What is Internet Healthcare?

Internet healthcare is not necessarily healthcare transacted exclusively through the internet. As most physicians and patients know, healthcare is a profoundly human process and always requires some degree of direct human contact.

Healthcare is also a profoundly complex endeavor, and seemingly more complex every day. In addition to the complexity of the underlying medical science, the healthcare process involves every type of business structure, financial structure and data structure ever conceived. Only recently has internet technology reached the point of sophistication required to support this diversely complex set of data and processes.

Getting your mind around the entire process is nearly impossible. Many have tried. Numerous terms have been coined in the process. Let’s explore two recent definitions, Health 2.0 and Medicine 2.0.

“Health 2.0” is a term that was defined by Scott Shreeve, M.D., about one year ago as follows: "New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, quality of health care delivery.”

Dr. Shreeve coined this term as part of his on-going effort to drive healthcare into the internet era in a manner that improves global healthcare efficiency and cost. The term has heralded a growing popular movement towards the provision of healthcare services using web technologies. Other terms exist which share a common space, for example “Medicine 2.0”.

On October 14, 2007, Walter Jessen, a PhD-trained biochemist and molecular biologist, presented the following definitions in his blog Highlight Health 2.0 - Following WEB 2.0 in Health and Medicine.

Medicine: derived from the Latin ars medicina, meaning the art of healing.

Web 2.0: the second-generation of web-based communities and hosted services that strive to facilitate collaboration and sharing between users.

Medicine 2.0 = Medicine + Web 2.0

For the uninitiated, lets begin with a general definition of the term Medicine 2.0 and the difference between it and Health 2.0.

Medicine 2.0 is the science of maintaining and/or restoring human health through the study, diagnosis and treatment of patients utilizing web 2.0 internet-based services, including web-based community sites, blogs, wikis, social bookmarking, folksonomies (tagging) and Really Simple Syndication (RSS), to collaborate, exchange information and share knowledge. Physicians, nurses, medical students and health researchers who consume web media can actively participate in the creation and distribution of content, helping to customize information and technology for their own purposes.

Health 2.0, a new concept of healthcare, also utilizes web 2.0 internet-based services but is focused on healthcare value (meaning outcome/price). Patients, physicians, providers and payers use competition at the medical condition level over the full cycle of care as a catalyst for improving safety, efficiency and quality of healthcare delivery.

I find very little difference between the terms “Health 2.0 and Medicine 2.0” - they both attempt to capture the extremely broad prospect of putting healthcare processes online. The fact is that no one term can capture the entire complexity. Fortunately, the internet is being constructed in such a way that it really does not matter.

Here are some specific examples of really new and different uses of the internet for healthcare—putting healthcare processes online:

­ A patient can grant any physician access to his or her “official” health record, including up-to-the-moment information, regardless of the location of the physician or patient.

­ A physician (or patient) can access emerging knowledge about a treatment at any time, and can “stay tuned” when new knowledge comes out.

­ A patient can use sophisticated monitoring and diagnostic machines at home (or implanted in the body) and the results transmitted via a PC and the internet to the doctor as needed or continuously… no need to stay in the clinic or hospital.

­ A physician can set up a virtual office at significantly less cost than a traditional “bricks and mortar” practice.

­ Physicians can self-organize meta-practices to optimize healthcare independently of and in parallel to insurance- or hospital-driven networks.

In essence, the doctor-patient encounter remains essential, but all the other stuff of transacting business AROUND that encounter can be streamlined and rationalized. Taken together, these new capabilities can help doctors and patients reinvent the delivery of healthcare.

The internet is extensible. The software applications provided through the internet are now being written in a manner that allows them to be extended by other applications written for the web. The concept of “dominant” software application is giving way to the concept of the internet becoming the dominant platform.

Old software was confined to operate within the confines of an organization (eg, a hospital, medical practice, ambulatory surgery center,…,etc.) Connecting outside this “scope” required special technology which essentially allows “outside” computers to connect to and interact with “inside” computers. With internet-based applications, there is no difference between “inside” and “outside” except for security protocols.

While this may raise all sorts of concerns, it also opens enormous opportunities and provides enormous immediate benefits. So much so that most feel that the benefits of this type of internet software design far outweigh the risks. In fact, given the current state of healthcare and predictions of further increases in the cost of health insurance, internet healthcare is a necessity, not a luxury.