Has the pandemic enhanced and sustained digital health-seeking behaviour? A big-data interrupted time-series analysis of Google Trends.

Abstract

Due to the emergency responses early in the COVID-19 pandemic, the use of digital health in healthcare increased abruptly. However, it remains unclear whether this introduction was sustainable in the long term, especially with patients being able to decide between digital and traditional health services once the latter regained their functionality throughout the COVID-19 pandemic. We aim to understand how the public interest in digital health changed as proxy for digital health-seeking behaviour and to what extent this change was sustainable over time. We used an interrupted time-series analysis of Google Trends data with break-points on 11 March 2020 (the pandemic announcement) and 20 December 2020 (the announcement of the first COVID-19 vaccines). Nationally representative time-series data from February 2019 to August 2021 was extracted from Google Trends for six countries that speak English as their dominant language: Canada, United States, United Kingdom, New Zealand, Australia, and Ireland. We measured the changes in relative search volumes of the keywords online doctor, telehealth, online health, telemedicine, and health app. In doing so, we capture the pre-pandemic trend, the immediate change due to the pandemic announcement, and the gradual change after the announcement. Digital health search volumes immediately increased in all countries under study after the pandemic announcement. There was some variation in what keywords were used per country. However, searches declined after this immediate spike, sometimes towards pre-pandemic levels. The announcement of the COVID-19 vaccines did not consistently impact digital health search volumes in the countries under study. The exception is the search volume of health app, which showed to either remain stable or gradually increase during the pandemic. Our findings suggest that the increased public interest in digital health associated with the pandemic did not sustain, alluding to structural barriers remaining. Further building of digital health capacity and developing robust digital health governance frameworks remain crucial to facilitating sustainable digital health transformation.