Long resistant to technology, the medical field is finally getting wired. But can anything short of a complete overhaul make a difference?
E-Medicine
Marcia brier was suffering from vertigo when she arrived for a doctor's appointment one morning this past winter. But as she soon found out, that wasn't her only problem. Brier had been referred to an ear, nose, and throat doctor at Boston's Beth Israel Deaconess Medical Center, and his office staffers couldn't locate the referral number that Brier's internist had given her. They wanted payment up front.
But unlike most patients who are powerless in the face of medical bureaucracy, Brier was armed with an unusual tool -- online access to her own medical records. "I said, 'Look, do you have PatientSite access?" recalls Brier, referring to a Web-based repository of the records of 5,000 of the 1 million patients enrolled in CareGroup HealthCare System, based in Boston. The office had access to the site, so Brier dashed behind the counter, took control of the keyboard, logged on to the secure site, and pulled up her referral number. It was in an E-mail from Dr. Steven Flier, Brier's internist and codeveloper of PatientSite.
Up and running since April 2000, PatientSite puts into patients' hands information that traditionally has been hidden within the confines of medical-records departments. Using the technology, Brier can E-mail her doctor to make an appointment, get a referral, or refill a prescription. She can also review the results of laboratory tests and radiology reports, all on her home computer.
"The system lets us take away the trivia of medicine -- appointments, prescriptions, referrals -- and focus on patient care," says Dr. John D. Halamka, chief information officer of CareGroup, who also helped develop PatientSite. The service, which CareGroup may begin licensing to other health-care systems, operates within secure firewalls -- much like an online financial-transaction service -- in order to protect patients' privacy.
A technology that gives customers immediate access to all their own data is old hat in any number of other industries, from banking to office supplies. But it's downright revolutionary in the medical field, in which papers, pencils, and manila folders are still state-of-the-art. "You can go to an ATM and get $20 from your bank account, but it's very hard to get an appointment with your doctor," says Halamka.
After years of resistance, the medical field is finally in the process of getting wired -- and going wireless. Web technology is empowering patients, and handheld wireless devices are beginning to wean doctors from their dependence on paper. Physicians are beaming prescriptions to pharmacies and scanning bar codes on patients' wristbands as if they were moving groceries through a checkout line. And doctors and patients alike are finding that technology is beginning to ease the perennial battle with insurance companies.
"The medical field is five to seven years behind other industries," says W. "R.P." Raghupathi, associate professor at Fordham University School of Business, in New York City. On average, hospitals and doctors groups spend just 3% of revenues on information technology, compared with the 5% spent by financial services and 7% by the communications sector, according to one Gartner Group study. In addition, a network that could seamlessly connect doctors to hospitals to patients to insurance companies seems as elusive as a cure for the common cold. The roadblocks to creating such a system are huge. Many doctors fear that technology will replace their decision-making authority, and patients worry about privacy.
Federal legislation and regulations are proliferating to safeguard the exchange of confidential medical data among providers and insurers. But as consumers experience the unfamiliar taste of access to their own medical information, it's hard to imagine that there will be any turning back. What may truly drive further technological developments are consumers themselves, who may begin voting with their feet for doctors who have access to seamless communications systems and smooth connections to insurance carriers.
Creating Patient Communities
Phillip L. Webb began surfing the Internet for medical information in the spring of 2000, soon after he was diagnosed as being infected with the potentially fatal hepatitis-C virus. The automotive technician from Bakersfield, Calif., believes that his membership in the online community Hepatitis Neighborhood ( www.hepatitisneighborhood.com) may well have saved his life.
"When I first found out I had the virus, I thought it was a death sentence," says Webb, who was referred to the online community by the pharmaceutical company that manufactured his medicine. "If I hadn't had access to Hepatitis Neighborhood, I would have been in the dark."
Even though the Web can't replace doctors, it can collect and disseminate medical information with unprecedented efficiency. Having access to online communities is a breakthrough for chronic-disease sufferers like Webb, who have flocked to the Internet for information not just from doctors but also from people who are similarly afflicted.
Hepatitis Neighborhood, which is a combination support group and medical-information warehouse, is a typical example of the new communities. The secure site provides personalized information to hepatitis sufferers, depending on the strain of the virus they have -- A, B, or the dreaded C -- and offers support and detailed data about treatment. It also monitors patients' drug therapy and tries to head off problems with medication noncompliance.
The Web site depicts a homey neighborhood consisting of a series of buildings that dispense different types of information. The Food Market gives dietary advice; the Clinic and the Library house volumes of data about the disease; the Town Hall offers forums; and the CafÉ hosts chat rooms.
"When you have one of these diseases, it dominates your life. You want to communicate with others in the same situation," says Steve Cosler, president and chief operating officer of Priority Healthcare, which owns the site. The company, based in Lake Mary, Fla., is a specialty pharmacy and distributor that dispenses primarily biotechnology drugs for chronic diseases. Not surprisingly, one of the buildings in the Hepatitis Neighborhood is the Pharmacy.
