How patients’ Google search histories could lead to better care

A cursor moves over Google's search engine page on Tuesday, Aug. 28, 2018, in Portland, Ore. (Don Ryan/AP Photo)

A cursor moves over Google's search engine page on Tuesday, Aug. 28, 2018, in Portland, Ore. (Don Ryan/AP Photo)

Patients’ search histories could be the key to delivering better health care, according to a new study by Penn Medicine researchers.

The study, which was recently published in the journal BMJ Open, found that health-related searches double in the week before an emergency-room visit. Pairing those searches with a patient’s electronic health records reveals gaps in patient communication and care.

“These patterns could suggest that we could know more about what our patients want before they come to the hospital,” said the study’s lead author, Jeremy Asch. “And therefore we can anticipate needing to deal with these problems.”

As an example, the study tells the story of one woman whose recent searches included: “How big is a walnut?” followed by “What is a fibrous tumor?”

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An examination of the patient’s electronic medical records showed that she’d recently been diagnosed with — you guessed it — a walnut-sized fibrous tumor.

“That really kind of struck a chord with us,” Asch said. “Patients may not know what questions they want to ask, or they don’t want to seem silly asking their doctor, ‘How big is a walnut?’ So it’s much safer for them to Google those things.”

The study came about as part of a larger project by Penn’s Center for Digital Health centered on what it calls the “social mediome” — a play on the term “genome” that refers to the unique digital footprints created by our interactions with social media and other online platforms.

Previous studies have shown that social media posts can help predict diagnoses of depression. Researchers wanted to know if they could leverage the comparatively private data of Google searches to improve patient diagnoses and care at the hospital.

“Patients search all the time for symptoms,” Asch said, “and we thought maybe this would be interesting information to look at and see what those pattern changes were around hospitalizations.”

Specifically, they wanted to know three things:

  • Would patients share their search data and electronic health records?
  • Would their search patterns change in the days or weeks leading up to emergency-room visits?
  • And, what do patients search for?

To conduct the study, research assistants talked to 703 patients seeking treatment in the emergency department and asked if they’d be willing to share their Google search data in exchange for a chance at winning a $40 gift card. Patients would be allowed to review the data beforehand and censor any searches they wished (though none did).

Of the 703 patients approached, around 50 percent of eligible patients agreed to share their data, for a final group of 103 people.

Researchers would later spend several months reading and logging the resulting 600,000 queries to create a picture of the patients’ Google patterns.

They found that, in keeping with Google’s own research, people’s health-related queries accounted for 6 percent of their overall searches — a figure that jumped to 16 percent in the week before an emergency-room visit.

Asch sees that window of increased activity as an opportunity for research into the kinds of questions patients are asking, both about their health and about health care.

“Knowing that people use this platform as a way of discovering more, or asking more questions about their own health, shows us that we can also use this platform as a way of interacting with our patients,” Asch said. “And while it’s difficult to know exactly how we would access that data, it’s more about knowing what those questions are, and learning about what does somebody want to know before they come into the hospital? And if we know that, we can make systematic changes throughout the hospital environment to better serve their needs.”

Search data could even play a clinical role in diagnosis, Asch said  — though he adds those days are likely a long way off.

“I don’t think that I foresee a future where you come into the hospital and a doctor says, ‘I’d love to take a look at your Google searches,’ ” he said. “It’s so much data, and it would take so much time to comb through that.”

Instead, he said, analysis of that data could be automated, and the results delivered to doctors as a supplement to what their patients are telling them.

On a more general level, Google searches can help researchers better understand their patients and their health.

“This Google study is one step in kind of a larger project of how do patients interact online, or how do they ask questions about their health,” Asch said. “And how can we kind of meet them where they are instead of waiting for somebody to come into the hospital, and finding out in that moment what needs to be done.”

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