Evidence-based support for the design and delivery of user-centred online public services Experiences of Europeans seeking health information in the cyberspace 21-23 Work Research Centre, Dublin c
2 Research Context and Methodology The Context - euser: "Evidence-based support for the design and delivery of user centred online public services" - A study supported by the IST programme of the European Commission under FP6 Policy context The current focus of policy makers - provision of eservices eeurope 2005 focus on provision of online health services (as one of the three of the core areas of European Information Society policy (i.e. eeurope 2005 Action Plan- government, health and lifelong learning).
3 Research Context and Research Focus The Survey (demand side analysis within the project) 9,807 respondents 10 EU old and new Member States Representative, multiple stratified random sampling Computer-assisted telephone interviews - CATI Fieldwork timing: Winter/Spring 2005 The approach ehealth related interests, needs and activity patterns user characteristics and requirements, health service access mode, and contextual factors => users experience impact - ehealth resources enabling patient empowerment (informed choice, greater patient autonomy, proactive interaction with health professionals, etc.) issues (for health professionals, policy makers, ehealth service providers)
4 Increasing prevalence of doing ehealth Search in g for h ealth in formation on In tern et (% popu lation ) 60 50 2002 2005 40 % 30 20 10 0 D E FR IT D K UK IE PL HU C Z SI O verall sam ple Source: euser, GPS 2005
5 Relative importance of the Internet Most important source of health information (% ehealth users) 100% 80% Other 60% 40% Books and magazines 20% Internet 0% DE FR IT DK UK IE PL HU CZ SI Overall sample Source: euser, GPS 2005
6 ehealth - potential for further growth Could see oneself using Internet for health information (% non-users - those currently not doing it) 90 80 70 60 50 40 30 20 10 0 DE FR IT DK UK IE PL HU CZ SI Overall sample Internet users Non Internet users Source: euser, GPS 2005
7 Preferences and barriers to ehealth Reasons for not using Internet to search for health information (% Internet users who did seek health information but not online ) 100% 80% Had no reason to look for it 60% Find the internet difficult for this 40% Did not know it could be done 20% Prefer other w ays 0% DE FR IT DK UK IE PL HU CZ SI Overall sample Source: euser, GPS 2005
8 Some ehealth use patterns - purpose of use 6 0 T y pe s of inf or ma tion s ea r ch e d f or on line ( % p o pu la tio n) 5 0 4 0 H e al th y l ifes ty le S p ec ific h ea lth i s s ue H e al th se rvi c e s % 3 0 2 0 1 0 0 D E F R IT D K U K IE P L H U C Z S I O ve ra ll s a m pl e Source: euser, GPS 2005
Empowerment potential - perceived usefulness of the Net 9 100% Usefulness of Internet for getting health information needed (% ehealth users) 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% DE FR IT DK UK IE PL HU CZ SI Overall sam ple not at all useful a little / somewhat quite / very useful Source: euser, GPS 2005
80.0 70.0 60.0 Empowerment potential - informed patient? Net-based empowerment? (base =ehealth users) Prepare before a visit Follow-up after a visit Both prepare and follow up 10 50.0 40.0 30.0 20.0 10.0 0.0 DE FR IT DK UK IE PL HU CZ SI Overall sample Source: euser, GPS 2005
ehealth use impact - empowered for decision making? 11 40 35 30 Made own decision as a result of information found on Internet (% those who searched online for health information) decided not to follow doctor's advice decided could treat self instead of going to doctor changed lifestyle significantly 25 % 20 15 10 5 0 DE FR IT DK UK IE PL HU CZ SI Overall sam ple Base: ehealth users Source: euser, GPS 2005
12 But User Beware! Have come across health information or advice that was obviously ong 25 20 15 % 10 5 0 DE FR IT DK UK IE PL HU CZ SL Overall sample Base: ehealth users Source: euser, GPS 2005
13 How are ehealth resources found? ehealth seeking patterns (% of ehealth seekers) 90 80 70 60 50 40 30 20 10 0 DE FR IT DK UK IE PL HU CZ SI Overall sample Use a search engine Use links from general portals Go directly to a specialised health site
Usage of, and interest in, ICT mediated consultations with doctors 14 Consultation with doctor by telephone and email (% population) 60 50 40 Phone e-mail % 30 20 10 0 DE FR IT DK UK IE PL HU CZ SI Overall sample Source: euser, GPS 2005
15 Information seeking - media channel used 60.0 Information seeking modes / media used (base = population) 50.0 40.0 Percent 30.0 20.0 10.0 0.0 DE FR IT DK UK IE PL HU CZ SI Overall Using the Internet, self-directed Using telephone services Using interactive online health resources sample Source: euser, GPS 2005
M a n a g e rs a n d p ro fe ssio n a ls W e ll e d u c a t e d n o n - ma n u a l & skille d S kille d wo rke rs / n o n - ma n u a l U n skille d ma n u a l & o t h e rs ehealth divides - overall... Profile of ehealth users (% population) -age, gender, education, employment, income, occupation 16 a b o ve me d ia n (e q u iva lise d ) b e t we e n t h re sh. a n d me d ia n (e q u iv.) b e lo w p o ve rt y t h re sh. (e q u iv.) re t ire d o r n o t wo rkin g (6 5 + ) e a rly re t ire d, p e rma n e n t in va lid it y (1 8-6 4 ) o t h e r n o t wo rkin g (1 8-6 4 ) u n e mp lo ye d (1 8-6 4 ) a c t ive t e rt ia ry (2 1 + ) h ig h e r se c o n d a ry (1 7-2 0 ) lo we r se c o n d a ry (1 5-1 6 ) p rima ry o r lo we r se c o n d a ry (< 1 5 ) fe ma le ma le 6 5 + 5 0-6 4 2 5-4 9 1 8-2 4 0 10 20 30 40 50 60
Profile of users: ehealth - an equalising potential? Profile of ehealth users (% Internet users) (age, gender, education, employment, income, occupation) 17 Ma na ge rs a nd profe ssiona ls We ll e duc a te d non- ma nua l & skille d S kille d worke rs / non- ma nua l Unskille d ma nua l & othe rs a bove me dia n (e quiva lise d) be twe e n thre sh. a nd me dia n (e quiv.) be low pove rty thre sh. (e quiv.) re tire d or not working (6 5 +) e a rly re tire d, pe rma ne nt inva lidity (1 8-6 4 ) othe r not working (1 8-6 4 ) une mploye d (1 8-6 4 ) a c tive te rtia ry (2 1 +) highe r se c onda ry (1 7-2 0 ) lowe r se c onda ry (1 5-1 6 ) prima ry or lowe r se c onda ry (<1 5 ) fe ma le ma le 6 5 + 5 0-6 4 2 5-4 9 1 8-2 4 0 10 20 30 40 50 60 70 80 90
18 Conclusions Across Europe, the prevalence of utilising online health resources is quite high, having increased substantially there is a further potential for wider use - interest of citizens / patients in using online ehealth services is apparently high a mixed picture with regard to user support / guidance a potential for empowerment and some evidence of actual empowerment issues for public health policy, health professionals and service providers a potential for equalisation - ehealth resources assisting policy making? for those relatively more at risk in general (social exclusion perspective) barriers and user support
19 Acknowledgements Project cofunded by the European Commission SIXTH FRAMEWORK PROGRAMME PRIORITY 1.1.2 Information Society Technologies empirica Gesellschaft für Kommunikations- und Technologieforschung mbh (Project Co-ordinator) Work Research Centre Ltd. Dublin, Ireland Danish Technological Institute Center for Competence and IT University of British Columbia, Vancouver, BC, Canada Foundation for Research and Technology Hellas Institute of Computer Science National Research Council Canada, Saint John, New Brunswick, Canada
20 Thank you for your attention! More information: or contact www.euser-eu.org Work Research Centre Ltd. 1 Greenlea Drive, Terenure 6W, Dublin, Ireland or empirica mbg Oxfordstr. 2 D-53111 Bonn (Project Co-ordinator) E-mail contact: i.milicevic@c-research.ie; k.cullen@c-research.ie E-mail contact: euser@empirica.com