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Healthcare Internet Revolution Heads in a Different Direction

Remember drkoop.com? Less than two years ago, the company went public with huge fanfare, and former U.S. Surgeon General C. Everett Koop was suddenly a millionaire. Where is it now? The company’s stock is trading at $0.12 per share, as the website limps along until its IPO cash runs out, the victim of irrational expectations for the distribution of consumer health information over the internet.

Consumers remain eager to search for medical information online, and caregivers are largely excited about having patients play a more active role in monitoring their health. According to Mark Smith, the CEO of the California HealthCare Foundation, the internet has lead to the “democratization” of health information.

No longer is all of the most important information contained in complex medical journal articles. Instead, it is contained on 22,000 different websites, with varying degrees of reliability and accuracy. This information revolution is particularly beneficial for patients diagnosed with a particular disease. They find online guides, support groups and chat rooms to get information about and discuss their illness and can be kept up-to-date on the latest published research in the area.
The trend of democratization, however, has created some interesting phenomena. The most common seems to be improper self-diagnoses. Patients read about certain health problems on the Web and visit their physicians convinced that they suffer from a certain malady. Patients have often jumped to an incorrect conclusion, and a certain amount of discussion time is required for the physician to explain why they were wrong. Those who repeat this behavior often enough are referred to as “cyberchondriacs”.

Despite the emphasis on patient empowerment and the demand for more data, websites based on advertising and e-commerce such as drkoop.com and IntelliHealth.com have failed. Concerns about information accuracy and medical record privacy have created doubts in the minds of the public. In fact, 79% of consumers expressed serious concerns about the veracity of existing online content in a recent Jupiter Communications poll, and 41% of consumers are unwilling to use such informational sites due to online privacy concerns.

Yet, as internet use becomes more widespread, the healthcare sector is looking for the right portals to provide trusted, private health information online. The key is to make a site more valuable to the consumer so as to make it a daily or weekly destination. The likely solution is a focus on using the Internet to complement existing channels, something that is happening in practically every other industry that has been touched by the online revolution.

In the same Jupiter survey, consumers said they trust provider brands, such as physicians’ own sites, physician-recommended sites and sites of national institutions, such as the Mayo Clinic or the American Academy of Family Physicians. Of these areas, only physician practice websites are still in their infancy.

The healthcare system has traditionally lagged behind other industries in the adoption of non-treatment related technology, and it is no different with the internet. Physicians primarily work alone or in small practices, in a decentralized system with a focus on the end customer. They have little professional use for email or the web, except perhaps to conduct medical research. The idea that they aren’t online, however, is untrue. According to The Cozint Report, a survey of physician Internet use, 91% of physicians use the internet regularly and over 50% log on at least once per day, but they primarily use the web for personal reasons.

Companies like WebMD, the leading consumer healthcare information site, face the challenge of convincing doctors that the Internet is more than just a way for ill-informed patients to waste their time. They are creating an online community of physicians and health information by providing free web hosting for physician websites. The company, harnessing the power of medical software maker Medical Manager, which WebMD purchased last year, is also pushing the benefits of additional web-based front-office functionality, including scheduling appointments online, electronic prescription submission, and patient email reminders, in addition to general healthcare information. Few doctors are interested in developing an online consultation system, for fear of being tied to their computer tending to current patients without generating additional revenue.
Despite their sluggishness, physicians do seem to be picking up on the internet trend. The Cozint Report found that 40% of “wired” physicians have some type of web presence, either a personal website or the site of an affiliated organization such as a hospital or HMO. Another 36% of doctors without an online presence plan to develop one in the next 12 months. (See chart)
The internet may not change the healthcare system as much as originally predicted, but it does provide ample opportunities to make a system with an estimated $300 billion in annual administrative inefficiencies substantially better. Among other things, patients may never need a doctor’s illegible written prescription again.

April 23, 2001
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