Patient health information search: an exploratory model of Web-based search behavior.

ABSTRACT

The Internet is drawing consumers in search of information about a broad range of topics. In order to understand how end users search for and benefit from Internet health information search, this paper presents a set of propositions and an explanatory model concerning Web-based patient health information search behavior. The analysis suggests that there is a link between an individual's health and his or her use of online health information, and also that the search intensity that individuals undertake results in an increased propensity to talk with health care providers about the information. (1)

Keywords: Internet; health information search; consumer decision making; search intensity; situational involvement

INTRODUCTION

The Internet is having an enormous impact on culture, society, and business The Internet is drawing consumers in search of information about a broad range of topics. In terms of purchase and consumption decisions, Internet users are becoming empowered consumers armed with more complete information than previous generations, and in the process, are forming virtual communities offering information about a broad range of topics, ranging from pop culture to gardening to academic issues to health care. However, as numerous failures of dotcom organizations have illustrated, the Internet has not fully lived up to its much-hyped promise. Organizations are refining old business models and creating new business models to achieve success in this new virtual realm.

An area of particular interest where the Internet has not been as successful as expected is in the field of health care. Recently, pundits have speculated how information available via the Internet would empower patients, involve them more in the care of their health, and have fundamental impacts on the patient-physician relationship (Friedewald, 2000). However, recent reports state that in the health care area, the Internet is not living up to the hype. This runs from patient apathy (Wilkins and Navarro, 2001) to the dissemination of potentially bad information (Webster, 2001). In order to understand how end users (2) search for and benefit from Internet health information searches, this paper presents a set of propositions and an explanatory model concerning Web-based patient health information search behavior. Of particular interest is how end users are locating and utilizing health information. Ultimately, what are the implications of end user Internet search for providers of health and other information online?

BACKGROUND

The Monday, June 10, 2002 issue of The Wall Street Journal included a special section on e-commerce, in which several articles report the state of adoption of information technology in the health-care industry. As one reporter, Laura Landro (2002), puts it, "The health-care industry finally has little choice: It has to get wired." (p. R6, emphasis in the original). However, most articles in this special section report about utilizing IT for activities such as cataloging patient information, facilitating efficient patient billing (and insurance payments), and effective tracking of disease outbreaks (due to post-September 11th bioterrorism concerns). Yet little is mentioned about how the Internet is utilized for the dissemination of health information, either by sources seeking to "push" the information to patients or by patients seeking to "pull" the information from the Web.

Eysenbach and Kohler (2002) utilized qualitative research techniques to understand how end users locate and appraise health information on the Internet. They found that even though participants stated that they looked at the source of the health information on a website in order to establish credibility, few actually checked to find the source of that information or later recalled from which website they had obtained health information.

Bazzoli (2000) suggests that consumers (patients) and physicians are both using the Web to search for diagnostic and treatment information, Ninety percent of physicians use the Web to research clinical information, according to a 2002 poll conducted by the Boston Consulting Group and Harris Interactive, while only 74% and 63% read medical journals or consult with colleagues, respectively. (The eMarketer Daily; 2002). See Figure 1 for further details.

But Ferguson (2002) reported that patients bringing information obtained from the Web to their physician appointments have put a strain on the patient-physician relationship. If a physician refuses to read such information, the patient may become irritated. Also, the information might be unrelated to the patient's condition or reveal lack of knowledge on the part of the physician. Further, The Pew Internet and American Life Project (Fox and Rainie, 2000) conducted a study of the frequency of Web access by end users to seek health information, which revealed that 52 million American adults have used the Web to get health or medical information, 48% of these health seekers say such advice has improved the way they take care of themselves, and 91% of health seekers have looked for material related to a physical illness. In general, online shopping comes naturally to young consumers (Forrester Research, 2000), and online shoppers are generally younger and more highly educated than conventional consumers (OECD, 1998; Kotkin, 1998).

However, no studies have specifically examined the relationships between patients' motivations for using the Web and the outcomes of their search endeavors. This paper develops a model of end user search for health information via the Web, helping to explain end user behavior when using the Internet to locate health information.

MODEL AND PROPOSITIONS

The consumer decision-making process describes the stages a consumer moves through in order to make a purchase decision (see Figure 2). It typically is viewed as being composed of the following: problem recognition, information search, alternative evaluation, purchase, and post-purchase behavior (Sheth and Mittal, 2004). Problem recognition refers to how a consumer identifies the need to make a decision. Problem recognition can be …