The Effect of the COVID-19 Pandemic on Digital Health-Seeking Behavior: Big Data Interrupted Time-Series Analysis of Google Trends

Abstract

Background: Due to the emergency responses early in the COVID-19 pandemic, the use of digital health in health care increased abruptly. However, it remains unclear whether this introduction was sustained 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.

Objective: We aim to understand how the public interest in digital health changed as proxy for digital health-seeking behavior and to what extent this change was sustainable over time.

Methods: We used an interrupted time-series analysis of Google Trends data with break points on March 11, 2020 (declaration of COVID-19 as a pandemic by the World Health Organization), and December 20, 2020 (the announcement of the first COVID-19 vaccines). Nationally representative time-series data from February 2019 to August 2021 were extracted from Google Trends for 6 countries with English as their dominant language: Canada, the United States, the 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 prepandemic trend, the immediate change due to the announcement of COVID-19 being a pandemic, and the gradual change after the announcement.

Results: Digital health search volumes immediately increased in all countries under study after the announcement of COVID-19 being a pandemic. There was some variation in what keywords were used per country. However, searches declined after this immediate spike, sometimes reverting to prepandemic levels. The announcement of 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 was observed as either being stable or gradually increasing during the pandemic.

Conclusions: Our findings suggest that the increased public interest in digital health associated with the pandemic did not sustain, alluding to remaining structural barriers. Further building of digital health capacity and developing robust digital health governance frameworks remain crucial to facilitating sustainable digital health transformation.

Keywords: COVID-19; Google Trends; big data; data; digital health; healthcare seeking behaviour; pandemic; real-world data; telehealth.

Figure 1

Google Trends search volumes before and after the announcement of the COVID-19 pandemic. The vertical axis shows the average search volume (scaled from 0 to 100) before and after the pandemic was announced and after the announcement of conditional market authorization of the first COVID-19 vaccines.

Figure 2

Interrupted time-series regression estimates for the relative search volumes of online doctor, online health, telehealth, telemedicine, and health app before and after the announcement of the COVID-19 pandemic and the announcement of the first COVID-19 vaccines. (A) Acute changes in the search volumes following the pandemic announcement in March 2020 and the vaccine announcement in December 2020. (B) Changes in search volumes per week before the pandemic announcement, after the pandemic announcement, and after the vaccine announcement. Values shown are estimates and 95% CIs.

Figure 3

Country-specific regression estimates for the relative search volumes of online doctor, online health, telehealth, telemedicine, and health app before and after the announcement of the COVID-19 pandemic and the announcement of the first COVID-19 vaccines. (A) Acute changes in search volumes following the pandemic announcement in March 2020 and the vaccine announcement in December 2020. (B) Changes in search volumes per week before the pandemic announcement, after the pandemic announcement, and after the vaccine announcement. Values shown are estimates and 95% CIs.