Telecommunication

And the Transformation of Healthcare

I remember when . . . An acoustic coupler was high tech Programs were stored and loaded on

cassette tapes A hot computer was a full-loaded Apple II,

with a 30 inch box fan blowing over it to keep it functioning

Two disk drives were mass storage

Transformation . . . . . . the act of changing form, appearance, or

structure Acoustic coupler has become a T1 or a T3 Apple II has become a multi-processor

workstation Kilobytes have become gigabytes

The Internet Was a text-based medium for military and

scientific communication Required technical skills to use Has become a multimedia vehicle for

information exchange Has become accessible to the general public

The Internet Opportunity How big?

Estimates vary from 5.8 million3 in the United States to 37 million4 in the US and Canada

Demographics5

21% have a sales, marketing, or promotion job function

15% have an engineering job function 11% have an MIS/data processing job function

3 & 5 http://www.ora.com/bus/ora/survey/index.html (O’Reilly)4 http://www.nielsenmedia.com/whatsnew/execsum2.htm (Commercenet/Nielsen)

Demographics

Demographics5

67% are male 50% have incomes over $50,000

High educational levels 40% are between the ages of 30 and 44 years

5 O’Reilly

April 1997

How big is it today? If the Internet is doubling in size every year,6

then there are 17.4 million users If the Internet is doubling in size every 6

months,7 then there are 26 million users Whatever the estimate, the Internet is reaching –

or has reached – critical mass in marketing terms, 10% market penetration

6 O’Reilly, October 1995.7 Health Care: The Battle on the Internet, Health Ink Communications

Health Care Was delivery based Became integrated Is in the process of “dis-integration” Is being more driven by financing Profit vs. not-for-profit Mergers, acquisitions, and closures Will continue to change rapidly and

dramatically

The Perfect Marriage Dynamic environments

Rapid changes in both industries Both industries are competitive Information intensive

Healthcare: the need for information Technology: the provision of information

Dynamic and Volatile Dynamic

A new site is created every 50 seconds8

The Internet is growing rapidly The Virtual Hospital at the University of Iowa receives

more than a quarter million requests for information per week9

8 Health Ink Communications9 Journal of Health Care Marketing, Spring 1997

Dynamic and Volatile Volatile

Technology giants Microsoft, IBM, and AT&T scrapped their plans to build stand-alone consumer health information sites10

10 Health Ink Communications

A Case Study: www.hmhp.comHarris Methodist Health Plan

Development began in the Fall of 1995 In January of 1996, a presentation was to be

made to senior management and was scuttled for political reasons The political question:

Is the Internet a communication vehicle or an information technology strategy: marketing/ business development vs. MIS?

The Battle for the Internet Marketing contended it was a communication

channel MIS declared it a technology initiative It was a battle of the titles: the executive VP

and the senior VP Electronic mail in ALL CAPS flew around the

organization, jobs were threatened Communication (executive VP) won

www.hmhp.com Initial goals:

Provide another channel by which prospective clients (companies) and individuals (for the individual HMO) could gather information about product offerings

Demonstrate that we are forward thinking We threw out the notion of communicating

about the integrated health care delivery system

www.hmhp.com Site registered with InterNIC in April of 1996 Version 1 posted immediately Flat, “two dimensional” site No interactivity Development of hmhp.com has mirrored the

development of the Internet: text-based to graphical

www.hmhp.com Version 2 initiated some interactivity

Implemented a new graphical look Provided an application for our individual

product Downloadable files, PDFs, of our provider

directories Online, real-time search for primary care

doctors A “hodge-podge” of information

www.hmhp.com Version 3: where we are today

A site with two “linear” tracks, though still a “shopping” site

Client track shows the range of products available to companies

Individual track shows HMO options for individuals and families

We’re still not controlling the visitors experience of the site

www.hmhp.com Version 3 activity

Generating about 275 hits per week Guest book shows that people are arriving

at our site as a result of other elements of the marketing mix, particularly direct mail and billboards

Guest book indicates about 70% of visitors are men

Individual sales have been made

The Future: A Prognostication HMOs will provide more information over the

Internet Kaiser has a pilot program to deliver member

information over the Internet11

United Healthcare and Aetna/US Healthcare will roll out similar information products

Columbia/HCA will continue its major Internet effort and others will follow

Health information sites will continue to proliferate

11 “Improving Service to Patients,” Health Data Management, April 1997

Continued Prognostication Major development will happen within health

care organizations to use Internet technology internally – intranets.

Intranets and the Internet will merge on a selective and secure basis – the extranet.

The Future for Harris Version 4 of our Internet site is under

development and should be posted in June Specialized tracks:

Shopper tracks: prospective clients and members

Client track: for those companies that are already HMO clients

Member track: information for members Attempt to exert additional control over the

visitor’s experience

The Future for Harris,Continued

Move to server-side applications Health Risk Assessment

“Open” to the general public, unsecuredAvailable to members, secured/encrypted

Mass customize the visitor’s experience based on market segment Client/non-client, member/non-member, age,

gender, interests, etc. The communication vs. technology debate

arises again

Closing Thoughts Is the Internet the perfect marriage between

health care and technology? Need to match the goals of an Internet

presence with the needs of the customer and the way health care decisions are made

In a household, the decision-maker is a woman and women make up approximately 30% of Internet users

If a match is found, Internet technology is a cost-effective communication medium