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TECHNOLOGY How the Web Unties Knots by Cliff Wright, O.D. Everybody complains about health care, but nobody does anything about it. On the Internet, though, a few upstart companies are trying to change that. You might not have noticed when Healtheon and WebMD merged in May. They created a powerhouse in the nascent on-line health-care industry. With a combined market capitalization of $20 billion, the new Healtheon/WebMD is
one of the largest U.S. health-care companies, on-line or off. The implications for us as O.D.s? Integration, shared information and speed. Health care is terribly inefficient. Providers, insurers and hospitals share
and gather patient information in old-fashioned ways. Doctors use paper for patient records, for Rxes, for billing insurers. Someone has to mail or fax these data, and re-enter them into the unique systems of other providers, none
of whom communicates with each other very well. Healtheon/-WebMD and competitors such as Confer Software are trying to fix this. These companies propose to use the Internet to automate medical data gathering and
dissemination. We would enter findings and care orders into an electronic patient record, then click "submit" to connect to the rest of the care chain via an Internet portal. Insurance pre-authorization and billing
information will go to the insurance company. Prescription information will go to the pharmacy, where the Rx will be waiting for the patient when he arrives. Lab orders will go directly to the lab. Health care needs
this kind of organizational overhaul because any given patient might require the coordinated interactions of a dozen or more providers-insurers, doctors, nurses, physical therapists, labs, hospitals, pharmacies and so on. In our case care-chain automation means entering exam data into an electronic system. The data would include all patient demographic and insurance information as well as all results from the exam—perimetry,
auto-refraction, lensometer, Rxes, etc. We'll enter all these data in real time during the exam. The patient will then go to the dispensary to select a frame. Dispensers will enter the spectacle Rx, then share it with
the frame vendor, optical lab and insurance company, all through an electronic interface. Imagine how many return calls this would eliminate when data entry clerks no longer have to decipher our hand-written notes. Think about how
many fewer calls we'll have to return to pharmacies because patient prescriptions will be complete and legible when they are entered, and smart software won't let us order medicines that are unavailable or incompatible with the
patient's other medications. Insurers will pay us sooner (theoretically, anyway) because all the exam information will be submitted in complete form at the time of the exam. We could achieve better disease management
because we would be capturing and managing outcomes as they're happening. Rather than simply invoicing the insurance company for a glaucoma office visit, we could capture data as it went across the wire between members of the
health-care community. We would know when it's best to start glaucoma therapy because we would constantly monitor outcomes of various therapies. We could even capture questions about the best way to fit RGPs and monitor them for
quality assurance as data flows between doctors, labs and insurers. The Internet is enabling the paperless office dream of "write once, share many" among the varied members of the health-care community. You may soon
benefit from this gain in efficiency. Dr. Wright, a private practitioner in San Leandro, Calif., is Review of Optometry's Consulting Internet Editor. |
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Healtheon (
www.healtheon.com) in Santa Clara, Calif., primarily offers technology services to
connect doctors, hospitals, insurers and consumers via the Internet. WebMD (www.webmd.com
), based in Atlanta, provides medical information and transaction services to doctors and operates a consumer Web site. Combined, Healtheon/-WebMD aim to offer a single portal to allow doctors and patients to conduct
transactions and obtain medical information. Competitor Confer Software ( |
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