Despite the potential of the Internet and the feverish application of Internet-related technology by software vendors, the market for such technology in healthcare is largely in a holding pattern.
Only a slight majority of healthcare provider and payer organizations polled for a new study have designated the Internet as a top priority during the next three years.
A third of respondents expressed no interest in increasing their use of the Internet, and six of every 10 don't have an articulated strategy for making use of the Internet and the breakthroughs in data-access technology created for it.
Those that haven't embraced Internet technology overwhelmingly cited security issues as the major reason for holding back.
The survey is part of a series of monographs titled Health Care Cybervision: the Role of the Internet in Health Care. A chapter detailing the current state of Internet use in healthcare was released last month.
The series is underwritten by several companies with an interest in promoting the potential of the Internet and related technology:
Ernst & Young, the Cleveland-based accounting and consulting firm, which has a healthcare information technology consulting practice.
ConnectedHealth.Net, an Ernst & Young subsidiary seeking to harness Internet information-delivery capabilities.
Sun Microsystems, creator of an Internet language called Java.
Sprint Health Care Systems, a unit of the telecommunications giant formed to develop products and services for the healthcare industry.
Sybase, a developer of computer databases and computer tools for information networks.
3Com Corp., which makes electronic-network routing and switching products and which recently declared an Internet strategy in a big way by agreeing to buy modem maker U.S. Robotics in a $6 billion stock deal.
A collection of products and services has sprung up around technology created to navigate the Internet but applicable to a range of problems afflicting integration of private computer networks.
The technology offers a potentially simple solution to extracting data from previously incompatible computer systems.
To determine the current state of Internet adoption and the barriers in the way, the Cybervision study polled 816 people in a range of positions in healthcare senior management, information systems, healthcare research, consulting and vendor companies. In addition, intensive interviews were conducted with 12 information technology executives from healthcare organizations.
In the survey, 92% of respondents agreed that security and confidentiality concerns would hamper expansion of the Internet (See chart). Only 8% disagreed.
The second-highest barrier was related to the vision for such technology, with 84% agreeing that a lack of clarity in how to use the Internet would hinder its expansion in healthcare organizations.
And from a practical standpoint, limitations on access to Internet-related networks by target users were seen as the third-highest barrier. But those limitations had nothing to do with the ability to use the available browser tools; ease of use was not a concern to 67% of respondents.
The security concerns contrasted with one of the study's major conclusions: that security is a nonissue from a technological standpoint.
"The irony of the study findings is that it is security issues that are preventing the industry from realizing potentially huge monetary and scientific gains by applying Internet technology," said Daniel Nutkis, chairman of the Cybervision study and chief executive officer of ConnectedHealth.Net.
"In terms of security, ensuring that sensitive information, including patient data, can only be accessed by authorized users is not only feasible today but represents a leap forward in securing access to data for all industries," Nutkis said.
The study summarized several projects in healthcare that are providing immediate benefits:
At Columbia/HCA Healthcare Corp., a private network using Internet technology-called an "intranet"-has connected more than 750 users at 50 hospitals, and the company is projecting that 10,000 users will be on line by the end of the first quarter of 1997. Among the current uses are interactive executive education and management of used equipment.
At University of Kentucky Chandler Medical Center in Lexington, an intranet links the facility's emergency department, providing quicker access to patient medical histories, billing information, outpatient data and physicians on call. The intranet is being rolled out to all 450 physicians and staff at the hospital.
At Partners HealthCare System in Boston, clinicians can gain access to an ordering system by using a browser in addition to dialing in from a telephone modem. The regional healthcare delivery network has spawned 42 active World Wide Web sites, primarily for academic medical purposes. Currently, only 10% to 15% of the organization has Internet access.
Providing access to a multiple-site, diverse healthcare system was recognized as a principal barrier by another recent study, a poll of 1,200 computer professionals attending the Healthcare Information and Management Systems Society conference last month in San Diego (Feb. 24, p. 26).
Though 80% of those pros expressed some level of commitment to implementing an intranet, more than half of them said infrastructure to connect sources of data was the main priority for the coming year.
The Cybervision study summarized several advances in high-speed and high-volume transfer of electronic information that it said will improve the ability of Internet technology to serve healthcare.