Web Tools Target Patients
LEGISLATORS AND CONSUMER advocates across the country are debating controversial bills protecting the rights of patients under managed care. Meanwhile, a host of Internet startups is advocating a private-sector approach to help consumers take control of their health. More robust and interactive than a Web site, these products use Internet technology to connect patients with their providers, and through online surveys, research and decision support, promise to transform healthcare consumers into case managers. Healthcare organizations and payors, too, are bound to benefit when patients push valuable data back over extranets or the Internet.
According to Doug O’Boyle, program director of healthcare IT strategies for META Group, Inc., these early-stage products fall into two categories: 100 percent Web-based, and home PC applications that have a Web component. "Generally, all of these are designed to make it easy to input clinical data and relay it back to the provider," he says. "The idea is to keep patients out of the hospital."
The Florida experiment
Consumer outreach is an abiding vision behind the part resort, part high tech laboratory Celebration Health facility, located in the Disney-backed town of Celebration, Fla. With nontraditional health services like a sleep disorder center, pain center and lifestyles management center; a 60,000 square-foot fitness center, library and health food cafe on campus; owner Florida Hospital Health System has created a wellness-focused environment for the 21st century. Celebration’s commitment to technology is unfolding with medical records software from EPIC Systems Corp., Internet-based computer kiosks and touchscreen computers for patients throughout the facility, telemedicine workstations (later this year) and a Web-based patient-centric suite of applications and services.
One of the core programs, scheduled for beta roll-out this summer, is a personal health record for patients called HealthCompass, codeveloped with HealthMagic, Inc., Denver. HealthCompass is free for Celebration patients and accessible from the organization’s Web site (http://www.celebrationhealth.com). Through an interface to the EPIC system, patients will be able to receive parts of their official records--authorized by the physician--to store in their personal record, says Fred Galusha, VP of IS at Florida Hospital, Orlando.
Patients can then build on this by taking surveys or keeping a medication diary. The system also pushes relevant articles and research to patients based on their profile, and offers resource links and chat groups for 75 disease categories. Patients will be able to record vitals such as blood pressure and send the results over the Internet to the primary care provider’s office, which in turn could email reminders for preventive services--triggers that the software also could generate, according to Nelson Hazeltine, chief technology officer of HealthMagic. He says the timing of such applications is key in the current climate of managed care consumer backlash. "Baby boomers are now at an age where they’re going to demand appropriate care and they aren’t going to accept just what the doctor says," he says. "The patient has now become the case manager."
The software is NT-based Microsoft SQL Server and uses proprietary digital certificate and firewall technologies for authentication and access control, according to Hazeltine. This gives the patient secure access to his or her record but also the ability to select parts of it to share with the provider. The Web interface was designed by Renaissance Interactive, in Columbia, S.C.
Through HealthCompass and a growing slew of online services at both the Florida Hospital and Celebration Web sites--including a physician database and referral service, patient preregistration and appointment scheduling, and interactive health surveys--Galusha hopes the organization will provide better customer service, realize lower healthcare costs and gain market advantage. "We really want to provide a technology and an avenue to facilitate a relationship [between providers and their patients]."
Large employers buying in
Northern Telecom (Nortel) is launching a pilot of a similar Web-based personal health product from GlobalMedic, Ottawa, Ontario, that will be available to 12,000 Nortel employees in Canada this summer. The product will serve as a complement to Nortel’s existing wellness programs, and will help Nortel meet the health information needs of a decentralized workforce of virtual, home-based and traditional office employees, according to Anda Bruinsma, Nortel’s manager of employee well-being and global programs.
GlobalMedic President and CEO Fernand Taras, M.D., describes the Health Manager product as a single channel for employees to manage their health benefits, receive health information and maintain a personal record. It runs on a Windows NT server at GlobalMedic, and through an extranet connection, Nortel employees can log on to the program from the employee health Web site. To maintain confidentiality, Global Medic serves as a third-party administrator by issuing PIN numbers and passwords, and provides Nortel administrators with access to aggregate, disidentified patient data only. Pricing is based on a monthly per member fee ranging from 80 cents to $1.50 per user--not including customization and installation.