The Empowered Patient – ‘people power’ in e-health


Over the past few years, the impact of IT on healthcare has been mind boggling.

From shared electronic health records (EHRs) to remote diagnostics; from secure, role-based access to patients, medicine and operating room information to “virtual” surgery using haptic technologies; from physicians being able to instantly pull patient data from a variety of repositories on to their laptops and PDAs, to sophisticated technologies enabling comprehensive collaboration among healthcare providers in different countries and continents.

Indeed, IT’s powerful and positive impact on healthcare is spurring governments and the private sector to invest more in this area.

Research published by IDC in Framingham, Mass. indicates health care IT spending in North America will increase significantly over the next eight years.

The study forecasts a compounded annual growth rate of 15.8 per cent in the EHR market over the next ten years (spending in 2005 was estimated at $1.27 billion (US$1.1 billion).

In 2015, the analyst firm predicts IT spending in the U.S. EHR will grow to $5.54 billion (US$4.8 billion). “We’re seeing a renewed interest and investment in healthcare IT,” said Lynne Dunbrack, lead author of the IDC report.

So here’s what we know: IT is having a phenomenal impact on healthcare – wonderful. Investments in e-health are growing – awesome.

But there’s still one big problem, I believe – imbalance.

It seems most significant healthcare IT investments and initiatives are focused on the providers of healthcare – on creating tools, technologies and resources that help them do their job better, quicker, and more efficiently.

True the ultimate beneficiary of all this is the patient (or the recipient of healthcare services), but there are relatively few noteworthy IT projects that seek to directly empower the recipients of healthcare.

Instead, there seems to be an unspoken, but nonetheless pervasive view that sees patients as purely as consumers of healthcare, as or more or less passive recipients of services provided by the “experts.”

Few initiatives seek to offer patients or lay people the IT resources they require to better diagnose or understand their own condition (for example), or to more effectively interact with their healthcare providers – in short, resources that would help them take control of their own health.

But the good news is some recent efforts have been made to correct this imbalance – though it’s not very clear yet what their ultimate impact will be.

Let’s review a few of these initiatives: – This site was launched by AOL co-founder Steve Case, who says its goal to help common folk “[make] sense of the complicated world of healthcare” and to put the patient at the centre of that world. The site – still in its development phase – seeks to offer people at least three types of resources: information, interaction channels, and assessment tools. promises that healthcare information on its site is trustworthy. “We’re creating a resource you can rely on, a place you can go to learn about all aspects of your health, from sources you can trust,” Case says in his introduction to the site.

The portal also enables “patients” to interact – and, if possible, to find support and trade information and insights – with others who have similar health issues.

For example, if you or someone in your family has had a stroke, you can connect with others living through that experience, and learn what worked or didn’t work for them, as well as share your own learnings and insights.

The portal also offers “Revolution Ratings” – a system that helps people select a doctor, hospital, or treatment option based upon how these are rated by others. (Right now, the ratings feature is limited to hospitals or physicians in the U.S.).

Case talks about how “crazy” it is that we have ratings to help us pick movies, restaurants and hotels, but no comparable tools to assist us in evaluating doctors, hospitals and treatments.

Revolution Health, he says, seeks to change that.

The company has a membership program as an optional “adjunct” to its free site because “not every question can be dealt with online.”

Members will be able to “speak to someone who can help – whether it’s a question about a diagnosis, or difficulty in finding a doctor, or issues with your insurance company,” the site says.

Membership of is being offered free in 2007 – but it seems the founders have already thought of some pretty innovative ways to monetize the site’s offerings.

Medstory and Microsoft – Fact: millions of people seek answers to health question on the Web. Fact: millions can’t get the answers they seek or can’t trust the answers they get.

An October 2006 study by the Pew Internet and American Life Project revealed the following:

• More than eight million people in the U.S. go online for health information every day.

• More than half (53 per cent) said a recent Web search had an impact on how they took care of themselves or someone else.

• Around a quarter (22 per cent) said they felt frustrated by the lack of information, or an inability to find what they were looking for.

In the light of all this, I believe any initiative to enhance people’s ability to search and locate relevant health information on the wild wild Web is a good thing.

One company that seeks to do this is Foster City, Calif.-based Medstory Inc. that offers a new approach to healthcare search.

Medstory founder Dr. Alain Rappaport explained it thus: “Instead of trying to force people to think the way a computer searches, we’re enabling computers to conduct searchers in a way people think.” offers users “intelligent guides” to help them refine and better target their searches. The search results are organized in ways “more relevant” to the search criteria used.

Cool technology, but one that obviously needs to be refined and enhanced – and that takes money.

That’s why I believe the acquisition of Medstory by Microsoft Corp. in February this year is a good thing. Microsoft’s global reach and financial wherewithal can help Medstory significantly improve its healthcare search technology in ways that are likely to really benefit users and healthcare professionals.

Google – great ideas but…

One would expect Google to be leading the charge for consumer access to relevant healthcare access online. And at the level of theory, it has. However, while the company has articulated its position very eloquently on the issue, it does seem that what we have from Google on this issue so far is more sound than substance. Last December in a blog entry titled health care information matters, Google vice-president Adam Bosworth brilliantly articulated the need for better educated patients. “If patients understand their diseases better,” he wrote, “the symptoms, the treatments, the drugs, and the side effects, they are likely to get better and quicker care – before, during, and after treatment.” A month later, in a <a href="

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