"We can now add chronic disease to the list of attributes which have an independent, negative effect on someone’s likelihood to have Internet access, along with age, education, and income level," says Kristen Purcell, an associate director of the Pew Internet Project and a co-author of the report.

The Internet access gap creates an online health information gap. More than any other group, people living with chronic disease are strongly connected to offline sources of medical information and assistance such as health professionals, friends, family, and books. Once they have Internet access, people living with chronic disease report significant benefits from the health resources found online.

Overall, 51 percent of American adults living with chronic disease have looked online for health information about a specific disease, a certain medical procedure, or health insurance. By comparison, 66 percent of adults who have no chronic conditions use the Internet to gather health information.

Lack of Internet access, not lack of interest in the topic, is the main reason for the gaps. Pew says when demographic factors are controlled, Internet users living with chronic disease are slightly more likely than other Internet users to access health information online.

"The deck is stacked against people living with chronic disease. They are disproportionately offline. They often have complicated health issues, not easily solved by the addition of even the best, most reliable, medical advice," says Susannah Fox, an associate director of the Pew Internet Project and a co-author of the report.

"But those who are online have a trump card. They have each other. Those who have access use the internet like a secret weapon, unearthing and sharing nuggets of information found online."
 

The majority (83%) of people looking for health information online indicate their search was successful and almost half (45%) say it was "very successful."

An even larger majority (87%) believes that this information was reliable, but only 28 percent said it was "very reliable."

Nearly half (44%) of health searchers have discussed the information the found online with their doctors, but that number is lower than the 58 percent Harris reported in 2007. In addition, 49 percent have searched for information online based on discussions they had with their doctors.

The poll found the number of people searching for health information online had not increased in two years. One reason is that the proportion of adults who are online, which rose rapidly from 38 percent in 1998 to 79 percent in 2007, has not increased for the last two years.

Another reason is that the proportion of those online that have used the Internet to look for health information has remained steady, varying only from 71 percent to 84 percent over the last eleven year.

"The Internet continues to provide a large majority of the public with information about health or health care that they find useful and reliable," the poll concludes.

"The Internet is surely helping to inform the public about health and health care and to stimulate discussions between doctors and patients that probably improve the doctor-patient relationship."

Health information websites such as WebMD were rated as the most popular destinations to view health information videos (43%) followed by pharmaceutical websites (14%), video sharing sites (9%) and social networking sites (6%).

Mary Murcko

User generated websites are also a popular resource for consumers. The survey found that 55 percent searches these sites for health-related information. This indicates that consumers value personal health experiences of average individuals along with trustworthy medical websites.

 36% searched healthcare information on Wikipedia.com
 36% read online forums, message boards on health-related topics
 27% read a blog on health-related topics

"Consumers are now the gatekeepers when it comes to their own personal healthcare issues," said Mary Murcko, SVP/Publisher of Prevention.

"Unlike years past, today’s consumers are empowered by knowledge and seek the research to make informative health decisions for themselves and their families."

Other key findings include:  

Online health searching does make its way into conversations with their doctor: 
                                                                                   

37% have discussed medical information they found online with their doctor 
 

The majority of consumers report positive effects: 
 

 57% said it was positive, it helped our conversation 
 7% said it was negative
33% said it was neutral (it didn’t help or hurt their conversation)

The application called the "Mayo Clinic Health Manager" allows users to organize health information for multiple family members, access information from one location, and proactively manage their health.

Powered by Microsoft HealthVault, Mayo Clinic Health Manager allows users to store health records from their providers, pharmacies, schools, employers and upload the information from home health devices.

The application also sends reminders and recommendations specific to each family members health status. The more personal health information a person enters the more customized the reminders and recommendations become.

"Mayo Clinic Health Manager can help patients share information more easily with their doctors and manage their own health better between office visits," said Sidna Tulledge-Scheitel, M.D., a primary care physician at Mayo Clinic’s campus in Rochester and medical director of Mayo Clinic Global Products and Services

 "Mayo Clinic Health Manager is easy to use, with features designed for busy parents, adults who are managing the health concerns of aging parents, and patients managing chronic conditions and multiple medications. Since the data is stored in Microsoft HealthVault, people can access their information whenever they need it – regardless of whether they change doctors, clinics, jobs or insurance plans."

Initially, Mayo Clinic Health Manager will include tools that help manage: pediatric wellness, immunizations, adult wellness, pregnancy and asthma. Additional tools will be introduced in the coming months.

More than three quarters of people said health care professionals are their most trusted health resource but Internet resources are considered more trustworthy than friends/coworkers, pharmaceutical companies and television.

Thirty-four percent of health searchers use social media resources to research health related topics, with Wikipedia, and online forums and message boards the most important individual tools. Social media attracts 18-to-34 year old health searchers in particular, while men over all are more likely than women to use online social media to research health issues.

Two-thirds of online adults have used general search engines such as Google and Yahoo to find health related information. Usage of health specific search engines such as Healia and Medstory is minimal by comparison.

The study concludes," To take full advantage of opportunities to connect with in-market health consumers, content must be available in and optimized for a range of formats, and ideally should comprise a truly interactive component that allows consumers to socialize."

"In order to maximize relevancy, content should be oriented around the health topics that most preoccupy consumers, such as symptoms, treatment, conditions and wellness issues including exercise, nutrition and weight loss."
 

The study found that the Internet was a more popular resource for health information than traditional media such as newspapers /magazines (30%), television (26%) and books (25%).

Along with this research, Ask.com has introduced Health Smart Answers that help people find health and medical information. Smart Answers are search results placed at the top of the results page that offer editorially- selected information and links to content.

The study also found that 73 percent of adults want to be more informed about their personal health along with the well being of friends and family. Two-thirds of Americans search to find information to help them diagnose or better understand a condition, and over half say they do the same for friends and family (55%).

"With so many Americans looking for health information online, it is critical that search engines make it easy for people to get reliable and accurate information," said Doug Leeds, vice president of product management at Ask.com.

"Our new Health Smart Answers provide quick access to trusted information searchers are looking for, right at the top of the search results page. While other search engines require people to ‘hunt and peck’ through an ocean of web links, Ask.com makes it easy to find the best information quickly."

The survey found that consumers who do online medical and drug research usually prefer general health Web sites (54 %) and specific illness focused sites (37%) over pharmaceutical company sites (4 %).

The survey also examined the frequency of conducting online health-related research. The majority (40%) said they had done online research only two times or less in the last six months, 33 percent said they did research at lest once-a-month and 27 percent said they did research every other month.

When they were asked what would make them interested in specific drug treatments for their ailments, the majority said drug samples (55%), followed by e-newsletters to help them learn more (35%) and coupons (10%) as the most popular incentives.

"What’s particularly interesting is the low number of consumers who rely on pharmaceutical sites for information, indicating that brand managers need to find new ways to peak consumer interest and engage them," said Jere Doyle, President and CEO of Prospectiv.

"Educational e-newsletters, health-focused web sites and micro-sites focused on specific ailments have proved very effective in this regard. The first step toward initiating these online resources is for brand managers to build an in-house database of self-profiled consumers who have expressed an interest in learning more about their treatment options."

In all, says the company, 3,500 symptoms and 900 diseases are documented. Healthline says that’s ten times the number of symptoms covered by WebMD or MayoClinic.

It seems simple enough. A person types in a symptom or collection of symptoms and the engine brings back all matching diagnoses. My main symptom brought back three pages of results. It’s probably the first one. Visitors can also keep a personalized list of symptoms to help narrow down the results.

“As a physician and heavy Internet user, I know that my patients are increasingly using the Web to research symptoms – it’s a great way, in the privacy of your own home, to explore topics you think you may want to talk to your doctor about,” said Enoch Choi, M.D., a family practice physician based in Palo Alto, Calif.

Healthline, a company that prides itself on its walled garden approach to health research by including only doctor-reviewed articles instead of the entirety of Web sources. The company says its new Symptom Search is set apart from other research tools because it uses a search-driven approach rather than static "interview formats," which, according to their numbers, only retrieve one-tenth of the number of symptoms and one-fifth of the number of possible causes.

Similar to Google’s Suggest feature, Symptom Search has a type-ahead feature that suggests ways to narrow it down. For example, if a person types in "cough," types of coughs like "painful cough" or "hacking cough" will be presented.

“Symptom Search offers a much more interactive, useful way for individuals to research health concerns, helping prepare them for conversations with their physicians,” said Paul Auerbach, M.D., clinical professor of Emergency Medicine at Stanford University and chair of Healthline’s Medical Advisory Board.

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Although 80 percent of American Internet users (113 million adults) have searched for one of Pew Internet’s seventeen health topics, nearly the same number (75%) trust the information they find online without noting the source or checking the date of the information.

Repeat: Three-quarters of those seeking health information online check the source and date of health information “only sometimes,” “hardly ever,” or “never.” 100 million people almost completely trust the health information they find online.

Surprisingly, only three percent report bad outcomes from the information, and nearly a third (31%) say they know someone who was helped significantly by information they found online.

Of course, Penn and Teller will tell you that the majority of the people at the mall can be fooled into believing that snail slime is good for the skin. But that’s just people at the mall, who perhaps have country roots reminding them that Robitussin is no match for a 40-year-old bottle of homemade whiskey and rock candy; those same ones who have a vague recollection of their grandfather shoving a wad of recently chewed tobacco into a wound as anesthesia.

Interest in alternative medicine though, according to Pew, has declined over the past couple of years, as users turn back to more accepted medical practices. Alternative treatments and medicine searches peaked in 2004, with 30 percent of respondents saying they had searched for it. That dropped to 27 percent in August 2006.

Users are focusing mostly on specific diseases or medical problems (64%), certain medical treatments or procedures (51%), and diet and nutrition (49%). Interestingly, it seems research on a particular doctor or hospital has been steadily on the rise, increasing from 21 percent in 2002 to 29 percent in 2006.

Ten million Americans are searching for health information on a daily basis, placing health sites in the same league as bill-paying, blog-reading, and directory information. Most of them (66%) begin their research with a search engine. Hitwise reported recently that Health and Medical websites receive over 43 percent of their traffic from search.

Nearly three-quarters (72%) of health information seekers visit more two or more sites during their sessions, so at least they’re consulting several sources – especially since almost half of them (48%) are seeking information on behalf of a loved one.

More than half (53%) say online information had an impact on how they handle health issues; 58 percent say online information influenced a decision about how to treat an illness; 55 percent say online information changed their overall approach to maintaining their health.

The vast majority (74%) of respondents felt reassured by the information they found – so much so that over half (51%) were eager to spread the information around. But again, only a few of them really checked their sources. Fifteen percent “always” check the source and date. Only 10 percent said “most of the time.”

Pew blames health websites for the “diminished diligence” in checking sources and dates. The US Department of Health and Human Services reported that just four percent of popular websites disclose their sources. Just two percent said how the content is updated.

Because of sheep-like trust of online health information seekers, new types of sites and search services may find an important niche – a controlled virtual medical environment may one day prove more valuable than traditional search with paid inclusion, relevancy gaming, and the like.

Healthline.com, for example, is a walled garden of sorts for health information. In addition to articles on various health issues that were written by doctors, Healthline also searches only what are considered the top medical sites on the Web.

Though it may not be happening now, as the population gets more Net-research savvy, niche sites like Healthline will become valuable resources to help weed out potentially false or out of date information.

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