1. Access to Online Healthcare Information and Services

2. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Contents Key Findings3 Statewide Broadband Adoption and Utilization Benchmarks4 Online Healthcare Information and Services8 Broadband Bridges the Divide in Access11 Public Health Benefits Linked to Online Healthcare22 Methodology and Sample Profile27 Attribution31

3. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Key Findings Broadband Adoption Benchmarks: Adults in Kentucky with broadband Internet access at home:44% U.S. Comparison (Pew Internet & American Life Project, Mar. 2007)47% Key Findings: Online Healthcare Information and Services More than one-half (51%) of adult residents access the Internet for healthcare information or to communicate with medical practitioners. –This proportion increases to 79% among residents with broadband service at home. Among broadband users, the share who obtain healthcare information online increased by 24 percentage points between 2005 and 2007. Without broadband service, usage rates for healthcare information and services among broadband users would be similar to that of today’s dial-up users. Broadband service at home narrows disparities in access to health and medical information often seen among relatively disadvantaged residents. Kentucky residents with broadband access in the home have saved an estimated $109 million in healthcare costs and avoided 3.7 million unnecessary office and ER visits as a direct result of having easy access to healthcare information and services online.

4. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Statewide Broadband Adoption and Utilization Benchmarks

5. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Broadband Access Q: Which of the following describe the type of Internet service you have at home? n=10,830 KY respondents in 2007 The share of households with broadband access has risen to 44%, up from just 32% near the end of 2005. In absolute terms, this converts to approximately 1.4 million adult residents and 720,000 households. Trends in residential broadband access

6. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Q: Which of the following describe the type of Internet service you have at home? n=10,830 KY respondents in 2007 Just over 20% of adults are still using dial-up service at home. Type of Internet access at home Broadband Access

7. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Broadband Internet Access

8. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Type of Broadband Access Q: Which of the following describes the broadband service you have at home? n=3,776 KY residents with broadband access at home in 2007 * Not captured in 2005 DSL and cable modem services are still the leading forms of broadband access in the state. Type of broadband accessTrend in residential broadband access

9. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare Information & Services

10. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare Applications * Not included in “any healthcare” More than half (51%) of adult residents access the Internet for healthcare information and services. This proportion increases to 79% among residents with broadband service at home. Percent of KY adult residents using Internet for healthcare applications in 2007 Q: Which of the following types of information have you used the Internet to look for online? Q: Which of the following types of individuals or organizations have you interacted with online, by visiting a website or communicating online to obtain information? n=10,830 KY residents and n=3,776 KY residents with broadband at home One-fourth of residents use the Internet for health insurance information.

11. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org * Not included in “any healthcare” Q: Which of the following types of information have you used the Internet to look for online? n=10,830 KY residents in 2007 and n=10,482 KY residents in 2005 Among broadband users, the share who obtain healthcare information online increased by 24 percentage points, from 54% of broadband users in 2005 to 78% of broadband users in 2007. Percent that get health or medical information online Online Healthcare Applications

12. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org *Defined as actual usage minus the share of users who say the application would “not be worthwhile” without their broadband service. Q: Which of the following types of information have you used the Internet to look for online? Q: Which of the following types of individuals or organizations have you interacted with online, by visiting a website or communicating online to obtain information? n=3,776 KY residents with broadband at home and n=2,701 respondents with dial-up access Online Healthcare Applications With and Without Broadband Service Without broadband service, the share of broadband enabled residents who use the Internet for healthcare applications would be similar to that of today’s dial-up users. Healthcare applications used by dial-up and broadband enabled residents

13. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Broadband Access Bridges a Divide in Access to Healthcare Information

14. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare by Age   indicates statistically significant difference relative to the total (at 95% confidence)      With broadband at home, the age gap in usage is reduced as more than two-thirds of seniors with broadband use the Internet for healthcare information. A majority of all adults aged 25 to 54 use the Internet for healthcare applications in Kentucky, but only 24% of residents age 65 or older do the same. Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications

15. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare by Gender and Age        Men are less likely than women to use the Internet for healthcare information and services. With broadband at home, the gender gap in usage almost disappears across all age brackets.  indicates statistically significant difference relative to the total (at 95% confidence) Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

16. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare by Marital Status    indicates statistically significant difference relative to the total (at 95% confidence) Married residents are more likely to access healthcare services online, than residents who are single, separated, divorced or widowed. With broadband at home, this gap in service usage is reduced, and a majority of unmarried residents use the Internet to access healthcare information and services. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home     

17. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Online Healthcare Applications by Presence of Children        indicates statistically significant difference relative to the total (at 95% confidence) Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Parents are more likely than non-parents to use the Internet for healthcare information and services, particularly those who are married with kids. With broadband at home, the disparity still exists, but it is greatly reduced. Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

18. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org         indicates statistically significant difference relative to the total (at 95% confidence) Online Healthcare Applications by Employment Status Retired, unemployed and disabled residents are significantly less likely to use the Internet for accessing healthcare information and services. With broadband at home, these groups are more than twice as likely to use the Internet for healthcare applications. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

19. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org           indicates statistically significant difference relative to the total (at 95% confidence) Online Healthcare Applications by Educational Attainment College graduates are more than twelve times as likely to use the Internet for access to healthcare advice as residents with an eighth grade education or less. With broadband at home, this gap is reduced significantly. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

20. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org         indicates statistically significant difference relative to the total (at 95% confidence) Online Healthcare Applications by Household Income Residents with household incomes less than $35,000 per year are significantly less likely to access healthcare information and services online. With broadband at home, the income-driven disparities are almost eliminated. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

21. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org       indicates statistically significant difference relative to the total (at 95% confidence) In general, African Americans and residents of other ethnicities are significantly less likely to access healthcare information and services online. With broadband at home, disparities still exist but are less severe. Online Healthcare Applications by Ethnicity Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

22. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org     indicates statistically significant difference relative to the total (at 95% confidence) Online Healthcare Applications by Urban/Rural Geography Use of the Internet for accessing healthcare information and services is highest among urban and suburban residents and lowest among residents in rural counties. With broadband at home, there is no geography- driven disparity in usage. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

23. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org     indicates statistically significant difference relative to the total (at 95% confidence) A below average share of residents in congressional district 5 use the Internet to obtain healthcare information or services. With broadband at home, at least 3 out of 4 residents in all congressional districts use the Internet for healthcare information. Use of Internet for healthcare applications among broadband enabled KY residents Percent of KY residents using the Internet for healthcare applications Online Healthcare Applications by Congressional District Q: Which of the following types of information have you used the Internet to look for online? n=6,050 KY residents with Internet access at home and n= n=3,776 KY residents with broadband at home

24. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Public Health Benefits Linked to Improved Access to Online Healthcare Information

25. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Becoming Healthier n=191 respondents with broadband service at home who obtain healthcare information online or communicate with healthcare providers “Obtaining healthcare info. online has empowered me to be healthier” Among broadband subscribers who obtain healthcare information online, 72% agree that obtaining healthcare information online has empowered them to be healthier. More than half (62%) of individuals who became healthier also report saving money, with average reported savings of $217 per person. Has becoming healthier in this way saved you money?

26. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Becoming Healthier Cost savings data are from Internet users in the statewide control sample who obtain health information and/or interact online with healthcare professionals: n=191 with broadband, 76 with dial-up and 31 with access out of home. Broadband users who obtain healthcare information online are somewhat more likely to agree that doing so has made them healthier. About six out of ten people who become healthier in this way save money. As a result, about $236 million in savings can be attributed to the Internet, including $109 million to broadband in the home.

27. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Prevention of Unnecessary Trips to Obtain Medical Care n=191 respondents with broadband service at home who obtain healthcare information online or communicate with healthcare providers Among broadband subscribers who obtain healthcare information online, nearly half (47%) agree that obtaining this information online has prevented trips to the doctor, a hospital or a medical center. “Obtaining healthcare info. online has prevented trips to my healthcare provider” How many trips were prevented? Mean: 4.2 trips/Median: 2 trips On average, these residents avoided 4.2 “unnecessary” trips to receive medical care.

28. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Cost savings data are from Internet users in the statewide control sample who obtain health information and/or interact online with healthcare professionals: n=191 with broadband, 76 with dial-up and 31 with access out of home. Prevention of Unnecessary Trips to Obtain Medical Care Nearly half (47%) of broadband users who obtain healthcare information online agree that doing so has helped them avoid trips to obtain medical care, and 31% say they have avoided unnecessary trips to an emergency room. As a result, as many as 3.7 million unnecessary office and ER visits have been avoided.

29. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Methodology and Sample Demographics

30. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Methodology Data were collected by telephone, through live computer assisted interviews from a statewide random digit dial (RDD) sample 10,830 households contacted between August 10 and September 22, 2007. –This research was designed to measure consumer technology indicators at the county level for all 120 counties in the state. Approximately 85 interviews were completed in each county, with a total of 10,225 interviews completed in this fashion. –An additional demographically representative statewide sample of 605 adult residents was completed to gather some additional details at the statewide level. The questionnaire screened to include only adults age 18 or older, with quotas set by gender and age to insure adequate representation of all adults in each county sample as well as the statewide control sample. Weights were applied to each county’s survey sample to match the most recent population Census estimates by age and gender. –Additional weights are applied to the combined statewide sample of 10,830 to account for the relative size of each county to use for statewide benchmarking purposes. Sampling error: –Total survey sample (n=10,830): +1.7% at the 95% level of confidence –Each county (n=~85): +10.7% at the 95% level of confidence. –Statewide control sample (n=605): +4.1% at the 95% level of confidence. * Sample error accounts for weighting, using the “effective sample size.”

31. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Total Survey Sample (n=10,830) Gender:Employment Status: Male48%Employed full or part time57% Female52%Retired20% Age:Homemaker not employed outside home7% 18 to 247%Student not working for wages1% 25 to 3423%Unemployed, disability, other12% 35 to 4417%No answer/refused3% 45 to 5422%Educational Attainment: 55 to 6414%Did not graduate high school13% 65 or older17%High school graduate31% Mean age (years)47.0Some college25% Median age (years)46.0College graduate or higher28% Region of the State:No answer /refused3% North Central47%Household Income: Eastern KY33%Under $25,00022% South Central KY11%$25,000 to $49,99925% Western KY9%$50,000 to $74,99915% Marital Status:$75,000 or higher21% Single, never married10%No answer/ refused17% Married or living in partnership66%Race: Separated or divorced13%White88% Widowed9%Black5% Refused to say2%Any other2% Any children under age 18 in household39%Refused5% Average household size (# of persons)2.8Of Hispanic origin or descent2%

32. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Statewide Control Sample (n=605) Gender:Employment Status: Male48%Employed full or part time53% Female52%Retired19% Age:Homemaker not employed outside home10% 18 to 2410%Student not working for wages2% 25 to 3421%Unemployed, disability, other14% 35 to 4418%No answer/refused2% 45 to 5421%Educational Attainment: 55 to 6414%Did not graduate high school15% 65 or older16%High school graduate31% Mean age (years)46.2Some college26% Median age (years)45.3College graduate or higher25% Region of the State:No answer /refused2% North Central47%Household Income: Eastern KY33%Under $25,00023% South Central KY11%$25,000 to $49,99926% Western KY9%$50,000 to $74,99915% Marital Status:$75,000 or higher18% Single, never married15%No answer/ refused18% Married or living in partnership62%Race: Separated or divorced13%White88% Widowed8%Black4% Refused to say2%Any other4% Any children under age 18 in household38%Refused4% Average household size (# of persons)2.9Of Hispanic origin or descent3%

33. 2008 © ConnectKentucky Do Not Copy Without Written Permission. www.connectkentucky.org Attribution Contact: René True Executive Director, ConnectKentucky ® rtrue@connectky.org (502) 875-7501 Report Compiled by: Drew Richardson -- Lucidity Research, LLC (410) 848 1641 drew@lucidityresearch.com