Information key to patients’ relationships with physicians
Consumers will turn in greater force to e-health sites
When Helen Smith visited her physician, she left frustrated that the hospital clinic didn’t give her more information about her illness. So she turned to the Internet, surfing Web sites that offered medical content. Not only did she find the information she wanted, she also found other patients with the same condition. One of these patients gave her the name of a more sympathetic physician.
Donald Jones arrived at his doctor’s appointment armed with a stack of material he downloaded off several e-health Web sites. He was then surprised to find the physician defensive when he tried to discuss what he had learned about his treatment options. The Internet can be a double-edged sword. "Connected" consumers can become more active participants in their care. They also can be much more impatient and demanding with their health care providers.
Connected consumers can be misinformed, too. "Sometimes physicians have to dispel information that people find out about their situations," says Arky Pollokoff, a partner in Arthur Andersen’s Central Region Healthcare Consulting practice in Chicago. "Most of the dispelling involves treatment protocols."
After surveying consumers through interviews and roundtable discussions, Deloitte Research and Cyber Dialogue in New York City proclaimed that "e-health consumers are set to transform the health care industry."
The companies identified five forces accelerating the evolution of a new e-health consumer. These are:
• Increased financial responsibility for consumers.
• Developments in public policy.
New legislation acknowledges increasing consumer demands for access to care, open communication with their physicians, and more overall choice in health care decision making.
• Emergence of comparative quality and performance indicators.
As consumers are eager to gain access to scientific information that will help them make informed decisions, more consumer-friendly versions of scientific data are being created, according to the survey. A number of information sources, such as TheHealthPages.com and HealthGrades.com, have begun offering Web sites that provide comparative data on hospitals, physicians, and treatment options.
• Social/demographic changes.
A larger percentage of workers will have greater accountability for their health care decisions and are likely to be more self-reliant in making decisions regarding their care. The aging baby boom generation will also demand more clout in their health care decisions.
• Connectivity.
Many consumers feel the Internet enables them to become more involved with their own health care, and such involvement increases their tendency to challenge their physicians.
"There is an enormous gap between what e-health consumers want and what they’re able to get, and there is a tremendous opportunity for those who can bridge it," says Graham Pallett, a principal with Deloitte Consulting Health Care Practice. "The underlying question remains: Who will understand e-health consumers best, react to them most effectively, and embrace e-health consumer readiness as a strategic advantage?"
Stay one step ahead
It’s understandable that many consumers are turning to e-health sites for health information. A study conducted by VHA, a national alliance of physicians and community-owned health care organizations based in Irving, TX, reports that 70% of patients surveyed did not receive any materials or referral to available information when they visited their health care provider.
Providers will find it a challenge to know everything or more than the connected patient does, Pollokoff says. "This e-phenomenon places increased demands on doctors to stay current on available information and to provide greater insight and clarification when recommending courses of treatment."
Providers also have to determine if the patient is accessing credible information. E-health sites sponsored by medical associations, hospitals, medical centers, and schools, should offer reliable information. InteliHealth.com, a venture of Aetna U.S. Healthcare and Johns Hopkins University and Health System in Baltimore, is one example. Patients also should evaluate the credentials of the people on the site who are giving the information. In addition, the patients need to ascertain if the information is current. Users may look for an "HON Code" symbol on the Web site, which means the site adheres to the "Health on the Net Code of Conduct." For example, these sites can only post information given by medically trained and qualified individuals.
"With more than 16,000 health-related Web sites, competitive advantage will go to those that have the most credentialed and trusted information," Pollokoff says. Consolidation of these "infomediaries" already is beginning to occur, as in the merger of WebMD and Healtheon in Atlanta.
Some sites might contain one or two items related to a patient’s particular condition that the provider may never have heard of or may not think are valid, Pollokoff says. "The patient will have to decide whether all the time invested in seeking that information was worth it compared to [speaking directly to the physician]. He or she may decide to call another doctor."
Pollokoff recommends that providers follow one Web site. (For a selected list of e-health Web sites, see p. 35.) Some providers, for example, are accessing Medscape to keep up to date on their medical reading. From this same site, they can now access Medscape’s link to consumer health information, CBS HealthWatch.
Providers who ignore the amount of consumer health information on-line may be sticking their heads in the sand. "I predict that upward of 100 million consumers will consume health care information during the year 2000," he says.
Don’t forget e-mail
Another way for physicians to communicate with connected consumers is through e-mail. But e-mail can quickly overwhelm a physician or a hospital’s Web site, experts warn.
"There has to be the ability to control the e-mail received," Pollokoff says. "[Providers] can sit and answer e-mail all night, answering questions that people should not be asking their doctor about or questions that are simple and could have been answered with a quick call to the provider’s office.
E-mail helps a provider give information better but also makes it more difficult for the provider to manage its time, he continues.
When providers give patients their e-mail addresses, they need to indicate that patients may not always get a response in the time they want. "Tell them the kinds of things you can e-mail them about and when they should contact you. It might help in a preventive mode, too."
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