One would be hard-pressed to find a U.S. hospital that doesn't have at least a crudely basic Web site that provides simple data such as phone contact information and driving directions. Beyond that level, however, it all gets very complicated very fast.
Experts estimate that at least a large plurality of hospitals nationwide now provide some level of substantive content, which tends to fall into one of three very broad categories: information on the hospital's patient care services; physician network/health insurer/payment information or facilitation of various sorts; and actual clinical content, in the form of organized consumer health information.
As more consumers move onto the Web, hospitals are struggling with strategic and practical issues around all three areas, and trying to manage the technological aspects of maintaining Web sites, while determining what kinds of consumer health information to provide (if any).
"A majority of larger hospitals are providing some clinical content," notes Rick Skinner, a vice president at Long Beach, Calif.-based First Consulting Group, "and there are about three general levels" when it comes to providing such content, says the Portland, Ore.-based Skinner, a former CIO.
At the highest level, a handful of prestigious tertiary care organizations, like the Mayo Clinic, are able to fully self-develop their own original clinical content, organized around research activities. "Obviously, there are only a few academic institutions that can do that," Skinner points out.
Below that level are a very large number of hospital organizations that contract with third-party clinical content vendors (such as Atlanta-based A.D.A.M., Boise, Idaho-based Healthwise, and Norwalk, Conn.-based HealthDay) to put such content on their Web sites, along with, in varying degrees, elements of their own creation, such as columns from chairs of cardiac surgery, for example.
And then there are the hospitals that carry no consumer health information at all. Within the second group are hospitals that don't buy content services, but might extract individual articles from, say, the Journal of the American Medical Association, to highlight particular clinical service areas they want to promote.
Columbus-based OhioHealth system, with nine member hospitals serving 46 central Ohio counties, has provided consumer health information for six years, reports Adrienne Shin, the health system's Web manager. OhioHealth provides over 4,000 pages of consumer health content, organized so that, for example, "If you go into 'angina,' you could see our heart service line information," Shin explains. But, Shin adds, she and her colleagues realized not long ago that, "We wanted to get out of having a second-tier Web site that just provided static information, and instead provide interactivity and end-to-end integrated services, while finding some way to make content changes and navigation easier." So she and her colleagues turned to Solvang, Calif.-based Medseek.
More than one way
There are two subgroups within the category of hospitals putting consumer health information on the Web, says Gale Wilson Steele, Medseek founder and chief strategy officer.
"There are those willing to pay up to $100,000 a year, which is what it costs" to buy content from the major content providers; and those who take a smaller-scale approach, with heavy mixing of their own medical staff-produced content.
Given the cost, some hospitals have decided to forego the development of clinical content online in favor of other priorities. At the four-hospital, 1,030-bed St. Joseph's-Baptist Health System, Tampa, Fla., Webmaster Amy Gall notes that her organization had maintained some clinical content online for years, but has decided to abandon that service.
Instead, it plans to reach out to the Tampa Bay area's burgeoning Hispanic population through online Spanish-language facility/system information from automated multilingual online information service provider MotionPoint, Coconut Creek, Fla.
Mark Hagland is a contributing writer based in Chicago.
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