online health information is made available.
Let’s use a real-world example: Google advertisers can pay to have certain search results appear at the top of a page and, as a result, the Google algorithm’s ability to contextualise data for the health seeker is a function of paid advertising. This is a huge problem that has been a huge problem for years and is only getting worse. Couple this with the fact that health seekers are, by and large, incapable of distinguishing between high-value and low-value healthcare information and this burgeoning issue has important implications for health policy in regards to the manner in which health systems certify, adjudicate and validate online health information.
At the end of the day, a global system that is strictly enforced and that puts limits on the ability of paid advertising to influence search query results in health information seeking is critical. Otherwise, none of us may ever find what we’re looking for.
