The Internet and Healthcare, 2d ed - Review

Healthcare Financial Management, April, 1999 by Patricia R. Simmons

Edited by Louis Nicholson Health Administration Press, Chicago, Illinois, 1999 125 pages; $28

The second edition of The Internet and Healthcare is a compilation of nine independent articles by 11 authors who discuss various aspects of the emerging role of the Internet in health care. The book covers a broad range of topics, from broad-based Internet applications for community access, to the implementation of intranets as a means of providing a single common point of access to a health system's information resources. The book not only recounts the benefits of the Internet as a means of enhancing the processes of healthcare delivery and administration, but also addresses concerns such as security, privacy, reliability, and user acceptance.

The book's introduction offers a compelling discussion of why healthcare organizations should embrace the Internet. The authors refer to the cost pressures resulting from managed care initiatives, the trend toward developing integrated delivery systems, and increasingly discriminating healthcare consumers.

In the first chapter, Aaron Garinger provides historical back- ground and a discussion of basic statistics and trends regarding Internet use. The discussion is general, not specifically touching on health care, but most readers will be interested in comparing themselves with the demographic profiles of typical Internet users.

The second edition contains two chapters not included in the first edition. Chapter 3, by Peter M. Kilbridge and Michael Schneider, examines the Internet from the perspective of the physician. The authors discuss the considerable advantages of the Internet in terms of enhanced physician-patient communication, while also addressing the obstacles that must be overcome, such as ensuring confidentiality of patients' e-mail communications with physicians. Chapter 4, by John Odden, describes the potential benefits and pitfalls of incorporating Internet access into a call center. The book is considerably strengthened by the addition of these two chapters.

A common theme running through the book is the capacity for the Internet to serve multiple functions, such as facilitating patient scheduling, providing a repository of data that can be used in research and education, and serving as a conduit for real-time data that can be used to support clinical decision making. For example, patients might use the Internet as a convenient way to self-schedule appointments, or a patient with heart problems might wear an electronic bracelet that transmits EKG signals to a Web site that automatically pages the patient's physician should an abnormal reading occur.

Despite its brevity, The Internet and Healthcare is large on ideas. If the book fails to provide a clear overall picture of where the Internet is taking health care, it does impart an overwhelming sense of the massive potential of the Internet for health care. Always stimulating, and sometimes futuristic and scary, the book is a quick read that will keep readers thinking long after they have finished it.

Reviewed by Patricia R. Simmons, FHFMA, director, decision support, Community Medical Center, Toms River, New Jersey, and a member of HFMA's New Jersey Chapter.