Wall Street Journal (May 18, 2005).

Web Grows as Health-Research Tool.

By LAURA LANDRO

A survivor of childhood polio, Lynn Lekander became worried that she might be at risk for post-polio syndrome, and went online to research the debilitating condition, which can strike 10 to 40 years after recovery. On a Web site called postpolio.org, she found an expert close to home -- Nicolas E. Walsh, chairman of the department of rehabilitation medicine at the University of Texas Health Science Center at San Antonio -- and emailed him to set up a consultation.

Increasingly, Americans like Ms. Lekander are using the Web to find the right doctor or research the quality of care at their local hospitals: last year 42% of Internet users with a college degree reported that they have looked for information about a particular doctor or hospital, a sharp increase from just 27% who sought such information in 2002, according to a survey from the nonprofit Pew Internet and American Life Project, which is due to be released today. Among all Internet users, such searches increased to 28% from 21%.

The survey, part of a Pew Research Center initiative that studies the impact of the Internet on families, communities and other elements of daily life, paints an encouraging picture of ever-savvier health-care consumers, who are researching doctors, paying attention to warnings about obesity and poor nutrition,

considering entering clinical trials in greater numbers, and taking steps to better manage their health-care costs. Since the survey was first released in 2002, the fastest-growing topics of interest for online health searches include these key subjects: information on doctors and hospitals; diet and nutrition, and vitamins; experimental treatments; health-insurance coverage; and prescription and over-the-counter drugs. The survey is available at www.Pewinternet.org.

By reflecting Americans' shifting priorities in health care, the Pew findings may help provide a road map for employers, health plans, and patient advocates looking to provide better health information for consumers in the future. But the survey also raises concerns about a new digital divide, between more educated and affluent Internet users with high-speed broadband access -- about half of all Internet users at home -- and less educated or older health consumers with slower dial-up connections who are less likely to have sought various kinds of health information online. For example, 41% of home broadband users have searched for information about a doctor or hospital, compared with 19% of dial-up users. And broadband users are more likely to turn to the Internet first when they have a health question, rather than turning to a doctor.

Though the overall number of Internet users going online for health information hasn't changed much in the past two years -- about 100 million, or eight in 10 Internet users -- many "power users" with six or more years of online experience are turning to the Web not only when they have a pressing concern, but also when they have everyday sort of questions, such as how to get fit, how to eat well, or to check if something is covered by their health insurance, Pew says.

"Everyone knows that if there is a health crisis in your life, or a new symptom, or diagnosis or prescription drug, that you can go online and do a quick search," says Susannah Fox, associate director of the Pew project. "But the difference now is that Internet users are going online to do their health homework on things like wellness and prevention."

Of course, there are still gaps in the quality of such information online. A recent survey of large employers by Health2 Resources, a health-care marketing firm, found that the online tools available for consumers to evaluate and choose health care just scratch the surface of what companies would like to use to educate employees about their health, communicate with disease and care-management providers, and even help workers change unhealthy behaviors. And when it comes to finding information about doctors, "you can get information on credentials, training, experience, etc., but not much on outcomes or quality," says Don Kemper, chairman of nonprofit Healthwise, which provides consumer-health information for health plans, hospitals and doctors.

Still, consumers are having more luck using the Web to find medical experts when they need them, without necessarily waiting for a referral or asking a friend or relative for a recommendation. Survey respondents told of finding doctors by reading medical journals online, such as a woman in her 60s whose symptoms were undiagnosed for a decade before she finally found, in an online medical-journal article, the name of the doctor who ultimately diagnosed her illness and "started me on the road to better health." Ms. Lekander, the polio survivor, says Dr. Walsh has provided her with "recommendations for how I can live my life and what I need to be mindful of." The 56-year old has since started seeing a personal trainer to build her strength.

And clearly, doctors are becoming more receptive to patients who find them via the Internet. Dr. Walsh says that while most of his patients are referred by their primary care doctor or a specialist, recently he has started getting more inquiries via email from patients who find his name on the post-polio group's Web site. And he occasionally even uses the Web site himself to find the closest health-care provider for patients who contact him from other states.