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Harnessing the power of the Web

An updated site improves communication with patients and staff

From the January ACP Hospitalist, copyright © 2007 by the American College of Physicians.

By Lisa Holton

A decade ago, many hospitals plunged into the nascent Web marketing trend by offering online access to basic information such as location, medical specialties, facility information and the institution's mission statement. But development stalled, and many hospital sites look almost the same today as when they were created.

That's a problem with today's increasingly savvy Internet users who are driving innovations in how information is exchanged between doctor and patient. Hospitals that have failed to keep pace with technology are also missing out on improving the flow of information internally.

"The hospital industry picked up quickly on the Internet. What they didn't do was devote resources to it, and it wasn't always a question of money," said John Eudes, chairman and founder of Greystone.net, an Atlanta-based Internet consultant for health care organizations.

There are many excuses for holding back on Web development, including concerns about privacy, cost and manpower. But the most formidable obstacle may be getting people to accept change.

"The hospital environment is one that values tradition, and there are a lot of people within hospital organizations who have a real problem with transparency. The Web can be a challenge because it simply discloses so much," Mr. Eudes said.

Historically, physicians and physician-managers have been the information gatekeepers in hospitals. Information has traditionally flowed down from doctors to patients and staff without an easy way to get information upstream. The new challenge is to harness the power of the Web to facilitate a two-way exchange.

The problems within

The Internet can be a versatile problem-solver. For example, Internet-enabled links between hospital staff and referring physicians can provide real-time treatment data on patients. Online training and feedback systems for clinical and nonclinical staff and two-way communication systems between staff and management could lead to more efficient processes and cost management.

"The hospital industry picked up quickly on the Internet. What they didn't do was devote resources to it, and it wasn't always a question of money." —John Eudes, Greystone.net

Children's Hospital of Philadelphia (CHOP), for example, added a secure Web portal for referring physicians who want up-to-the-minute information on their patients.

"Historically, referring physicians in any hospital setting have had to wait for a dictated and mailed discharge summary to see what happened to their patients in the hospital," said Terese Vekteris, director of integration solutions at CHOP. "Our system provides referring physicians access to…a mini version of a patient's hospital chart."

Information such as test results, operative summaries and discharge notes feed electronically from the hospital's clinical systems to a portal so referring physicians can enter with a password and secure real-time updates. CHOP doctors are reachable by e-mail through the portal, giving the referring physician an alternative to a telephone call. Questions can be asked and answered at times convenient to either physician.

Cast a wide net

An October 2006 survey by the Pew Internet & American Life Project showed that most Internet users start with a search engine when looking for health information. If hospitals can find a way to step into this random search process, they can establish themselves as regional and national centers of expertise for certain diseases and conditions. That strategy may attract not only patients but also referring physicians.

Pointing out that her organization's study was not intended for marketing purposes, Susannah Fox, an associate director at Pew Internet, says that hospitals need to expand their thinking about who's really online.

"They shouldn't be thinking about one person, but everyone who surrounds that person (and influences their decision-making)," Ms. Fox said. For example, she said, hospitals should have an "e-mail this page" feature on every page of their Web sites so a visitor can send information to a loved one.

The Pew study suggests that hospitals might find a way to generate or license clinical content and use it to deepen relationships with patients, potential patients and their doctors on a much wider geographic scale.

Michael Howley, Ph.D., a physician assistant and assistant professor of marketing at Drexel University in Philadelphia and a former hospital medical assistant, sees hospital Web sites as more than an outside marketing tool.

"Doctors, nurses and assistants may not have as much time as necessary to answer all patient questions before a procedure," Dr. Howley said. "In an appropriate situation, why not let them view information on the hospital's intranet before or after you speak with them? They'll be better informed and that will help communication overall."

To facilitate development of on-site Web-based education, physicians, nurses and extenders might meet to consider how doctor-patient communication can be enhanced by material on the Web. Web-based instruction might also be useful to educate ER patients before they're transferred to surgery, radiology or some other unfamiliar department.

"We do a lot of research, and we will interview families or do online surveys when considering changes," Ms. Vekteris said. "We even worked directly with our patients to develop educational multimedia specifically for kids. The Internet can provide as many solutions as you want it to provide."

Lisa Holton is a freelance writer in Evanston, Ill.

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ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated