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In collaboration with:
First Doctoralia Report on
Health and the Internet
2015
  2
	
  
	
  
Index
1. Introduction ................................................................................. 3
2. New patient profiles .................................................................... 5
3. New information and communication flow .................................. 8
4. Further information.................................................................... 14
5. New trends ............................................................................... 20
6. Users create content................................................................. 23
	
  
7. Barriers and impact................................................................... 26
	
  
	
  
  3
1. Introduction
The object of this report is to analyze the current state of access and use of information
and communication technology among Internet users in the field of health on a global
level. To achieve this goal we created an online survey that was distributed between
October 2014 and January 2015 through the Doctoralia website in eight countries:
Argentina, Brazil, Chile, Colombia, Spain, France, Italy and Mexico. The following table
describes the characteristics of the final sample collected (N = 3621).
Table 1: Sample
%
Gender
Female 67%
Male 34%
Age
18-30 12%
31-40 18%
41-50 23%
51-60 24%
Over 60 22%
Education level
Low 5%
Medium 28%
High 67%
Health
Poor 6%
Moderate 25%
Good 39%
Very good 25%
Excellent 6%
Chronic illness
No 45%
Yes 55%
Doctor visits in the past 12
months
None 16%
Between 1 and 2 19%
Between 3 and 4 21%
  4
More than 4 44%
N=3621
It is important to note that in order to carry out the statistical analysis of the whole sample
different weight was assigned to each country according to their population. The following
table shows the number of responses in each country:
Table 2: Sample by country
Countries
Argentina 699 – 19%
Brazil 646 – 18%
Chile 265 – 7%
Colombia 229 – 6%
Spain 412 – 11%
France 353 – 10%
Italy 232 – 6%
Mexico 785 – 22%
N=3621
  5
2. New patient profiles
The use of information and communication technology for health-related issues is a reality
for the vast majority of Internet users: 90% report having used this technology to search
for content or services related to their health. If Internet usage is a consolidated reality, the
results of this study also show the emergence of the use of smartphones (35%) and other
"wearable" devices (14%).
Figure 1: Distribution of information and communication technology
N=3621
The combination of use of these three technologies allows the identification of three
distinct profiles. A first group related to those Internet users who only use the Internet. This
group is traditionally known as ePatients and includes 60% of the surveyed population.
The second profile includes those individuals who, in addition to Internet, also have some
type of application in their smartphone and / or tablet to help them manage, measure or to
track issues related to health, lifestyle and well-being. We have called this group
mPatients and they make up 26% of the surveyed population.
14%
35%
90%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Wearable
Mobile
Internet
  6
Finally, the third group of users consists of individuals who, as well as the technologies mentioned
above, have also used some kind of smart device (bracelets, watches, etc ...) to help them
manage, measure or monitor issues relating to health , lifestyle, well-being (physical exercise, diet,
etc...). We have called this group of users wPatients, where "w" refers to the term "wearable".
Figure 2: Type of Internet users related to health
N=3621
These three profiles have different socio-demographic characteristics. Firstly, women
(28%) stand out slightly over men (22%) in the use of mobile phones, while the percentage
of men is higher (18%) than women (12%) in the case of use of "wearables." Secondly, the
percentage of ePatients increases as age increases, while in the case of wPatients and
mPatients percentages are higher among young and middle-aged people. Thirdly,
differences in education are only noticeable in the case of wPatients. There are no
remarkable differences in other profiles. Fourthly, as expected, given the age ranges,
there is a higher than expected percentage of people with poor health among ePatients
than in the other two profiles. This also means that ePatients make more visits to the
doctor than mPatients and wPatients.
Table 3: Socio-demographic profiles
14%
26%
60%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
w-Patient
m-Patient
e-Patient
ePatient mPatient wPatient
Gender
Female 59% 28% 12%
Male 60% 22% 18%
Age
18-30 55% 35% 11%
31-40 56% 29% 16%
  7
N=3621
If we look at the distribution of different profiles in each country, no great differences are
observed. The profile of Internet users is similar in all countries. However, Chile stands out
for a greater presence of ePatients than other countries, while Italy is notable for a greater
presence of wPatients.
Table 4: Profiles by country
ePatient mPatient wPatient
Argentina 63% 25% 12%
Brazil 59% 28% 13%
Chile 72% 18% 10%
Colombia 64% 24% 12%
Spain 62% 24% 14%
France 53% 27% 21%
Italy 51% 31% 18%
Mexico 62% 25% 13%
N=3621
41-50 59% 25% 16%
51-60 60% 26% 15%
Over 60 66% 22% 12%
Education level
Low 59% 27% 14%
Medium 63% 26% 12%
High 58% 27% 15%
Health
Poor 65% 21% 15%
Moderate 62% 26% 12%
Good 61% 25% 14%
Very good 55% 30% 15%
Excellent 53% 27% 20%
Doctor visits in the past 12
months
None 60% 27% 13%
Between 1 and 2 55% 29% 17%
Between 3 and 4 63% 25% 12%
More than 4 59% 26% 15%
  8
3. New information and communication flow
The emergence of new patient profiles is not only related to the use of technology but also
to the transformation of information and communication flow between patients, healthcare
professionals and health organizations. Some 71% of those surveyed said they had talked
to their doctor about the subjects found on the Internet.
If we look at the socio-demographic characteristics of these individuals we can see that
women (73%) are more likely to share information found on the Internet about health than
men (68%).
By age, the group of younger individuals (77%) stands out for having more fluid
conversations on the Internet than people over 60 (71%). However, it is noteworthy that
more than two thirds of Internet users aged over 60 are now talking about the Internet in
the doctor’s surgery. No doubt this phenomenon will soon reach most Internet users.
The education level plays a key role in the aspects of doctor-patient communication.
Those with a higher level of education tend to talk things over more with their doctor (75%)
than those with a lower level of education (55%).
The results concerning the state of health do not allow for clear conclusions, although
what is clear is that those individuals who report having a chronic illness tend to talk more
about the internet with their doctors (74%) than those who do not have this type of health
problem (67%). As expected, a higher number of visits to the doctor is associated with
increased dialogue about the information found on the internet.
Table 5: Health professional – patient communication
No yes
Gender
Female 27% 73%
  9
Male 32% 68%
Age
18-30 33% 77%
31-40 29% 71%
41-50 26% 74%
51-60 29% 71%
Over 60 29% 71%
Education level
Low 44% 55%
Medium 35% 65%
High 25% 75%
Health
Poor 35% 66%
Moderate 30% 70%
Good 29% 71%
Very good 26% 74%
Excellent 37% 63%
Chronic illness
No 33% 67%
Yes 26% 74%
Doctor visits in the past 12
months
None 41% 59%
Between 1 and 2 33% 67%
Between 3 and 4 31% 69%
More than 4 22% 78%
N=3615
The breakdown by country shows that Italy is the leader in this practice, where 81% of the
individuals surveyed reported having shared information found on the Internet with their
doctor. By contrast, countries where the practice is less widespread are Brazil (68%) and
France (64%).
Table 6: Health professional –patient communication by country
No Yes
Argentina 28% 72%
Brazil 32% 68%
Chile 34% 66%
Colombia 27% 73%
Spain 30% 70%
France 35% 65%
Italy 19% 81%
Mexico 27% 73%
N=3615
  10
In addition, internet use is not only limited to individual use, but users become "nodes" of
information for other users. Some 44% of the individuals surveyed used the Internet to
search for health information for themselves, 21% for someone else, and 34% for
themselves and someone else. Therefore, the Internet is present in both patient-to-patient
conversations as well as talks between patients and their doctors.
Figure 3: Finding health information on the Internet
N=3600
The socio-demographic characterization shows that men tend to seek information for
themselves (49%) to a greater extent than women (41%), while women (37%) tend to seek
information for themselves and others at higher rates than men (30%). Without doubt,
women are also the main nodes of information in the internet field. We saw that people
aged between 31 and 40 years and those between 51 and 60 years are the most active in
seeking information from third parties. This shows that during this period of their lives
these individuals become health nodes in the household for both children and older
dependents. In this sense, segmentation by level of education reveals that it is those with
higher education who are leading this type of activity, when compared to individuals with
low / medium education. Finally, state of health, suffering from a chronic illness and trips to
see the doctor are related to a higher percentage of searching for oneself. As we saw
earlier, these people are the most likely to be sharing these searches with healthcare
professionals. However, those with a better state of health, are searching for information
for others in greater proportions than was expected.
21%
34%
44%
For oneself
Both
For someone else
  11
Table 7: Searching for health information on the Internet
N=3602
Undoubtedly, these different profiles pose a challenge when it comes to defining who is
the target of health information because it can be both the person with a health problem
and those who, without being in the situation themselves, play the role of information
gatherer. Therefore, the contents should take into account both the end user and possible
intermediaries, who in some cases could be their caregivers. In this sense, there is no
difference between ePatients, mPatients or wPatients, since the need for information and
communication to health care professionals is not dependent on variables related to
access and use of technology among internet users.
For oneself For someone else Both
Gender
Female 41% 22% 37%
Male 49% 21% 30%
Age
18-30 48% 19% 33%
31-40 43% 21% 36%
41-50 40% 26% 34%
51-60 42% 22% 36%
Over 60 50% 17% 33%
Education level
Low 50% 20% 30%
Medium 47% 22% 31%
High 43% 21% 36%
Health
Poor 64% 8% 28%
Moderate 51% 15% 34%
Good 42% 21% 37%
Very good 37% 28% 35%
Excellent 38% 34% 28%
Chronic illness
No 38% 30% 32%
Yes 49% 15% 36%
Doctor visits in the past 12
months
None 34% 32% 34%
Between 1 and 2 33% 31% 36%
Between 3 and 4 47% 19% 36%
More than 4 52% 15% 33%
  12
This trend is also observed if we analyze the different sources of information and means
used by users to a health problem that affects their well-being. Most individuals surveyed
(68%) use their doctor first or other health professional in person either offline- (45%),
exclusively online (5%) or using both (18%). The second most consulted source are family
and / or friends (54%) either offline - in person (29%), exclusively online (6%) or using both
(20%). Finally, 45% of respondents also turn to other people with the same health problem
only in person (21%), exclusively online (7%) or using both means (17%).
The data show that the combination of different sources and media is a reality. A meeting
in person with a health care professional is the preferred choice for almost half of
respondents (45%). If in addition to the in-person only option we add the combination of
this and the use of online media the percentage rises to 63%. In this sense, the use of
Internet either exclusively or in combination with meetings in person remains almost
constant regardless of whether the source is a health professional (23%); family member
and / or friend (26%) or another person with the same health problem (24%).
Figure 4: Sources and media
N=3561
All these data show us the social approach that individuals make to the sources of
information as well as to the different means- offline and online. In this regard, there are no
5%
6%
7%
18%
20%
17%
32%
46%
55%
A doctor or
healthcare
professional
Family members
and/or friends
Someone else
with the same
health problem
I haven't used any of these
means/sources
Both online and offline
Online online, email, video
conference call, Skype…
Only offline, visit in person or
via phone call
  13
significant differences between the identified patient profiles. The different technologies
available (Internet, mobile and "wearables") are socialized, either in person (offline),
virtually (online) or in both spaces, through different streams of information and
communication between the different actors (individuals, families, friends, health
professionals).
  14
4. Beyond information
Undoubtedly finding information on the Internet relating to health is the main activity
carried out by respondents. Most individuals who responded to the survey reported having
searched online about a specific disease or health problem (96%) about drugs (92%),
about doctors or other health professionals (91%) about a treatment or surgical procedure
(89%) about hospitals or other medical institutions including private- practices (80%) and
about health insurance (54%). In addition to these issues related to health problems, the
majority of Internet users surveyed (90%) also looked at issues related to lifestyle or
wellbeing (diet, physical activity, beauty, etc.).
Figure 5: Internet searches – Health topics
These data demonstrate that health information is already a "commodity" on the internet,
something users already assume they will find. However, there are significant differences
between the profiles identified and consultation topics, especially in the consultations
related to health insurance, hospitals and other medical institutions or private
consultations, treatments and doctors.
54%
80%
89%
90%
91%
92%
96%
0% 10%20%30%40%50%60%70%80%90%100%
Health insurance
A treatment or medical procedure
Lifestyle/Wellbeing (diets…)
Doctors or other healthcare professionals
Medicines
An illness or health problem
  15
Figure 6: Topics consulted in Internet health searches and patient profiles
In addition to finding information, there are other activities related to health and well-being
that can be performed online. The following table shows the percentage of respondents
who during the past 12 months have used the internet beyond the search for health
information. The activities that most respondents carried out were related to looking at
other people's comments about their health experiences (84%) and reading opinions about
medicines or treatments (80%). In second place is reading opinions and reviews about
doctors or medical visits (62%) followed by finding people with the same health problem
(61%) and reviews of hospitals or other institutions (59%). Finally, less than 35% of
respondents make inquiries through videoconference or Skype, access their medical
records online; they buy drugs or share their experience about any medication, hospital or
other medical facility.
3,36 3,57 3,55
2,99 3,35 3,49
3,18
3,44 3,41
2,99
3,21 3,38
2,91
3,15 3,15
2,59
2,86 2,95
1,83
2,14 2,28
ePatient mPatient wPatient
Health insurance
Hospitals or other types of
medical centres, including
private consultancies
A treatment or medical
procedure
Doctors or other healthcare
professionals
Medicines
Lifestyle/Wellbeing (diets,
exercise, beauty, etc…)
An illness or a specific
health problem
  16
Figure 7: Activities related to health and wellbeing
The following table shows the percentage of individuals who perform these activities in
each country:
Table 8: Uses of the Internet by country
Argentina
Brazil
Chile
Colombia
Spain
France
Italy
Mexico
Subscribe to a website to receive emails or messages related to
health or specific illnesses
44% 52% 47% 39% 51% 33% 72% 48%
Send or receive emails from a doctor, nurse or health center 32% 37% 30% 42% 40% 31% 44% 38%
Download or fill out online forms related to health services,
including private health insurance
32% 35% 30% 27% 31% 46% 45% 37%
Make, cancel or change an appointment with a doctor or other
healthcare professional online
29% 32% 26% 27% 30% 67% 44% 34%
9%
23%
31%
31%
31%
35%
36%
38%
38%
46%
49%
59%
61%
62%
80%
84%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%
Have an appointment via video conference or
Skype
Access or upload one’s health information to an
online clinical history
Buy medicines or vitamins
Comment on or share experience online about
some medicine or treatment
Comment on or rate a hospital or other health
centre
Download/fill out online forms, including private
health insurance
Comment on or rate a doctor or other healthcare
professional
Send or receive emails from a doctor, nurse or
health centre
Make/cancel/change a doctor’s appointment
online
Receive medical test results online
Subscribe to a health website
Search online for opinions, reviews and ratings
of hospitals or other medical centres
Look for people with the same health problem or
the same worries
Search online for opinions, reviews and ratings
of doctors and appointments
Search online for opinions and reviews of
medicines or treatments
Read or view comments from other people about
their health experiences
  17
Have an appointment with a doctor or nurse via video conference
call or Skye
7% 9% 9% 12% 7% 4% 22% 8%
Receive medical test results or diagnoses online 37% 41% 55% 59% 42% 46% 49% 43%
Access or upload one’s health information (or that of a family
member) to an online clinical history
26% 20% 18% 22% 21% 21% 38% 22%
Buy medicines or vitamins 36% 30% 47% 40% 28% 22% 40% 31%
Search on the internet for opinions, reviews or ratings of doctors
or appointments
55% 58% 64% 65% 62% 71% 73% 61%
Search on the internet for opinions, reviews or ratings of hospitals
or other health centers
53% 53% 63% 70% 62% 66% 66% 59%
Search on the internet for opinions or reviews of medicines and
treatments
75% 81% 79% 79% 80% 76% 89% 74%
Make a comment or rate a doctor or other healthcare
professional
36% 32% 40% 43% 35% 36% 46% 36%
Make a comment or rate a hospital or other health center 30% 26% 40% 40% 29% 27% 41% 32%
Make a comment or share an experience about a medicine or
treatment
34% 24% 33% 32% 28% 19% 53% 34%
Read or view comments from others about their health
experiences
74% 85% 82% 82% 84% 86% 93% 81%
Search for people with the same health problem or the same
worries
60% 55% 72% 63% 58% 63% 79% 60%
All these activities can be grouped into four main factors that can be interpreted as the
dimensions that drive the use of the internet in health beyond searching for information.
These dimensions group related activities: Experience, Participation, Services and Visits.
Figure 8: Dimensions of Internet use in Health.
	
  
	
  
	
  
0
1
2
3
4
5
Read or view comments
from other people about
Look for people with the
same health problem or
Search online for
opinions and reviews of
Search online for
opinions, reviews and
Comment on or rate a
hospital or other health
Search online for
opinions, reviews and
Comment on or rate a
doctor or other
Comment on or share
experience online about
Access or upload one’s
health information to an
Have an appointment via
video conference or
Subscribe to a health
website
Download/fill out online
forms, including private
Buy medicines or
vitamins
Send or receive emails
from a doctor, nurse or
Receive medical test
results online
Make/cancel/change a
doctor’s appointment
Experience Participation Services Visits
  18
In first place, would be activities related to the experience of other users. Internet users
not only seek health information, nor information related only to the "expert" knowledge of
professionals, but they also seek knowledge from the experiences of other users with
problems relating to health, medications or treatments and healthcare professionals.
Secondly we can highlight activities related to participation. Users not only seek the
experience of others, but they themselves share theirs through comments or ratings of
hospitals, healthcare professionals, medications and treatments.
Thirdly, we have identified a dimension related to the services that users use via the
Internet. This dimension encompasses the activities related to access to medical records
online, consultations via video conferencing; subscriptions to receive alerts or use of
online forms.
Finally, the fourth dimension is related to the management of the medical visit that
combines activities related to communication via email with health care professionals;
receiving medical test results online and the online management of medical visits.
If we approach these dimensions understanding them as drivers driving Internet usage
beyond simply the search for health information, we see that users characterized by the
use of internet, mobile and "wearables" (wPatient) are noticeable in all aspects, especially
in that related to services and managing visits. The second most prominent group is the
mPatients. This group stands out as having the same level of use in all four dimensions.
Finally ePatients or "traditional" patients have a lower level of use of the four dimensions
compared to other profiles. In this case the type of technology used by the users
themselves does determine the type of activities they perform. The greater the number of
devices used the greater the range of activities.
  19
Figure 9: Dimensions of Internet use in health and patient profiles
1
2
3
4
5
Experience Participation Services Visits
ePatient mPatient wPatient
  20
5. New trends
Mobile telephones have burst into the field of health. As we saw earlier 35% of those
surveyed reported having used their smartphone for questions related to health issues.
The main applications used are related to health information online (86%), exercise (77%),
diet (66%) and medication management (66%). About half of the users of mobile apps
have also used apps related to sleep management (56%), Doctoralia online appointment
(56%), mood monitoring (55%) and blood pressure (51 %). Finally, less than half have
used apps related to diabetes (44%), the menstrual cycle (35%) and pregnancy / maternity
(32%) applications.
	
  
Figure 10: mHealth activities
N=1253
The following table shows the percentage of users by country performing each type of
activity related to mHealth:
32%
35%
44%
51%
53%
55%
56%
56%
66%
66%
77%
86%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Pregnancy/maternity
Menstrual cycle
Diabetes/glucose
Online appointments with healthcare
Blood pressure
Mood
Doctoralia online appointment app
Sleep
Drug management (monitoring…)
Diets, calorie counter
Exercise
Online health information
  21
Table 9: mHealth activities by country
Argentina
Brazil
Chile
Colombia
Spain
France
Italy
Mexico
Exercise, fitness, heart rate…including activities
such as running, weight training, yoga, etc…
65% 59% 59% 75% 64% 56% 72% 69%
Diets, calorie counter 49% 45% 56% 55% 55% 35% 53% 59%
Menstrual cycle 23% 19% 23% 31% 20% 19% 28% 29%
Blood pressure 45% 43% 43% 48% 48% 24% 56% 44%
Doctoralia online appointment app 42% 43% 42% 45% 44% 65% 57% 48%
Online health information 79% 76% 81% 81% 76% 71% 83% 83%
Pregnancy / Maternity 22% 19% 15% 19% 19% 18% 29% 28%
Diabetes / glucose 29% 33% 35% 47% 37% 15% 41% 33%
Drug management (monitoring, alerts, etc.) 58% 64% 57% 58% 58% 37% 77% 63%
Mood 44% 45% 47% 53% 46% 24% 59% 47%
Sleep 43% 44% 47% 40% 46% 27% 53% 51%
Online appointments with healthcare professionals 34% 33% 29% 39% 35% 69% 45% 47%
Other 59% 52% 56% 57% 50% 37% 67% 57%
N=1253
As with internet activities, the activities of mHealth can be grouped into three dimensions.
On the one hand, the activities related to monitoring or "Tracking" constants related to
health or well-being. Furthermore, those activities related to the management of "Health"
and finally activities related to the "Well-being". In this case, most of the traditional
ePatients are not using these applications. It is only mPatients and wPacients alike who
are using their mobile actively in all dimensions identified.
  22
Figure 11: Dimensions of mHealth
	
  
0
1
2
3
4
5
Mood
Blood pressure
Sleep
Diabetes/Glucose
Drug managementExercise
Diets/calorie counter
Online appointments
with healthcare
professionals
Doctoralia appoinnent
app
Tracking Wellbeing Health
  23
6. Users as content creators
The field of health has not been isolated from the web 2.0 phenomenon. 26% of Internet
users surveyed said in the past 12 months they had asked questions or shared their state
of health (experience) through Internet forums, social networks, Twitter...
The socio-demographic analysis shows that women (27%) tend to be more active than
men (22%) at generating content on the Internet. By age, as expected, younger users are
the most active participants at sharing their opinions and experiences on the internet. The
analysis of education levels shows us that people with low and medium levels of education
participate more than those with a higher level of education. Despite the relationship
between age and participation in Web 2.0, it is the people with poor health (43%) who are
most likely to share their experiences or to ask questions via the Internet. This trend is
reinforced because those users who have a chronic health problem are also shown to be
more active than those who do not declare this type of health problem. The same trend is
observed with the user visits to the doctor. Undoubtedly, these data are a clear sign of the
type of patient who is facing the health systems today.
Table 10: Users as content creators
No Yes
Gender
Female 72% 27%
Male 78% 22%
Age
18-30 71% 29%
31-40 73% 27%
41-50 73% 27%
51-60 75% 25%
Over 60 77% 23%
Education level
Low 67% 33%
Medium 70% 30%
High 76% 24%
Health
Poor 57% 43%
  24
Moderate 71% 29%
Good 75% 25%
Very good 80% 20%
Excellent 74% 26%
Chronic illness
No 79% 21%
Yes 70% 30%
Doctor visits in the past 12
months
None 80% 20%
Between 1 and 2 79% 21%
Between 3 and 4 78% 22%
More than 4 69% 31%
N=3619
We have also checked whether there are significant differences between the countries
surveyed. In this case, Mexico and Spain are the countries with the highest percentage of
users generating content, while France stands out as the country with a smaller number of
users than expected.
Table 11: Health professional – patient communication by country
No Yes
Argentina 75% 25%
Chile 76% 24%
Colombia 77% 23%
Spain 72% 28%
France 85% 15%
Mexico 61% 39%
N=3615
Finally we have found that there is a positive and significant relationship between access
and use of different technologies and the generation of content by internet users. In this
respect, those who use the internet, equally via their mobile and "wearables" (wPatients)
are the most active at generating content (33%), while those who only use the internet
(ePatient) are less active (22%). Therefore diversity of access through different
technologies facilitates participation. In this sense, both the mobile and especially the
"wearables" could be the first step for the arrival of the "Internet of Things" in the field of
health.
  25
Figure 12: Profiles of content generating users
22%
30%
33%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
ePatient mPatient wPatient
  26
7. Barriers and impact
Most users surveyed, despite being Internet, users also face numerous inhibitors or
brakes. More than 70% of respondents stated issues related to security, privacy and trust
as important. The second group of barriers is related to health training of individuals, the
specific use of Internet related to health and motivation or interest in the subject. In this
case more than half of the individuals, 55%, 54% and 50% respectively, consider these
barriers as very important. Finally only 36% of individuals consider barriers related to their
digital skills as important.
Figure 12: Major inhibitors
N=3621
Finally the individuals surveyed were asked about the benefits they receive from the use of
information and communication technology in relation to their health. The perception of
these benefits is very high among all individuals. Some 90% of respondents state that by
using the Internet they have learned something new. 77% pointed out that they find
questions to ask healthcare professionals on the Internet. In addition, 73% say that using
the Internet facilitates decision-making that can be beneficial to their health. In this regard,
53% agree or strongly agree that the Internet gives them the confidence to share their
health concerns with others.
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Digital skills
Motivation/Interest
Knowledge of the Internet for health use
Health training
Trust
Privacy
Security
Very important Important up to a certaint point
Up to a certaint point not important Not important at all
  27
Figure 13: Main benefits
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100%
I’ve learnt something new using the internet
I feel I have a lot in common with other people
who use the internet for issues…
Using the internet allows me to make decisions
which can be beneficial to my health
On the internet I find questions which I can ask
my doctor or nurse
The internet gives me the confidence to share
my health concerns with others…
Totally disagree Disagree Agree Totally agree
  28
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Doctoralia Report on Health and the Internet 2015

  • 1. In collaboration with: First Doctoralia Report on Health and the Internet 2015
  • 2.   2     Index 1. Introduction ................................................................................. 3 2. New patient profiles .................................................................... 5 3. New information and communication flow .................................. 8 4. Further information.................................................................... 14 5. New trends ............................................................................... 20 6. Users create content................................................................. 23   7. Barriers and impact................................................................... 26    
  • 3.   3 1. Introduction The object of this report is to analyze the current state of access and use of information and communication technology among Internet users in the field of health on a global level. To achieve this goal we created an online survey that was distributed between October 2014 and January 2015 through the Doctoralia website in eight countries: Argentina, Brazil, Chile, Colombia, Spain, France, Italy and Mexico. The following table describes the characteristics of the final sample collected (N = 3621). Table 1: Sample % Gender Female 67% Male 34% Age 18-30 12% 31-40 18% 41-50 23% 51-60 24% Over 60 22% Education level Low 5% Medium 28% High 67% Health Poor 6% Moderate 25% Good 39% Very good 25% Excellent 6% Chronic illness No 45% Yes 55% Doctor visits in the past 12 months None 16% Between 1 and 2 19% Between 3 and 4 21%
  • 4.   4 More than 4 44% N=3621 It is important to note that in order to carry out the statistical analysis of the whole sample different weight was assigned to each country according to their population. The following table shows the number of responses in each country: Table 2: Sample by country Countries Argentina 699 – 19% Brazil 646 – 18% Chile 265 – 7% Colombia 229 – 6% Spain 412 – 11% France 353 – 10% Italy 232 – 6% Mexico 785 – 22% N=3621
  • 5.   5 2. New patient profiles The use of information and communication technology for health-related issues is a reality for the vast majority of Internet users: 90% report having used this technology to search for content or services related to their health. If Internet usage is a consolidated reality, the results of this study also show the emergence of the use of smartphones (35%) and other "wearable" devices (14%). Figure 1: Distribution of information and communication technology N=3621 The combination of use of these three technologies allows the identification of three distinct profiles. A first group related to those Internet users who only use the Internet. This group is traditionally known as ePatients and includes 60% of the surveyed population. The second profile includes those individuals who, in addition to Internet, also have some type of application in their smartphone and / or tablet to help them manage, measure or to track issues related to health, lifestyle and well-being. We have called this group mPatients and they make up 26% of the surveyed population. 14% 35% 90% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Wearable Mobile Internet
  • 6.   6 Finally, the third group of users consists of individuals who, as well as the technologies mentioned above, have also used some kind of smart device (bracelets, watches, etc ...) to help them manage, measure or monitor issues relating to health , lifestyle, well-being (physical exercise, diet, etc...). We have called this group of users wPatients, where "w" refers to the term "wearable". Figure 2: Type of Internet users related to health N=3621 These three profiles have different socio-demographic characteristics. Firstly, women (28%) stand out slightly over men (22%) in the use of mobile phones, while the percentage of men is higher (18%) than women (12%) in the case of use of "wearables." Secondly, the percentage of ePatients increases as age increases, while in the case of wPatients and mPatients percentages are higher among young and middle-aged people. Thirdly, differences in education are only noticeable in the case of wPatients. There are no remarkable differences in other profiles. Fourthly, as expected, given the age ranges, there is a higher than expected percentage of people with poor health among ePatients than in the other two profiles. This also means that ePatients make more visits to the doctor than mPatients and wPatients. Table 3: Socio-demographic profiles 14% 26% 60% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% w-Patient m-Patient e-Patient ePatient mPatient wPatient Gender Female 59% 28% 12% Male 60% 22% 18% Age 18-30 55% 35% 11% 31-40 56% 29% 16%
  • 7.   7 N=3621 If we look at the distribution of different profiles in each country, no great differences are observed. The profile of Internet users is similar in all countries. However, Chile stands out for a greater presence of ePatients than other countries, while Italy is notable for a greater presence of wPatients. Table 4: Profiles by country ePatient mPatient wPatient Argentina 63% 25% 12% Brazil 59% 28% 13% Chile 72% 18% 10% Colombia 64% 24% 12% Spain 62% 24% 14% France 53% 27% 21% Italy 51% 31% 18% Mexico 62% 25% 13% N=3621 41-50 59% 25% 16% 51-60 60% 26% 15% Over 60 66% 22% 12% Education level Low 59% 27% 14% Medium 63% 26% 12% High 58% 27% 15% Health Poor 65% 21% 15% Moderate 62% 26% 12% Good 61% 25% 14% Very good 55% 30% 15% Excellent 53% 27% 20% Doctor visits in the past 12 months None 60% 27% 13% Between 1 and 2 55% 29% 17% Between 3 and 4 63% 25% 12% More than 4 59% 26% 15%
  • 8.   8 3. New information and communication flow The emergence of new patient profiles is not only related to the use of technology but also to the transformation of information and communication flow between patients, healthcare professionals and health organizations. Some 71% of those surveyed said they had talked to their doctor about the subjects found on the Internet. If we look at the socio-demographic characteristics of these individuals we can see that women (73%) are more likely to share information found on the Internet about health than men (68%). By age, the group of younger individuals (77%) stands out for having more fluid conversations on the Internet than people over 60 (71%). However, it is noteworthy that more than two thirds of Internet users aged over 60 are now talking about the Internet in the doctor’s surgery. No doubt this phenomenon will soon reach most Internet users. The education level plays a key role in the aspects of doctor-patient communication. Those with a higher level of education tend to talk things over more with their doctor (75%) than those with a lower level of education (55%). The results concerning the state of health do not allow for clear conclusions, although what is clear is that those individuals who report having a chronic illness tend to talk more about the internet with their doctors (74%) than those who do not have this type of health problem (67%). As expected, a higher number of visits to the doctor is associated with increased dialogue about the information found on the internet. Table 5: Health professional – patient communication No yes Gender Female 27% 73%
  • 9.   9 Male 32% 68% Age 18-30 33% 77% 31-40 29% 71% 41-50 26% 74% 51-60 29% 71% Over 60 29% 71% Education level Low 44% 55% Medium 35% 65% High 25% 75% Health Poor 35% 66% Moderate 30% 70% Good 29% 71% Very good 26% 74% Excellent 37% 63% Chronic illness No 33% 67% Yes 26% 74% Doctor visits in the past 12 months None 41% 59% Between 1 and 2 33% 67% Between 3 and 4 31% 69% More than 4 22% 78% N=3615 The breakdown by country shows that Italy is the leader in this practice, where 81% of the individuals surveyed reported having shared information found on the Internet with their doctor. By contrast, countries where the practice is less widespread are Brazil (68%) and France (64%). Table 6: Health professional –patient communication by country No Yes Argentina 28% 72% Brazil 32% 68% Chile 34% 66% Colombia 27% 73% Spain 30% 70% France 35% 65% Italy 19% 81% Mexico 27% 73% N=3615
  • 10.   10 In addition, internet use is not only limited to individual use, but users become "nodes" of information for other users. Some 44% of the individuals surveyed used the Internet to search for health information for themselves, 21% for someone else, and 34% for themselves and someone else. Therefore, the Internet is present in both patient-to-patient conversations as well as talks between patients and their doctors. Figure 3: Finding health information on the Internet N=3600 The socio-demographic characterization shows that men tend to seek information for themselves (49%) to a greater extent than women (41%), while women (37%) tend to seek information for themselves and others at higher rates than men (30%). Without doubt, women are also the main nodes of information in the internet field. We saw that people aged between 31 and 40 years and those between 51 and 60 years are the most active in seeking information from third parties. This shows that during this period of their lives these individuals become health nodes in the household for both children and older dependents. In this sense, segmentation by level of education reveals that it is those with higher education who are leading this type of activity, when compared to individuals with low / medium education. Finally, state of health, suffering from a chronic illness and trips to see the doctor are related to a higher percentage of searching for oneself. As we saw earlier, these people are the most likely to be sharing these searches with healthcare professionals. However, those with a better state of health, are searching for information for others in greater proportions than was expected. 21% 34% 44% For oneself Both For someone else
  • 11.   11 Table 7: Searching for health information on the Internet N=3602 Undoubtedly, these different profiles pose a challenge when it comes to defining who is the target of health information because it can be both the person with a health problem and those who, without being in the situation themselves, play the role of information gatherer. Therefore, the contents should take into account both the end user and possible intermediaries, who in some cases could be their caregivers. In this sense, there is no difference between ePatients, mPatients or wPatients, since the need for information and communication to health care professionals is not dependent on variables related to access and use of technology among internet users. For oneself For someone else Both Gender Female 41% 22% 37% Male 49% 21% 30% Age 18-30 48% 19% 33% 31-40 43% 21% 36% 41-50 40% 26% 34% 51-60 42% 22% 36% Over 60 50% 17% 33% Education level Low 50% 20% 30% Medium 47% 22% 31% High 43% 21% 36% Health Poor 64% 8% 28% Moderate 51% 15% 34% Good 42% 21% 37% Very good 37% 28% 35% Excellent 38% 34% 28% Chronic illness No 38% 30% 32% Yes 49% 15% 36% Doctor visits in the past 12 months None 34% 32% 34% Between 1 and 2 33% 31% 36% Between 3 and 4 47% 19% 36% More than 4 52% 15% 33%
  • 12.   12 This trend is also observed if we analyze the different sources of information and means used by users to a health problem that affects their well-being. Most individuals surveyed (68%) use their doctor first or other health professional in person either offline- (45%), exclusively online (5%) or using both (18%). The second most consulted source are family and / or friends (54%) either offline - in person (29%), exclusively online (6%) or using both (20%). Finally, 45% of respondents also turn to other people with the same health problem only in person (21%), exclusively online (7%) or using both means (17%). The data show that the combination of different sources and media is a reality. A meeting in person with a health care professional is the preferred choice for almost half of respondents (45%). If in addition to the in-person only option we add the combination of this and the use of online media the percentage rises to 63%. In this sense, the use of Internet either exclusively or in combination with meetings in person remains almost constant regardless of whether the source is a health professional (23%); family member and / or friend (26%) or another person with the same health problem (24%). Figure 4: Sources and media N=3561 All these data show us the social approach that individuals make to the sources of information as well as to the different means- offline and online. In this regard, there are no 5% 6% 7% 18% 20% 17% 32% 46% 55% A doctor or healthcare professional Family members and/or friends Someone else with the same health problem I haven't used any of these means/sources Both online and offline Online online, email, video conference call, Skype… Only offline, visit in person or via phone call
  • 13.   13 significant differences between the identified patient profiles. The different technologies available (Internet, mobile and "wearables") are socialized, either in person (offline), virtually (online) or in both spaces, through different streams of information and communication between the different actors (individuals, families, friends, health professionals).
  • 14.   14 4. Beyond information Undoubtedly finding information on the Internet relating to health is the main activity carried out by respondents. Most individuals who responded to the survey reported having searched online about a specific disease or health problem (96%) about drugs (92%), about doctors or other health professionals (91%) about a treatment or surgical procedure (89%) about hospitals or other medical institutions including private- practices (80%) and about health insurance (54%). In addition to these issues related to health problems, the majority of Internet users surveyed (90%) also looked at issues related to lifestyle or wellbeing (diet, physical activity, beauty, etc.). Figure 5: Internet searches – Health topics These data demonstrate that health information is already a "commodity" on the internet, something users already assume they will find. However, there are significant differences between the profiles identified and consultation topics, especially in the consultations related to health insurance, hospitals and other medical institutions or private consultations, treatments and doctors. 54% 80% 89% 90% 91% 92% 96% 0% 10%20%30%40%50%60%70%80%90%100% Health insurance A treatment or medical procedure Lifestyle/Wellbeing (diets…) Doctors or other healthcare professionals Medicines An illness or health problem
  • 15.   15 Figure 6: Topics consulted in Internet health searches and patient profiles In addition to finding information, there are other activities related to health and well-being that can be performed online. The following table shows the percentage of respondents who during the past 12 months have used the internet beyond the search for health information. The activities that most respondents carried out were related to looking at other people's comments about their health experiences (84%) and reading opinions about medicines or treatments (80%). In second place is reading opinions and reviews about doctors or medical visits (62%) followed by finding people with the same health problem (61%) and reviews of hospitals or other institutions (59%). Finally, less than 35% of respondents make inquiries through videoconference or Skype, access their medical records online; they buy drugs or share their experience about any medication, hospital or other medical facility. 3,36 3,57 3,55 2,99 3,35 3,49 3,18 3,44 3,41 2,99 3,21 3,38 2,91 3,15 3,15 2,59 2,86 2,95 1,83 2,14 2,28 ePatient mPatient wPatient Health insurance Hospitals or other types of medical centres, including private consultancies A treatment or medical procedure Doctors or other healthcare professionals Medicines Lifestyle/Wellbeing (diets, exercise, beauty, etc…) An illness or a specific health problem
  • 16.   16 Figure 7: Activities related to health and wellbeing The following table shows the percentage of individuals who perform these activities in each country: Table 8: Uses of the Internet by country Argentina Brazil Chile Colombia Spain France Italy Mexico Subscribe to a website to receive emails or messages related to health or specific illnesses 44% 52% 47% 39% 51% 33% 72% 48% Send or receive emails from a doctor, nurse or health center 32% 37% 30% 42% 40% 31% 44% 38% Download or fill out online forms related to health services, including private health insurance 32% 35% 30% 27% 31% 46% 45% 37% Make, cancel or change an appointment with a doctor or other healthcare professional online 29% 32% 26% 27% 30% 67% 44% 34% 9% 23% 31% 31% 31% 35% 36% 38% 38% 46% 49% 59% 61% 62% 80% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% Have an appointment via video conference or Skype Access or upload one’s health information to an online clinical history Buy medicines or vitamins Comment on or share experience online about some medicine or treatment Comment on or rate a hospital or other health centre Download/fill out online forms, including private health insurance Comment on or rate a doctor or other healthcare professional Send or receive emails from a doctor, nurse or health centre Make/cancel/change a doctor’s appointment online Receive medical test results online Subscribe to a health website Search online for opinions, reviews and ratings of hospitals or other medical centres Look for people with the same health problem or the same worries Search online for opinions, reviews and ratings of doctors and appointments Search online for opinions and reviews of medicines or treatments Read or view comments from other people about their health experiences
  • 17.   17 Have an appointment with a doctor or nurse via video conference call or Skye 7% 9% 9% 12% 7% 4% 22% 8% Receive medical test results or diagnoses online 37% 41% 55% 59% 42% 46% 49% 43% Access or upload one’s health information (or that of a family member) to an online clinical history 26% 20% 18% 22% 21% 21% 38% 22% Buy medicines or vitamins 36% 30% 47% 40% 28% 22% 40% 31% Search on the internet for opinions, reviews or ratings of doctors or appointments 55% 58% 64% 65% 62% 71% 73% 61% Search on the internet for opinions, reviews or ratings of hospitals or other health centers 53% 53% 63% 70% 62% 66% 66% 59% Search on the internet for opinions or reviews of medicines and treatments 75% 81% 79% 79% 80% 76% 89% 74% Make a comment or rate a doctor or other healthcare professional 36% 32% 40% 43% 35% 36% 46% 36% Make a comment or rate a hospital or other health center 30% 26% 40% 40% 29% 27% 41% 32% Make a comment or share an experience about a medicine or treatment 34% 24% 33% 32% 28% 19% 53% 34% Read or view comments from others about their health experiences 74% 85% 82% 82% 84% 86% 93% 81% Search for people with the same health problem or the same worries 60% 55% 72% 63% 58% 63% 79% 60% All these activities can be grouped into four main factors that can be interpreted as the dimensions that drive the use of the internet in health beyond searching for information. These dimensions group related activities: Experience, Participation, Services and Visits. Figure 8: Dimensions of Internet use in Health.       0 1 2 3 4 5 Read or view comments from other people about Look for people with the same health problem or Search online for opinions and reviews of Search online for opinions, reviews and Comment on or rate a hospital or other health Search online for opinions, reviews and Comment on or rate a doctor or other Comment on or share experience online about Access or upload one’s health information to an Have an appointment via video conference or Subscribe to a health website Download/fill out online forms, including private Buy medicines or vitamins Send or receive emails from a doctor, nurse or Receive medical test results online Make/cancel/change a doctor’s appointment Experience Participation Services Visits
  • 18.   18 In first place, would be activities related to the experience of other users. Internet users not only seek health information, nor information related only to the "expert" knowledge of professionals, but they also seek knowledge from the experiences of other users with problems relating to health, medications or treatments and healthcare professionals. Secondly we can highlight activities related to participation. Users not only seek the experience of others, but they themselves share theirs through comments or ratings of hospitals, healthcare professionals, medications and treatments. Thirdly, we have identified a dimension related to the services that users use via the Internet. This dimension encompasses the activities related to access to medical records online, consultations via video conferencing; subscriptions to receive alerts or use of online forms. Finally, the fourth dimension is related to the management of the medical visit that combines activities related to communication via email with health care professionals; receiving medical test results online and the online management of medical visits. If we approach these dimensions understanding them as drivers driving Internet usage beyond simply the search for health information, we see that users characterized by the use of internet, mobile and "wearables" (wPatient) are noticeable in all aspects, especially in that related to services and managing visits. The second most prominent group is the mPatients. This group stands out as having the same level of use in all four dimensions. Finally ePatients or "traditional" patients have a lower level of use of the four dimensions compared to other profiles. In this case the type of technology used by the users themselves does determine the type of activities they perform. The greater the number of devices used the greater the range of activities.
  • 19.   19 Figure 9: Dimensions of Internet use in health and patient profiles 1 2 3 4 5 Experience Participation Services Visits ePatient mPatient wPatient
  • 20.   20 5. New trends Mobile telephones have burst into the field of health. As we saw earlier 35% of those surveyed reported having used their smartphone for questions related to health issues. The main applications used are related to health information online (86%), exercise (77%), diet (66%) and medication management (66%). About half of the users of mobile apps have also used apps related to sleep management (56%), Doctoralia online appointment (56%), mood monitoring (55%) and blood pressure (51 %). Finally, less than half have used apps related to diabetes (44%), the menstrual cycle (35%) and pregnancy / maternity (32%) applications.   Figure 10: mHealth activities N=1253 The following table shows the percentage of users by country performing each type of activity related to mHealth: 32% 35% 44% 51% 53% 55% 56% 56% 66% 66% 77% 86% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Pregnancy/maternity Menstrual cycle Diabetes/glucose Online appointments with healthcare Blood pressure Mood Doctoralia online appointment app Sleep Drug management (monitoring…) Diets, calorie counter Exercise Online health information
  • 21.   21 Table 9: mHealth activities by country Argentina Brazil Chile Colombia Spain France Italy Mexico Exercise, fitness, heart rate…including activities such as running, weight training, yoga, etc… 65% 59% 59% 75% 64% 56% 72% 69% Diets, calorie counter 49% 45% 56% 55% 55% 35% 53% 59% Menstrual cycle 23% 19% 23% 31% 20% 19% 28% 29% Blood pressure 45% 43% 43% 48% 48% 24% 56% 44% Doctoralia online appointment app 42% 43% 42% 45% 44% 65% 57% 48% Online health information 79% 76% 81% 81% 76% 71% 83% 83% Pregnancy / Maternity 22% 19% 15% 19% 19% 18% 29% 28% Diabetes / glucose 29% 33% 35% 47% 37% 15% 41% 33% Drug management (monitoring, alerts, etc.) 58% 64% 57% 58% 58% 37% 77% 63% Mood 44% 45% 47% 53% 46% 24% 59% 47% Sleep 43% 44% 47% 40% 46% 27% 53% 51% Online appointments with healthcare professionals 34% 33% 29% 39% 35% 69% 45% 47% Other 59% 52% 56% 57% 50% 37% 67% 57% N=1253 As with internet activities, the activities of mHealth can be grouped into three dimensions. On the one hand, the activities related to monitoring or "Tracking" constants related to health or well-being. Furthermore, those activities related to the management of "Health" and finally activities related to the "Well-being". In this case, most of the traditional ePatients are not using these applications. It is only mPatients and wPacients alike who are using their mobile actively in all dimensions identified.
  • 22.   22 Figure 11: Dimensions of mHealth   0 1 2 3 4 5 Mood Blood pressure Sleep Diabetes/Glucose Drug managementExercise Diets/calorie counter Online appointments with healthcare professionals Doctoralia appoinnent app Tracking Wellbeing Health
  • 23.   23 6. Users as content creators The field of health has not been isolated from the web 2.0 phenomenon. 26% of Internet users surveyed said in the past 12 months they had asked questions or shared their state of health (experience) through Internet forums, social networks, Twitter... The socio-demographic analysis shows that women (27%) tend to be more active than men (22%) at generating content on the Internet. By age, as expected, younger users are the most active participants at sharing their opinions and experiences on the internet. The analysis of education levels shows us that people with low and medium levels of education participate more than those with a higher level of education. Despite the relationship between age and participation in Web 2.0, it is the people with poor health (43%) who are most likely to share their experiences or to ask questions via the Internet. This trend is reinforced because those users who have a chronic health problem are also shown to be more active than those who do not declare this type of health problem. The same trend is observed with the user visits to the doctor. Undoubtedly, these data are a clear sign of the type of patient who is facing the health systems today. Table 10: Users as content creators No Yes Gender Female 72% 27% Male 78% 22% Age 18-30 71% 29% 31-40 73% 27% 41-50 73% 27% 51-60 75% 25% Over 60 77% 23% Education level Low 67% 33% Medium 70% 30% High 76% 24% Health Poor 57% 43%
  • 24.   24 Moderate 71% 29% Good 75% 25% Very good 80% 20% Excellent 74% 26% Chronic illness No 79% 21% Yes 70% 30% Doctor visits in the past 12 months None 80% 20% Between 1 and 2 79% 21% Between 3 and 4 78% 22% More than 4 69% 31% N=3619 We have also checked whether there are significant differences between the countries surveyed. In this case, Mexico and Spain are the countries with the highest percentage of users generating content, while France stands out as the country with a smaller number of users than expected. Table 11: Health professional – patient communication by country No Yes Argentina 75% 25% Chile 76% 24% Colombia 77% 23% Spain 72% 28% France 85% 15% Mexico 61% 39% N=3615 Finally we have found that there is a positive and significant relationship between access and use of different technologies and the generation of content by internet users. In this respect, those who use the internet, equally via their mobile and "wearables" (wPatients) are the most active at generating content (33%), while those who only use the internet (ePatient) are less active (22%). Therefore diversity of access through different technologies facilitates participation. In this sense, both the mobile and especially the "wearables" could be the first step for the arrival of the "Internet of Things" in the field of health.
  • 25.   25 Figure 12: Profiles of content generating users 22% 30% 33% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% ePatient mPatient wPatient
  • 26.   26 7. Barriers and impact Most users surveyed, despite being Internet, users also face numerous inhibitors or brakes. More than 70% of respondents stated issues related to security, privacy and trust as important. The second group of barriers is related to health training of individuals, the specific use of Internet related to health and motivation or interest in the subject. In this case more than half of the individuals, 55%, 54% and 50% respectively, consider these barriers as very important. Finally only 36% of individuals consider barriers related to their digital skills as important. Figure 12: Major inhibitors N=3621 Finally the individuals surveyed were asked about the benefits they receive from the use of information and communication technology in relation to their health. The perception of these benefits is very high among all individuals. Some 90% of respondents state that by using the Internet they have learned something new. 77% pointed out that they find questions to ask healthcare professionals on the Internet. In addition, 73% say that using the Internet facilitates decision-making that can be beneficial to their health. In this regard, 53% agree or strongly agree that the Internet gives them the confidence to share their health concerns with others. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Digital skills Motivation/Interest Knowledge of the Internet for health use Health training Trust Privacy Security Very important Important up to a certaint point Up to a certaint point not important Not important at all
  • 27.   27 Figure 13: Main benefits 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%100% I’ve learnt something new using the internet I feel I have a lot in common with other people who use the internet for issues… Using the internet allows me to make decisions which can be beneficial to my health On the internet I find questions which I can ask my doctor or nurse The internet gives me the confidence to share my health concerns with others… Totally disagree Disagree Agree Totally agree