Metaforix@Health: Healthcare, Online and Off

Lois C. Ambash is President and Chief Infomaven of Metaforix Incorporated, whose services include organizational assessment and planning activities, web site and e-letter content development, and design and delivery of customized workshops for healthcare, education, business, and community organizations. Lois holds a PhD in American Culture and Writing, Master’s degrees in Library/Information Science and Public Policy, and a Bachelor’s degree in English. She serves on the board of the Internet Healthcare Coalition and on URAC’s Health Web Site Accreditation Committee, and is a frequent writer and speaker on e-health, Internet research, business communications, and organizational culture.


No industry or profession has been more profoundly transformed by the challenges of the Information Age than healthcare. Healthcare is the Internet writ large, privacy magnified, electronic bits and bytes turned potentially into matters of life and death. That’s why its electronic incarnation is so critical to information professionals and attorneys and so fascinating to me, and why, beginning next month, I’ll be contributing a column to LLRX.com on health and e-health issues. (For clarity’s sake, I’ll use health to refer to health and medicine in the bricks-and-mortar world. For the universe of health information, products, and services offered online, I’ll use e-health.)

Healthcare in the United States is a $1.6 trillion industry, accounting for almost 15% of the GDP in 2002. Like any Information Age business, healthcare is not just about making a profit by producing desirable products and services (or, in the case of public and not-for-profit organizations, fulfilling a mission while living within a tight budget). The visibility and speed of electronic communications make competition fiercer than ever and business practices ever more subject to public scrutiny, legislation, and regulation. The demise of lifetime tenure with a single organization means that companies are growing one another’s future leaders, thereby increasing the need for common ethical, professional, and quality standards that translate well within and across entire industries. For their part, individuals find themselves constantly reexamining the nature of privacy, identity, and values in an era when each data nugget takes on an endless life of its own.

Information technologies form the linchpin of this new environment, daily posing new dilemmas that defy the capacities of law and public policy to address them before they morph into new and unrecognizable forms. A few cases in point:

  • Codes of ethical and professional standards (registration req'd), along with quality processes and benchmarks, have been amended and sometimes completely reinvented to keep pace with technological innovations.

  • The virtual homes of healthcare providers, systems, and businesses may now seek accreditation through a rigorous web site accreditation process that did not exist as recently as three years ago. Administered by URAC, the program has thus far accredited an impressive array of .coms, .orgs, and .govs.

  • Hotly contested health privacy regulations, mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), began to take effect last April. Comment and controversy (link requires a free subscription) over the standards and their enforcement remain widespread among patients, providers, and privacy advocates. The first of what promise to be many lawsuits began wending their way through the courts as long as a year prior to HIPAA implementation.

  • Americans so routinely search for health information online – 93 million adults, according to a study by the Pew Internet and American Life Project released last July -- that the healthcare community is growing ever more concerned about the quality of the results. URAC and Consumer WebWatch, funded by grants from the Robert Wood Johnson Foundation and the Department of Health and Human Services, have recently completed a project designed to “examine the factors influencing the results of online health searches” and to “develop technical and educational approaches for maximizing the quality and benefit of health searches” for consumers.
  • (The project results and recommendations are to be posted on the URAC site within the next week or two. I will discuss them in an upcoming column.)

    All of which is to say nothing of electronic medical records, doctor/patient e-mail, online pharmacies, disease management software – or any of the real world health policy issues that beset our aging, underinsured, overly litigious nation. There’s plenty to cover. As one rough indicator, when I GoogledTM “health web sites,” I got over 8 million results.

    I would like this column to address the health and e-health issues that interest readers most. So I hope you’ll help me narrow things down by taking a moment to complete a 3-question survey. Your responses will not be tracked or individually identified in any way.

    Just click here to be redirected to the survey page. I’ll look forward to your responses.