E-Health: Demand May Finally Catch Up with Supply

Those recipes, like Grandma's recipe for holiday pie, looked simple on paper. But, like with many of Grandma's recipes, there always seemed to be an ingredient missing.

For e-health vendors, that missing ingredient was demand. However, some experts say momentum for e-health has quietly built since the late `90s "e-health bust." As a result, they say, in the next five-plus years e-health will drive significant change in health care.

Many provider and payer organizations have been sniffing around Internet technologies for the past two years or so, ever since the e-health tide ebbed, these experts say. And, like that alluring scent of fresh-baked pie, the potential of e-health to link providers, payers, consumers and employers has made many organizations rediscover their "appetite."

Increasingly, health care organizations will use e-health to communicate internally and externally, implement telemedicine programs, and generally come to realize more efficient ways of conducting the business of health care, predicts Mark Johnson, a consultant with Perot Systems Corp., Plano, Texas.

"We see gradual, continual growth of e-health as people's expectations of doing business on the Web increase," Johnson says. Organizations that don't meet those expectations risk alienating their constituencies, he adds, and could jeopardize their standing in a competitive marketplace.

In addition, patients increasingly will use personal computers and Web-connected devices to monitor their own conditions, Johnson says. Some patients already perform self-monitoring tasks such as taking blood pressure at regular intervals. Soon, for example, they'll be able to do such tasks as use a hand-held ultrasound device to manage a complicated pregnancy and transmit information over a secure Internet connection to a clinician devoted to overseeing remote patient care, Johnson predicts.

E-health will become commonplace as technology evolves to enable more effective gathering and communication of clinical information. Wireless networks and hand-held devices will become the norm as technology improves and costs come down, some experts predict.

While many advances will be pushed ahead by increasingly "Web-enabled" patients, clinicians also will pull the technology into health care as they find more useful tools, says Steve Rushing, a consultant with BearingPoint Inc., the McLean Va.-based consulting firm formerly known as KPMG Consulting. A good example of this pull is the implementation of physician Web portals, he says.

"Health care is embarking on its use of Internet technologies slowly and methodically," Rushing says. "But there are increasing signs there is momentum-if not acceleration-around more robust physician portals."

Connecting the docs

Physicians are accessing some very basic information, such as electronic "libraries" with patient care and drug information, from Web portals. Next, physicians will start electronically retrieving information like meeting minutes and newsletters that typically is "pushed" to them on paper.

"The signs are encouraging-many physicians are far more `connected' than they were 18 months ago," Rushing says. "Their habits are changing."

Such cultural changes figure mightily into the expanding use of Internet technologies. Motivation also will come from payer organizations, which eventually will depend on Internet technologies to streamline operations and cut costs, Rushing says.

"There will be increasing pressure from payers to use online transactions," he says. "It's a less costly transaction. Provider organizations will have incentives to use the Internet, including faster payments and discounted fee schedules."

Opening portals

Some payer organizations already are using Web portals to exchange data with providers and employers. Harvard Pilgrim Health Care, for instance, has a provider portal in place and sees e-health as critical to its future, says Deborah Norton, CIO at the 775,000-member health plan based in Wellesley, Mass.

Its e-health initiatives will be juiced by the emergence of XML as a communication language standard along with health care transactions standards mandated by the Health Insurance Portability and Accountability Act, Norton adds.

"E-health is going to see exponential growth," she says. "We've not only made providers happy, but also made employers happy they enroll with us."

Employers already can manage employee beneficiary rosters and make payments online, she says. Yet health plan member demand lies behind the greatest potential for increasing use of Internet technologies. "Members are increasingly impatient about waiting to use the Internet to manage their care and make sense of the health care system," Norton says.

Harvard Pilgrim expects to roll out a member portal featuring some claims transactions in early 2003.

Impatient consumers will be one of the main factors fueling e-health growth, some experts contend. Operational efficiencies and cost savings will be expected from all quarters of health care as e-health gains momentum, says Ralph A. Korpman, M.D., president and CEO of HealthTrio Inc., a Nashville, Tenn.-based Internet connectivity vendor.

`Why not health care?'

"Providers and health plans are at the center of e-health initiatives now and they are seeing the most savings," Korpman says. "But there will be increasing pressure from employers and patients. People will say, `This has to be better. There are so many things I can do on the Internet, why not health care?' "

Patient "empowerment" will drive demand for e-health services, agrees Gale Wilson-Steele, CEO of MedSeek Inc., a Solvang, Calif.-based Web content management and services vendor.

"Patients will want greater access to information online," she says. "It won't be for everyone, because some patients still will want to get information from the physician. But those who wish to will become experts on their diseases and will do so through information gathered on the Internet."

Patients will continue to expect more of e-health. As a result, some provider organizations using Internet technologies have big ideas in mind. At Greenville (S.C.) Hospital System, the push is on to convert all clinical applications to Web browser-based technology from Siemens Medical Solutions Health Services Corp., Malvern, Pa.