PITT, JEWISH HEALTHCARE FOUNDATION STUDY IMPACT OF TECHNOLOGY ON HEALTHCARE INFORMATION IN COUNTY

PITTSBURGH, Nov. 13 -- Anecdotal evidence has suggested that health care consumers, armed with Internet information on their medical condition, are prepared to guide, challenge, or even bypass their doctors' advice. Earlier this year, a prominent panel of scientists, information specialists, physicians, and researchers gathered to try and turn these anecdotes into facts about health care in the information age with the first study of its kind in the Pittsburgh area.

Begun at the request of the Jewish Healthcare Foundation, the study was managed by the Graduate School of Public and International Affairs (GSPIA) at the University of Pittsburgh under the direction of David Y. Miller, Ph.D., associate dean and professor. Donald Lindberg, M.D., director of the National Library of Medicine at the National Institutes of Health (responsible for creating the national online database known as Medline) and Charles Friedman, Ph.D., director of the Center for Biomedical Informatics at the University of Pittsburgh, co-chaired the advisory group. GSPIA consultant Susan Elster, Ph.D., managed the research process and authored the final report.

Noting that new information technologies, such as the Internet and specialized computer programs, have the potential to change the ways in which people are involved in their own medical care, Friedman said, "This could be good or bad. On the one hand, better informed and involved patients should be healthier patients. On the other hand, patients who find and act on inaccurate information may be threatening their health and well-being. It is also very important that doctors support patients as they navigate these new information resources."

Until recently, little was actually known about the extent to which the Internet and other information technologies were being used in the Pittsburgh area: Are people increasingly relying on the Internet for medical advice? Are patients flocking to new information sources and, if so, how are their doctors responding? The recently released report, Consumer Health Information in Allegheny County, begins to answer these questions. Its findings are drawn from focus groups and 1,000 telephone interviews with Allegheny County residents. It documents the extent to which Allegheny County residents looked for health information from their physicians, the Internet, and other sources, and reports their confidence in and satisfaction with each.

Key findings include:

• Locally, people are using home computers and the Internet as much as they are nationally: More than half of Allegheny County households have home computers and 62% have access to the Internet.

• A new kind of health care consumer is emerging: While half of Allegheny County residents relied only on their doctors for health information and 25% did not seek medical information at all in the past year, more than 25% also looked for additional information, primarily from the Internet, books and magazines. This group of "New Information Seekers" is relatively young and is likely to make up an increasing proportion of health care consumers -- a trend that could challenge both existing information resources and physicians to meet their needs.

• Doctors make very limited use of new information technologies with their patients: Despite evidence that some new technologies can improve health outcomes, doctors are making limited use of such consumer-oriented information technologies as videos, computer programs, and Internet referrals. Even though more than half of consumers who looked for extra information used the Internet to find it, fewer than 3% reported that their doctors referred them to Internet web sites.

• People who are inclined to look for health information are not satisfied with what they are finding: It is not clear that health information resources are adequate to meet consumer needs. Although consumers reported consulting a wide variety of sources beyond their doctors for information, none of these sources was ranked as "very helpful" by even as many as a third of respondents. In addition, many consumers reported that it was a problem to get help, or to understand information available, from their insurance company's customer service departments, literature, and web sites.

• Physicians and patients are grappling with new communications challenges: While most people surveyed preferred and were satisfied with their doctors as their primary source of health information, people managing chronic illness and people who looked for extra information (even when not facing any specific health problem) evaluated their doctors less favorably. For example, 66% of healthy people said that their doctors always answered their questions to their satisfaction, compared to 56% of those with chronic health problems.

• Not everyone has equal access to health information technologies: As in the rest of the country, householders with lower incomes or educational levels, and householders over age 65 or who are African American, have lower levels of home computer ownership and more limited access to the Internet that other households.

• Public libraries are emerging as one of the principal means by which low income, African American, and older households access the Internet: Such households were between two and three times more likely to access the Internet from a public library than were surveyed households overall.

Karen Wolk Feinstein, president of the Jewish Healthcare Foundation, noted that the report provides key baseline information about a rapidly changing and important issue.

"We are very pleased with the GSPIA report and look forward to working with others in our community to address some of the challenges posed by its findings," said Feinstein. "We are particularly interested in exploring ways to encourage both doctors and consumers not only to communicate more effectively, but to take advantage of the rich potential for improving health outcomes that new information technologies offer."

Copies of the report may be obtained by calling GSPIA at 412-648-7600 or the Jewish Healthcare Foundation at 412-594-2550, or emailing the foundation at info@jhf.org.

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