Internet Usage Among Seniors and Patients

I think it’s only fitting to begin this blog with some real data. Probably one of the most comprehensive and trusted (at least by me) sources has been the Pew Internet and American Life Project from the Pew Research Center. Lead by Susannah Fox, the project produces some of the most pertinent data related to Internet usage I’ve ever found. And one of their latest reports is enlightening.

I will first confess a bias … in many places within the online mHealth community, people are encouraged to ignore the perception that older people don’t use the Internet. I’ve always felt that advocates for this perspective are letting their availability bias cloud their judgment. Everyone knows or has a progressive older relative. You know, the iPhone using Grandma, or the Skype-using Grandpa. But my job offers me the opportunity to interact directly (face-to-face or via phone) with dozens of real patients living with one or more chronic conditions (usually diabetes or hypertension) and indirectly with hundreds more. And my experience tells me a few things.

  • These patients are usually older.
  • Few use a computer.
  • Fewer still are interested in learning to use a computer or smartphone.
  • Among those who use a computer, usually it’s only for a specific task like e-mail. Introducing new uses is difficult.

So I’ve carried around a bit of guilt, wondering if I was biased or if our population of patients was somehow different.

In December, Susannah Fox posted on the blog something that helped confirm my impression:

My next report will focus on internet use among adults living with chronic diseases (with a special focus on diabetes, heart conditions, lung conditions, high blood pressure, and/or cancer).  The last time I took a look at this group was in 2007, when we asked a broader question to define e-patients living with a disability or chronic disease. No matter which way we slice the population, though, I can tell you that internet access is still low among people challenged by health problems. Not much has changed in two years.

This was a disappointing, though expected statement for me. And when Pew released the full report a few days ago, I believe that my impressions were correct — in the population of older, possibly chronically ill Americans, Internet usage and mobile technology usage is low.

I encourage you to read the report. One additional data point important for mHealth is:

just 16% of U.S. adults age 65 and older go online wirelessly, via a laptop or handheld device. By contrast, 55% of all adults connect to the internet wirelessly.

This is not as discouraging at it seems at first. Rather than give up, this information has helped confirm my strategy. I interpret these numbers in the context of “active” Internet users or “active” wireless users. I still believe deeply in the power of mHealth and wireless technologies to change the lives of chronically ill patients and to improve the relationship between patients and their providers, but I think the immediate future requires passive mHealth devices, rather than active mHealth solutions. Think of the Kindle from Amazon … how many users do you think really know that the Kindle is powered by the Sprint EVDO data network? I’ll bet less than 30% … yet the device is a paradigm-shifting mobile device. Kindle owners don’t have to care about the wireless connectivity … after an initial activation, it just works wherever there is signal. I believe the immediate future of mHealth needs to work like this. Healthcare devices need to just work with a minimum of action required by the patient.


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