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Feb 04

The health-related terms that people type into search engines can provide great insights into what health topics people are curious about, what they’re worried about, and how they’re educating themselves.

And really, who would have guessed the phrase “Where is my liver?” is one of the top 10 searches starting with the words “where is”?


What Search Activity Tells Us About Health, Heather Dougherty (15 minutes)
Watch the video and please visit our video sponsor, Klick Pharma.

Heather Dougherty of Hitwise, an online data analytics firm, shares information and insights into the online landscape, drug recalls, and consumer behavior.

She talks about top search terms, spikes in search activity and what they mean, as well as where people are looking for information - e.g., 40% are looking at large information websites such as WebMD.

Heather concludes with 3 key takeaways:

  • Internet is prevalent in everyone’s everyday life - consumers are searching to self-diagnose and get second opinions
  • The e-trail we leave behind is rich with potential insights
  • Beware the narrative fallacy

Watch the whole video for details.

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Jan 28


Back in May 2010,, in partnership with Children’s Hospital Boston and Harvard Medical School, launched TuAnalyze, an application to allow members of TuDiabetes (and EsTuDiabetes) to track, share and compare their health information for research advancing diabetes care and public health response.

Just this week, they posted an update on the program’s progress.  In just a few short months, they have people participating from 43 countries!  Read the blog post here for details and to watch a 3 minute video about what our friends a TuDiabetes and their partners have learned so far.

Jul 15

The Pew Internet & American Life Project’s annual survey results of cell phone and wireless internet access has just been released. It shows dramatic year over year growth in the use of wireless access; now 59% of adults now access the Internet using a laptop or cell phone.

What do people do with their mobile phones?

  • Take pictures-76% now do this, up from 66% in April 2009
  • Send or receive text messages-72% vs. 65%
  • Access the internet-38% vs. 25%Play games-34% vs. 27%
  • Send or receive email-34% vs. 25%
  • Record a video-34% vs. 19%
  • Play music-33% vs. 21%
  • Send or receive instant messages-30% vs. 20%

To get the full report click here.


May 11

Some fascinating findings from Chris Schroeder, CEO of HealthCentral and James Burroughs, Associate Professor, University of Viriginia. Their research shows:

  • 20% of patients are “empowered patients”; 50% are traditional; 30% are resistant
  • Empowered patients have high self-efficacy, are problem solvers and have high needs for cognition
  • No correlation to income, education or insurance could be found for empowered patients
  • Empowered patients more likely to be social media users

Read the full article here.

May 10

The California Healthcare Foundation has released a new whitepaper, How Smartphones Are Changing Health Care for Consumers and Providers, authored by Jane Sarasohn-Kahn. Key findings include:

  • Two thirds of physicians used a smart phone in 2009
  • 6% of physicians were using an electronic medical records system
  • 42% of Americans use smartphones
  • Top uses of smartphones for consumers include: medication adherence, home monitoring, fitness apps, managing chronic conditions

Best quote in the report comes from Stanford’s B.J. Fogg, who is critical of the current design of many apps. His advice is that to change behaviors we need to “Put hot triggers in the path of a motivated person.”

Click here to read full paper.

Feb 05

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Johnson & Johnson on YouTube, Rob Halper (10 minutes) watch video

  • Who’s Watching YouTube? Everybody.
  • Health searches and views on YouTube
  • Metrics, metrics, metrics
  • Two-way interaction with viewers
  • Selling the idea internally and overcoming obstacles

for Pharma & Health Communications

Each one-day boot camp is led by Kevin Kruse and is limited to only 15 participants to maximize individual attention. Sign-up now to get a 50% early bird discount.

SAVE THE DATE: e-Patient Connections 2010!
September 27-29, 2010, Philadelphia Hyatt Bellevue

Feb 02

If you thought you were ahead of the game because you have a broadband internet connection at home or wireless on the road, The Pew Internet Project has news for you - the rest of the country is catching up. Americans in all demographics are rapidly adopting broadband and wireless, with 60% of people surveyed reporting that they’re using broadband and over half connecting wirelessly.

Overall Internet Usage Holds Steady


Pew’s most recent survey on internet, broadband, and cell phone usage took place in November and December 2009, and for the first time included interviews in Spanish. The survey found that 74% of adults in the US use the internet. Note that this is a slight drop from the same survey conducted in April 2009 which found 79% of English speaking Americans to be online.

Other findings did not vary significantly between the surveys. Both found that about 60% of adults (60% in December 2009 vs 63% in April) use broadband connections at home, and that 55% of adults in the country use wireless connections ( WiFi or WiMax) to connect from their smart phones or laptops.

Looking at the findings of Pew’s survey of internet use over the past 15 years, you can see that the number of Americans using the web has increased dramatically. And also that growth has slowed.

Wireless and Broadband Take Off

For example, overall internet usage has leveled off (73% in 2006 compared to 74% today), leading Pew to conclude that there has been “little significant growth” in the population of people using the Internet since 2006. Broadband usage in that same period, however, has increased considerably from less than half of all households being wired for broadband in 2006 to a near 60% in 2009.


Use of wireless connections is not far behind, with 55% of surveyed Americans using wireless at least occasionally. Among the 46% of the population who own a laptop 83% use Wi-Fi. The increasing trend toward internet access from everywhere is ongoing, and there is still plenty of room for growth. Although over 80% of those surveyed use mobile phones, only 35% have used their phones to access online content.

Who’s Using What?

When broken into demographic groups, Pew’s findings fall into predictable patterns. Among the 2,258 American adults who participated in the phone survey, internet use and use of broadband and wireless connections, correlated with youth, wealth, and higher levels of education.

People in households with incomes greater than $75,000 a year, college graduates, and people in the 18-29 age range have much higher wireless internet use rates than others in those groups. Suburban and urban populations also showed higher rates of use (56% and 57% respectively), to the 45% of wireless users found in rural areas.

It might seem intuitive that the expense of laptops and online services would create the biggest barrier to internet and broadband access for low income users. However, it turns out that the biggest determining factor is education. Of those without a high school degree, a mere 39% are online, compared to 60% of people in the lowest income group.  The only group that uses the Internet less is those over the age of 65. When it comes to broadband use, only 24% of those without a high school degree report using broadband connections, as compared to 46% for high school graduates, and 83% for those who graduated from college.

Putting it All Together

The big picture numbers show us that 3 out of every 4 people are online, and more and more are using wireless and high-speed broadband technologies. This is great news for people searching for health information, support, or communities online. And great news for health communicators, support networks, and others who want to reach them. But there are still gaps to be filled. Assuming these findings apply to the populations of e-patients, caregivers, and other digital health consumers, there are a lot of less affluent, less educated people that need health-related support and can’t access it online.

Dec 23

wikipedia_logoType any drug name into Google and the odds are good that a link to Wikipedia will be among the top results. According to Alexa Wikipedia has consistently been in the top-20 most visited sites on the Internet since 2006. And with 75% of American internet users turning to the web for health information, millions of e-patients will inevitably end up on a Wikipedia drug page.

But how accessible is the Wikipedia drug content for patients, given that most American adults read somewhere between a 4th and 8th grade level (National Center for Educational Statistics, 2003)? Devin Pelcher, a Pharm.D. candidate at Nova Southeastern University, addressed this in a recent talk at Medicine 2.0, entitled “Readability of the Top 50 Prescribed Drugs in Wikipedia.”

Bachelors Degree Required?
Pelcher analyzed the Wikipedia pages for the 50 most frequently prescribed drugs in the U.S., judging the relative reading difficulty of each and measuring these results against the average American comprehension level.


While the Department of Health and Human Services, using the Flesch-Kincaid Grade Level (FKGL) assessment standards, classifies anything at a reading level above grade 9 as “difficult,” Pelcher found the mean grade level of the 50 sampled drugs was 15.5–well above a high school education.

Health Information Readability Also Poor

Pelcher also used an additional readability test in order to measure certain criteria the FKGL neglects to address. This system, called the Health Information Readability Analyzer (HIReA) looks at what makes a passage easy or difficult to read. It scores  text on semantic, lexical, syntactic, cohesive, and stylistic scales running from 1.0 (very easy to read) to -1.0 (very difficult). Again, most of the most commonly prescribed drug’s Wikipedia pages were found to be well outside the reading level of most Americans.


Are Patients the Intended Audience?
While its clear that for the average reader the Wikipedia article on a given drug may be largely inscrutable in terms of basic information, its difficult to determine what the broader implications are. Wikipedia articles are “crowd-sourced” from many different people and not from any one “official” sources. And while millions of patients may end up on Wikipedia pages, the goal of the drug articles is not patient education.

Simpler Is Not Always Better
Furthermore, a close look at specific cases reveals that simpler may not be better. The page for lansoprozole, a proton-pump inhibitor found to be one of the most difficult to read, provides detailed information about interactions with other drugs, side effects, and a comprehensive list of brand names the drug is sold under. The “easiest” article, for the blood pressure medication dyazide, is a mere two lines long and omits much information crucial to an e-patient looking for an informed opinion.

Will e-Patients Write The Fix?
Pelcher’s research is a fascinating look at how language can be a barrier even in a world of democratized information, but in focusing on the inaccessibility of “difficult” pages, it may neglect that these very pages might prove to be the most comprehensive.

Wikipedia’s greatest strength is that articles are living documents, shaping themselves to meet the needs of the community. With Pelcher’s findings in hand, perhaps readability and vital details can co-exist. But it will take a knowledgeable writer to craft the solution. Perhaps a “What Every Patient Needs to Know” section or “Links for Patient Education” addition should become standard elements on Wikipedia drug pages.

If you decide to add that Wikipedia content for a drug you are familiar with, let us know.


Editor’s Note:
The original post of this article mistakenly referred to Pelcher as holding the title of Professor and mistakenly credited Pelcher with the creation of the HIReA. We regret the errors.

Dec 06

Kru Research used the ListenLogic social media monitoring platform to monitor social media comments and measure sentiment for two cholesterol lowering drugs, Lipitor and Crestor, for one month (August 2009). An influence ranking of 5+ was used to reduce the amount of spam and irrelevant posts.

The questions we sought to answer were:

1)      What is the total number of comments for each of these brands?

2)      Which sites generate the most chatter (eg, Twitter, Blogs)?

3)      What is the overall sentiment score for each brand?

4)      Is there a difference in the topics or issues that are being commented on for each brand?

Share of Voice: Lipitor beats Crestor 2.3 to 1

After tracking 180 million websites and cleaning out the promotional chatter, we see that market class leader Lipitor had 695 total mentions and Crestor had 302 mentions. Lipitor has been on the market longer than Crestor, and is considered the best selling drug in the world, so it isn’t surprising that it has more activity on the social networks.

Little Difference in Sentiment-Mostly Neutral

When you look at all the conversations and comments about Lipitor and Crestor the vast majority, about 94%, is labeled “Neutral.” This is because most mentions picked up by listening platforms has to do with general corporate news, lawsuits, and investor related articles that mention the blockbuster drugs as part of their description of Pfizer and AstraZeneca. When you look only at health related comments, the picture changes.

Lipitor’s positive sentiment was approximately 9% versus Crestor’s 1%. Negative sentiment was 27% for Lipitor and 18% for Crestor.

Another way to look at sentiment is the ratio of positive to negative comments. Using this approach Lipitor scores .33 to .05 positive to negative sentiment.

Comment Cloud Analysis

The cloud tags shown below reflect that the brand names are being used in a variety of discussions that go far beyond the management of cholesterol.


Websites with Most Activity

Using a 5+ influence rating corrects for a lot of irrelevant chatter that happens on Twitter. However, both products unfortunately have most of their social comments happening on pharma gossip site CafePharma. Major sites that these chole

Of the 695 comments for Lipitor:

  • 46 (7%) came from
  • 36 (5%) came from
  • 22 (3%) came from
  • 18 (3%) came from
  • 13 (2%) came from
  • 11 (2%) came from
  • 10 (1%) came from
  • 9 (1%) came from
  • other

Of the 302 comments related to Crestor:

  • 17 (6%) came from
  • 12 (4%) came from
  • 11 (4%) came from
  • 10 (3%) came from
  • 7 (2%) came from
  • 6 (2%) came from
  • 5 (2%) came from
  • 5 (2%) came from
  • 4 (1%) came from
Sep 23

jch_coverWe know that many patients never fill the prescriptions given to them by their physician, and fewer still are fully compliant. But what patient beliefs are major factors in adherence with drug therapy?

Kathleen Mazor, Susan Billings-Gagliardi, and Melissa Fischer tackled this question in the recent Journal of Communication in Healthcare article “Initial Acceptance of Treatment with Antihypertensive Medication; the Importance of Communication, Trust, and Beliefs.”

Although it seems obvious, it’s important to remember that for drug therapy to actually occur, a patient must accept the recommendation to start the medication.

The major finding in the study was that there are four major beliefs that impact acceptance of drug treatment:

1) trust in the physician

2) the perception that the physician communicated well

3) the belief that medication is effective

4) the belief that doctors don’t prescribe unsafe medications


Mazor’s study is not without its flaws. Data was gathered by random subjects looking at paper material, rather than an analysis of actual patient opinions of their physician and actual behavior regarding treatment initiation. Mazor herself addresses these limitations, stating that, “While it may be a shortcoming, this methodology is an efficient way to systematically test hypotheses about factors that may influence patients’ decision-making about medications.”

As I dove deeper into this issue I stumbled upon the Trust in Physician Scale which is an 11 item instrument that seems to have decent validity. I’ll have to dig deeper but to see if others have already done the studies linking trust to other “empowered patient” issues. One of the demographic factors this scale uncovered is that people over 55 are far more likely to trust their doctor than those who are younger. As the younger, more empowered (and perhaps more cynical) generation matures, the trust and therefore adherence issue will just become worst.

[What are the drivers of TRUST?]

This leads to the real issue I think which is, How can trust be increased? What are the drivers of trust?

And while physicians and other healthcare providers should certainly be interested in this question, the providers of the medication certainly have a stake in the game too. Perhaps pharma reps shouldn’t just detail physicians on the science of the medicine, but offer suggestions on how best to communicate value to appropriate patients?

What are your thoughts on increasing patients’ trust in their physicians?