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E-Health II: Return of the Internet


By Greg Gillespie, Managing Editor January 2005

Just like a child, the Internet has experienced growth spurt after growth spurt as it speeds toward maturity. In the 1990s, during the e-health boom, what many in health care thought was a mature adult was in fact a mere high school student. The Internet talked the talk, but it could not yet walk the walk. It thought it knew everything but in reality didn't have much life experience. And, like many adolescents, it often preferred style over substance.

Then came the e-health bust, a great learning experience. Since then, the Internet has grown beyond the swagger of its high school years and become more practical. And in leaving high school behind, the Internet has become a focus for an increasing number of health care organizations either taking another look at or deepening their ongoing efforts in e-health.

Lumenos Inc., for one, is making the Internet work for a living. The Alexandria, Va.-based third-party administrator for self-insured employers has given members access to a full suite of interactive e-health services through its Web site. The site, which uses a suite of applications from Chicago-based Subimo LLC, enables patients to choose physicians and facilities for procedures based on personal preferences.

The site walks patients through a questionnaire that determines the most important treatment criteria for them-for example, quality, cost or location. Patients then can access detailed data about the provider, procedure or facility, as well as information about complications, alternative therapies and typical drug treatments. They can book a procedure online and confirm its out-of-pocket cost. To date, more than 75% of patients enrolled in the Lumenos health plan use its e-health offerings.

"Everyone talks about how this is the age of consumer-driven health care. But if you want to have patients making more decisions, you have to give them the tools to actually obtain the information to make those decisions," says Eric Fennel, Lumenos' vice president of information technology. "The Internet is the way to give patients discrete chunks of data in a manner that enables them to make a decision."

The big chill

After the dot-com debacle of the late 1990s, the Internet-and the myriad e-health services that so many predicted would change the health care landscape-seemed to disappear.

But the Internet and e-health were not gone, and certainly not forgotten, says Toby Ward, president of Prescient Digital Media, a Toronto-based e-health consulting firm. Instead, like a hard-partying teenager suddenly cut off from his parent's checking account, the Internet spent a few years sobering up and thinking about what it was going to do with its life.

"After the dot-com bankruptcies of 1999 and 2000, the evolution of e-health slowed because those bankruptcies made a lot of headlines, and the perception for many was that the Internet wasn't all it was cracked up to be," Ward says. "This put a chill on the market-a lot of e-health budgets were cut back and initiatives placed on hold. And at the same time, a lot of health care organizations began to understand there were a lot more costs and complexities involved in offering e-health services than they originally thought."

There also were misconceptions about patients' desires to interact online with health care organizations. The effort to create an interactive, online patient-provider community in Winona, Minn., is a case in point.

In September 2000, Kansas City, Mo.-based Cerner Corp. and the city of Winona embarked on an ambitious plan to provide a slew of e-health services to Winona residents. The city had a flagship provider organization-Winona Health-that treated the majority of residents. It also had a high-speed Internet backbone available throughout the city, implemented by Winona-based Hiawatha Broadband Communications Inc.

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