Executive Summary of

Health e-People: The Online Consumer Experience
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Mary M. Cain, Jane Sarasohn-Kahn, and Jennifer C. Wayne

Institute for the Future

Health on the Internet is maturing and going through lots of changes. e-Health start-ups are burning through their venture funding, going public, finding new niches, reaching new consumers. Established health care players are finding their voices in cyberspace. Consolidation and shakeout are probably not far away. 

All supply-side turbulence aside, the most important development for health on the Internet is that online consumers are actually using it — to look for health information, to communicate with one another and with providers about their conditions, to purchase pharmaceuticals and other health products online, and even to receive care. A Harris Interactive study in September 1999 found that 70 million of the 97 million American adults who were online had searched for health information in the past year, an increase of 10 million people in just six months.

This five-year forecast looks at three groups of online consumers: the Well, the Newly Diagnosed, and the Chronically Ill and their caregivers. It explores their use of the Internet for health-oriented content, community, commerce, and care.

Well online health consumers make up approximately 60% of the consumers searching for health information online. Because these consumers are well, they don’t often think about health. They search for preventive medicine and wellness information in the same way they look for news, stock quotes, and products.

Newly Diagnosed individuals are a smaller group of online health consumers (about 5% of the total). These individuals search frenetically and cover a lot of ground in the first few weeks following their diagnosis. Many of the Newly Diagnosed cast a wide net for online information and reach out to enlist the help of a large, diffuse network of family and friends.

Though relatively smaller in number than the Well population, the Chronically Ill and their caregivers (about 35% of the total online health consumers) have the greatest potential to affect and be affected by Internet health care provision. Many individuals living with a chronic illness actively manage that illness daily and have incorporated that management into their lives. They turn to the Internet for help.

Whether consumers are Well, Newly Diagnosed, or Chronically Ill, some key driving forces and barriers affect their interest in and use of the Internet for their health needs:

• Educated, affluent, computer-savvy people are a growing share of the population. They are more likely than others to use the Internet and to turn to it to for answers to their health questions.

• Direct-to-consumer advertising and online promotions are putting messages about health care Internet sites in front of consumers daily. Some of these messages stick and translate into online health use.

• Global information sources available on the Internet appeal to consumers who want access to a wider range of health information than their local physicians provide, and who want it 24 hours a day, seven days a week.

At the same time, some barriers are restricting the pace of development of Internet health use:

• Although groups of online consumers express different levels of concern about their privacy online, two-thirds of all online health consumers express concern about their personal privacy.

• The Digital Divide is also an online health divide. The same populations that have higher incidences of disease — minority ethnic groups, poor people, and older Americans — also are less likely to use the Internet.

• Health care is "high touch." The kinds of health services that can be delivered online are limited.

As consumer interest in the Internet for health care increases and converges with the growing capabilities of online health services, many opportunities will arise, both to improve health and for online health businesses. These opportunities fall into the categories of content, community, commerce, and care (see Table 1).

When it comes to health content for online consumers, one size does not fit all — in terms of gender, age, socio-economic status, ethnicity, health status, or medical condition. Significant content opportunities are based on targeting segments of the population with information that meets their specific needs. Among the most promising segments are women, seniors, and the Chronically Ill.

At its most basic, the Internet is a network of networks — a tool for connectivity. Internet services with large numbers of users have the critical mass to create useful online health communities. Significant opportunities exist to provide better connectivity, including links between patients and providers (at least those willing to go online), online agents to help users sort through complex information or find the best deals online, and wireless Internet services for health care. Many more opportunities will involve building communities. In addition to existing communities organized around disease states, sites may be provided for minority ethnic populations to exchange information on variations in health status and behaviors.

Perhaps the most significant opportunities in the next five years will be in the area of online health commerce. This forecast details many such opportunities. Among the most promising are electronic pharmacies, online prescriptions, online pharmacy benefits management, and online health insurance and financing.

Behaviors and Needs of Online Health Consumers