Decide to go on-line for the health of your business and your patients
Decide to go on-line for the health of your business and your patients
Experts offer practical tips to make the Web work for you
Remember the first time you saw a World Wide Web address on a billboard or on a television commercial? How about the first time someone asked if you had an e-mail address or whether you knew how to surf the Net? Unless you’re a "techie," you probably wondered what that seemingly nonsensical string of letters meant on that billboard, and your answers to the other questions were probably no.
You may have been in the dark then, but you can’t afford to stay there now, say experts in the field of on-line health communication. Even if you still don’t have an e-mail address and you still don’t know how to navigate the Web, your patients do. And they’re not just sending e-mail messages to Aunt Millie or looking up the weather in Cancun — they’re trying to determine their own diagnoses, getting second or third or tenth opinions from medical experts, researching drugs that are still in clinical trials, and communicating with other patients who have similar problems.
That means health care providers have an opportunity — and some would say an obligation — to help consumers fill their voracious appetites for health information. A growing number of hospitals, physician practices, health plans, and other providers are doing just that by establishing a presence on the Web. Should you?
Decidedly yes, says John Lester, information systems director for the department of neurology at Massachusetts General Hospital in Boston and chairman of the hospital’s Web committee.
"The Web is becoming the standard way of disseminating and collecting information," he says. "It’s vital because everyone is expecting Web sites to exist for any kind of organization. Patients and caregivers are starved for information. They’re voracious in their information needs, more so than someone looking at the Levi’s Web site to see what kind of jeans they want."
Since there aren’t any controls on what gets put up on the Web, patients may run across all kinds of quackery, Lester says, which is one of the main reasons he thinks providers should get into the game with accurate information. Other reasons are encouraging patients to get more involved in their own care, attracting new patients, and making existing patients feel more connected.
Lester developed and maintains the neurology department’s Web site, which features chat rooms where patients can have real-time discussions and bulletin boards where they can post messages and questions, a section that features poetry they’ve written about their diseases, and helpful links to finding the health information patients need. "We’re looking at the Web as a clinical intervention, something that could help people get healthier quicker or manage their chronic condition better," he says.
Two reasons to get on the Internet
So reason No. 1 for jumping onto the Web is the opportunity to improve the care and quality of life for your patients. Reason No. 2, the one that’s most likely to motivate your administration, is the opportunity to save money. Or the flip side, which is the opportunity to stay in business once all your competitors who are on the Web start stealing your patients, says Tom Ferguson, MD, who consults with health care providers about on-line communication and has written a dozen books on consumer health. Ferguson says consumer demand will lead providers to the Web.
"What’s going to happen in three years in a midsize city is that you’re going to discover you’re losing patients if you’re not on the Web," says Ferguson, who is also editor and publisher of The Ferguson Report: The Newsletter of Consumer Health Informatics and Online Health. "You’ll find they’re going to a competitor who sends them e-mail and who has a Web page and who makes it easy for them to get all the health information they want. That’s why you should worry about your Web site."
Watch out for the new players
Ferguson says that is already happening. "A lot of the best consumer Web sites are start-ups. It’s not the established hospital chains who are leading the industry here. It’s the people nobody ever heard of who are very Web-savvy and realize that on-line health is going to change health care. New players are taking market share away already from the established providers."
Once you’ve decided to establish a presence on the Web, you’re probably going to have a list of the usual questions that accompany any new effort:
o How much will it cost?
o What will be the return on investment?
o What elements do I need to incorporate to make it successful?
o Who can I benchmark with?
It probably won’t surprise you to learn that there aren’t really any good answers to those questions. The experts we consulted say there really aren’t any benchmarks out there for on-line strategies in any industry, much less health care. And because this is still a fairly new idea, there aren’t any good studies to yield cost or ROI data.
But you can’t afford to wait until there are. Consumers are heading in droves to the Internet for health information, and if they don’t get it from you, they’ll get it from someone else, says Barbara Bix, principal at Health Care Marketing Plus, a marketing research and consulting firm based in Newton, MA.
Bix cites statistics showing that 18 million Americans searched for medical content on the Internet in 1998, and 75% of people over 50 who go on-line are looking for medical information. If you look at those numbers from a marketing standpoint, you’ll see a gold mine of opportunity. Providers can use the Internet to expand their market presence, Bix says, as well as to tailor information to the consumer’s needs and engage in two-way communication with target audiences. And think of the potential marketing savings. Putting information on a Web site is a lot more speedy and cost-effective than printing a brochure. Changes can be made with a few clicks instead of a new print run, and you can reach an international audience with no extra expense.
"There really isn’t any research on whether Web marketing works for health care providers, but it doesn’t cost much to put up a site and see what happens," she says. "The good news is that the audience is already on the Web, so hospitals are better off being there, too."
How are others marketing on the Web?
Last summer, Bix did a study on how Boston-based health care organizations are using the Internet to support strategic marketing objectives. She conducted in-depth interviews with 14 hospitals and found that most had launched Web sites within the last year.
Here are some of the results of the Boston study, as published in Bix’s on-line newsletter, Health Care Marketing Matters:
- Boston-area health care companies are relatively new to the Internet marketing game. For the most part, they are putting a toe in the water before diving in with large-scale investments. They are not really sure how to gain maximum benefit.
- About half of those who had a site described that site as "successful," yet many respondents said they have not yet implemented ways to measure success. They said they didn’t know how to measure return on investment or the relative success of various approaches.
- Over half the respondents said they had received positive responses to their Internet efforts, including e-mail feedback, requests for more information, participation in on-line services, and registration for appointments.
- Despite the Internet’s potential, most of the respondents said that they didn’t expect their Web presence to give them a competitive advantage. Rather, they said that they were there because they had to be to remain competitive.
The caveat here is that you can’t just toss out a Web site and expect it to give you all the benefits mentioned above. Making the best use of on-line strategies requires a tall order: changing the way you think about providing health care, Ferguson says.
"As we all do, people in hospitals adapt to new technologies by figuring out how to do the things they’re accustomed to doing more effectively," he says. "They may overlook the opportunity to do some things they’re not accustomed to doing. That’s where the greatest opportunities in the Internet are. It really takes several paradigm leaps, one of which is taking patients seriously in a whole new way.
"The old paradigm was: When people had a problem, they went to see the doctor, the doctor told them what to do, they did it, and they either got better or died. Patients accessed health care by accessing doctors," Ferguson says. "With the Internet, we’re moving into an age of patient-centered medicine. The Internet gives patients power."
Many first-generation Web sites are basically on-line brochures, an example of taking something you already do and putting it on the Web. There’s certainly a need for information such as directions to the hospital and lists of specialties, but you need to think beyond that to really make good use of the technology, he says. Here are some of his suggestions:
- Buy a license to a database that provides self-care information and make that available. One source is Empower Health Corp.’s new Community Partner Program. The company, led by former U.S. Surgeon General C. Everett Koop, can create a co-branded local Web site that links your users to the features, content, and resources found on the drkoop.com site.
- Build a site around a physician. Ask him or her to supply content, offer to answer questions by e-mail, post a FAQ (frequently answered questions) list. Someone else can do the clerical work; the physician can dictate answers over the phone if he or she wants. Put up the physician’s photo and background information.
- Have your diabetes staff review diabetes Web sites and provide links to sites they think have accurate, useful information.
- Look at ways to automate routine processes using the Internet, such as prescription refills and appointments.
At Massachusetts General Hospital, a main Web site provides links to sites created by numerous individual departments. Strategies employed include on-line appointments, on-line patient support communities, private access areas where patients can get customized information from physicians, and physician/patient e-mail, Lester says.
"I do research to see what patients want on the Web," he says. "That’s really a bigger question than it seems. You can’t just ask what all patients want; you have to ask what patients with epilepsy want or people who just have a sprained ankle. Their needs are going to be different."
Lester says it’s a good idea to have a hospitalwide Web committee with representatives from different departments, as well as individuals who are responsible for Web pages on a departmental level. Massachusetts General also has four programmers whose primary responsibility is providing basic support.
He suggests starting with an on-line brochure, which would include a baseline of information such as directions to your facility. Don’t forget items such as the state in which your facility is located and area codes for phone numbers since your potential audience is worldwide. Make sure the information is updated regularly. Once you’ve got that much on the Web, start looking at ways to provide interactive elements, such as customized information, on-line support groups, and physician access.
"Static information is useful, but interactivity greatly adds to the support experience," Lester says. "Particularly with chronic illness where there is no cure or instant solution, the simple ability to communicate with people in the same situation is, to them, priceless."
The bottom line, Lester says, is on-line strategies have the potential to improve patient care. "A lot of it is banking on the future," he says. "You have to remember what your mission is in health care, and that’s to increase the quality of patient care. I think research will eventually show that patients who participate in on-line health communication will see their doctor less and have better outcomes."
[For more information, contact: John Lester, Information Systems Director, Massachusetts General Hospital, Department of Neurology, VBK Room 915, Fruit St., Boston, MA 02114. E-mail: lester@helix. mgh.harvard.edu. Web address: Neuro-www.mgh.har vard.edu.
Tom Ferguson, MD, Editor and Publisher of The Ferguson Report, 3805 Stevenson Ave., Austin, TX 78703. Telephone: (512) 474-1141. Web address: www.healthy.net/selfcare. To subscribe to Ferguson’s free e-mail newsletter, send a message to [email protected].
Barbara Bix, Principal, Health Care Marketing Plus, P.O. Box 404, Newton Center, MA 02459. Telephone: (617) 964-8193.
To subscribe to Health Care Marketing Matters, send the word SUBSCRIBE in the body of an e-mail message to [email protected]. You can also order the full report of Bix’s Boston-area study, including the original interview guide, methodology, and summary of results, by contacting Bix at the above number.
For Dr. Koop’s Community Partner Program, call Empower Health at (512) 726-5110 or visit the Web site at www.empowerhealth.com/partner.]
10 Web Sites to Bookmark
Here is a list of health care provider Web sites that can help you get started with benchmarking for your on-line efforts.
o www.sixsenses.com:
This site reviews other health care and medical sites. It’s a good place to start if you don’t know what you’re looking for.
o www.hon.ch/home.html:
Health on the Net Foundation has one of the leading sites as reviewed by sixsenses.com. You can search for other medical sites and hospitals as well as support groups and conferences. It also has a database of medical images and movies and offers a news page updated daily with links to articles on different health topics.
o www.columbia-hca.com.
This is another leading address from sixsenses. com, and you’ll see why. The "Web Babies" site allows users to view photos of newborn babies from Columbia/HCA hospitals. Only the baby’s first name and last initial come up, but once you find the right baby you can see birth details like date, time, and size as well as a message from the parents and a link to send them e-mail. Another interactive feature of the site is "Virtual Body," which uses macromedia shock-wave technology to let you see a multimedia presentation on the skeleton, brain, heart, or digestive system. Be sure to click on "what’s cool," although you’ll likely find the whole site cool.
o www.childrens.com:
Children’s Medical Center of Dallas offers health tips and a particularly interesting link to Starbright World, an interactive network that links pediatric patients from their hospital beds across the country into an interactive play-space designed especially for them.
o Neuro-www.mgh.harvard.edu:
This site from the neurology department at Massachusetts General Hospital in Boston offers chat rooms (live discussion groups for patients), a bulletin board that allows patients and physicians to post messages, a section for patient poetry about their illness, and "virtual chat," which is a graphical discussion room. Be sure to look at Hospital Web, a listing of other hospital Web sites. Also click on the link for the main MGH Web page.
o www.infonet.welch.jhu.edu:
Johns Hopkins Medical Institution in Baltimore has a Web site full of information arranged by category: health care, research, education, etc. It offers a searchable database to help you find people, documents, home pages, or jobs. Individual departments have their own Web pages with specific disease information, links to support groups, and on-line appointment making.
o www.mayo.edu:
The Mayo Clinic offers interactive quizzes with answers that lead you to relevant medical journal articles, health headlines, and research information.
o www-med.stanford.edu:
The Stanford University School of Medicine in Palo Alto, CA, offers news, health tips, and links to other sites as well as a virtual tour of the maternity ward. You can preview audiotaped lectures from the library.
o www.lowellgeneral.org:
To see what a smaller hospital can do, look at this site from the 208-bed Lowell (MA) General Hospital. "Patient Web" allows secure access to clinical information that can be searched by patients and providers. The site offers a library of medical images and health-related software, as well as information on health topics, hospital events, patient support groups, and the hospital’s Ask-A-Nurse service.
o www.celebrationhealth.com:
Celebration (FL) Health’s site offers a surround video tour with a 360-degree panoramic view of the hospital. You can check out physician/patient e-mail, class schedules, and health information on specific topics.
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