FOCUS ON eHEALTH:
A Computing Insider Looks at Health Care
Pamela R. Yoder,
MD, PhD, FACOG
The health care system is in the sights of the computing giants, and changes are occurring swiftly. The opportunity for providers to influence the upcoming changes in health care was addressed by Steve McGeady, Vice President of Content and Director of the Intel Internet Health Initiative. Steve spoke at two recent conferences on health care, Health Information Infrastructure '99 in Washington, DC, and eHealthcareWorld in Chicago, Illinois. After his presentation to a mixed audience of physicians, government and business leaders, and the press, Steve took time to talk with me.
Why is a company like Intel involved in a health care meeting like this?
It is very simple. It's a trillion dollar business. It's 14% of the gross domestic product. It represents the single largest opportunity for the sale of personal computers and microprocessors and other computing devices out for the next five years or more. That's why we are here. We're not here to sell a particular product. We're here because we think that expanding the overall market is good for us as well as good for the overall industry….
People feel a responsibility to take care of their own health. They are pretty sure no one else is going to do it for them…. They are seeking out alternative medications, and they are using the Internet. Again, this is not an Internet-only phenomenon; the Internet is simply providing a mechanism to bring these people together. Most people are buying PCs, more ore less, just to get on the Internet; it has become the dominant reason for buying a PC. Thirty-three percent of women and 24% of men…in the United States, are using the Internet to get health care information. Sixty-plus percent of physicians have had patients coming into them with information printed from the Internet. Of people who are on-line, over 2/3 of those people seek health information on-line. And among 55-year and older Americans, health information is the number one kind of information they seek on the Web. By the way, the number two one is financial services information. Health plus wealth--that is what elderly Americans, the third-agers, are increasingly seeking. So, the leading indicators are here, and at this point the health industry has not responded. However, a variety of upstart companies have and are delivering a very similar set of products and services on a stair-step model which is very analogous to what has happened in financial services…. There is an inflection point coming here…. We have to bring better technology, but the healthcare profession has to embrace this.
Steve, how can the busy practicing physician embrace the World Wide Web?
A lot of physicians are finding patients coming in with information they got from the Internet. Physicians often don’t know what to do with this. Sometimes the information is inaccurate. Sometimes it does not represent the clinical choices the physician would make. In general it often threatens the physician and makes them feel there is a source of information other than their judgment, which is what they are used to relying on. What we try to recommend to physicians is not to react in that way but to engage the net, get online, provide the information, and provide pointers to places on the web where their patients can get information the physicians approve of, information the physicians feel is correct. Patients DO have a relationship of trust with their physicians, but the physician has to take into account that these days patients get information that comes from a variety of sources in addition their doctor.
What approach do health care consumers take to judge the quality of information they receive on the Web?
In general, it is not very consistent. Sometimes patients judge it simply because it sounds right. At the best of times patients judge information on the Net based on who it comes from or who it is recommended by. If it is recommended by their physician, by a trusted friend, or by an institution with a national brand name like Mayo Clinic or Johns Hopkins. That kind of information is trusted in the same way you trust the Wall Street Journal more than the National Inquirer.
You spoke about how health care has gone from being a cottage industry to mass-production and of the need to begin mass customization. How can we personalize use of the Internet for our patients?
There are any number of technologies for gathering information about your patients--simple things, their age, their gender, their family history, their existing health conditions, if any--and delivering to the patients the kind of information that is relevant to those concerns if, of course, if the patient is inquiring about themselves. If the patient is inquiring about a loved one, you can gather similar highly generic information. Then if you track the information that the patient examines on the network, you can make judgments about the next kind of information they are likely to need--either more in-depth information or information with more breadth.
What is Intel's plan for involvement in health care?
We are not entering the health care business. As I sometimes tell people, the margins are too low, and there is too much regulation. Health care is something that touches every American, every person in the world. We are not going to enter health care per se, but we have two interests of various kinds. One I would put in the category of enlightened self-interest. One side of our business, the side that is most well-known, sells microprocessors, semiconductors. We are always interested in enlarging the market for personal computers that use our microprocessors. We think that the health care market both for physicians and hospitals to use computers and the Internet but more especially the demand for home use of personal computers and the Internet represents a large market. And in health care that large market is largely untapped. The health care industry has only 1/3 to 1/4 the use of computing than any comparable industry. That is not 1/3 to 1/4 less, but 1/3 to 1/4 the total amount of computer use and expenditure on technology. The second interest of Intel is much more recent. We are building a business to deliver Internet services that enable electronic commerce online.
In summarizing his speech, Steve pointed out that physicians need to embrace the change and to help determine its outcome. He stated that, in the new model, physicians need to become entrepreneurs, that employees of health system need to become teams and partners, and that health care businesses need to start taking some risks. "We need to stop thinking about how we move in an orderly fashion, safe and sane, and get there quickly on it…. We need to stop thinking one size fits all. Medicine needs to move to mass customization. We need to build a system that is distributed, like the Internet. We need to start thinking about investing in our own health, investing in our own systems…. Stop focusing on process and start focusing on outcome….because [this industry] is going to change."