In today's highly litigious society, physician executives can ill afford to be uninformed, misinformed or late getting the message. And the latest data pertinent to healing, including new findings in genetics, may be waiting in cyberspace.
"As consumers become primary decisionmakers for their own healthcare, they need tremendous amounts of information in a format that's easily accessible and easy to understand," says Susan Hoffman, spokeswoman for White Plains, N.Y.-based IBM Global Solutions. "They, and the doctors who care for them, are turning to the Internet and using 'intranets' and 'extranets' to fill the information gap." (See related story, page 49, for definitions of Internet terms.)
Today, senior managers at forward-thinking organizations are using technology to enhance provider-patient relationships.
One example is Minneapolis-based Allina Health System, an integrated system of hospitals and health plans serving 1 million enrollees in Minnesota, western Wisconsin and the Dakotas.
In general, however, physicians are lagging far behind corporations in adopting new technologies that can transform the workplace from one dependent on stacks of paper to one with a strong electronic foothold.
Communicating information on line makes sense especially for a large practice with many offices, a large practice with offices that aren't close geographically, or groups affiliated with hospitals and medical schools that can be reached on line. For small groups, sharing data on a joint basis can be more cost-effective than going it alone.
Some practices have the building blocks in place, says Blane Erwin, an analyst for Forrester Research in Cambridge, Mass. All a practice needs is a computer and a server to handle the traffic.
Turn-key intranet products already on the market are the Matrix data management intranet produced by Adra Systems of Chelmsford, Mass. (http://www.adra.com), and Infodata Systems (http://www.infodata.com) in Fairfax, Va., which this year opened its Virtual File Cabinet. The VFC is designed to handle simple text or compound documents with multiple components.
Richard Tworek, Infodata executive vice president, says the core product provides easy use and a customized view of documents. This "out-of-box" intranet costs $4,995--for those with an infrastructure in place (Web server, etc.). Sans infrastructure, the cost can run up to $50,000, depending on the quality of your computer, server, modem, etc.
Although there are how-to books and other assistance to help you set up your own intranet or extranet, most management experts believe that if such a communications tool is important for your business, it's best to bring in someone who really knows how to do the job.
Such was the case when Allina went on line with its extranet in 1996.
"It became evident we needed a new way of communicating with members," says David Strand, president of Medica Health Plans, an HMO owned by Allina. "We found ourselves communicating with members in a fairly traditional fashion; we used a lot of paper. The question was: How do you begin to reach a million members differently with information that would help them become better informed?"
It took a village to bridge the gap. Specifically, the solution was Allina HealthVillage, which provides Medica enrollees with easy-to-use, round-the-clock medical and health plan data. Initially, the village was available only to enrollees, but access is being expanded to include patients, physicians, brokers, employers, clinics, hospital administrators and other healthcare professionals.
The system was developed with IBM Global Healthcare, a division of IBM Global Solutions (http://www.solutions.ibm.com/healthcare), which provides the Internet application software, hardware and networking capabilities, consulting, and training. Allina is responsible for content, healthcare business process expertise, nurse triage service and first-level help desk. The IBM Global Network infrastructure provides access points in more than 200 countries.
A different approach comes from Dallas-based Claimsnet.com, a provider of Internet-based healthcare transaction processing. In September, it announced a partnership with Rochester (N.Y.) Healthcare Information Group to provide Internet-based claims processing and repository services to healthcare providers. The venture will allow physicians, physician organizations, healthcare systems, hospitals and other providers to process claims electronically and create a repository of data.
RHI will develop and support the repository to meet a customer's requirements and will control access according to the repository owners. Claimsnet.com will process the claims using its current Internet-based processing service. Claimsnet.com would only say the cost is reasonable considering what is gained from using it.
RHI (www.rhigroup.com), founded in 1983, is a healthcare information management organization and the development center for the Rochester Area Community Healthcare Information System, a communitywide system to support data sharing among local providers in a secure environment.
Not all intranet/extranet uses are highly technical and expensive.
For example, Fred M. Kaplan, president of Strategic Business Consultants in Wyncote, Pa., has encountered "many physicians in small or sole practices who participate in "journal clubs." They stay abreast of the plethora of publications with an impact on their practices. Otherwise isolated professionals receive peer reviews of articles from selected journals, many of which they might not have had time to read on their own."
These physicians go on line together at an appointed time and share anecdotal assessments and evaluations of new medications, techniques and procedures, adds Kaplan, who has 20 years of computer experience.
"These intranet 'chat rooms' are especially helpful for suburban and rural practices and can be coordinated by a regional hospital, state or county medical society, or physicians themselves," Kaplan says. "The data from such a 'cyber forum' can give physicians what they might otherwise miss--and could save suffering and lives."
CompuServe is one way to go on line to reduce research time and cost, get better research sooner and improve practice efficiency. You get the names and CompuServe identification numbers for public information officers, who will lead you to practitioners and data you may require.
Sources include the American Academy of Family Physicians; Centers for Disease Control and Prevention; Johns Hopkins Medical Institutions; Memorial Sloan-Kettering Cancer Center; Stanford University Medical Center; University of Pennsylvania Medical Center; and Yale University School of Medicine.
Herb Drill writes for magazines and newsletters in the U.S. and England and is a regular contributor to the Philadelphia Inquirer. He lives in Bucks County, Pa.