The Internet seen as a divine gift to solve all major problems in health care

Washington D.C. 03 January 2000The Internet will radically change the face of health care. This was the starting point for keynote speaker Peter G.W. Keen to outline the marks of future health care delivery during the five-day Conference of the American Medical Informatics Association (AMIA), last November. Peter G.W. Keen is recognised as a major consultant and writer in information technology. His viewpoints on the role which Internet will play for each party involved in the health care process of the 21st century can be called visionary.


The IP-protocol constitutes a true revolution because it enables each IP-address and every IP-device to mutually communicate. The good news is that almost anything can become an IP-device: PCs, refrigerators, walkmen, as well as medical equipment. The health care sector will evolve from implementing distributed networks to using intelligent tools, allowing the customer to request information. The customer might be a physician, a medical specialist, a nurse, but a patient as well.

Wireless communication will experience a major breakthrough, according to Mr. Keen. Wireless communication constitutes the only way of stimulating the majority of medical specialists to actively use the computer. Up till now, easy computer access has formed a serious difficulty for mobile physicians. Currently, it is possible to bring the requested information to whoever needs it, wherever this person might be. In three years time, this will have become a common practice.

Bandwidth will be practically unlimited. In Finland, a test project is running to create wireless bandwidth up to 2 Mbps. In this country, mobile phones are equipped with perfect LCDs, almost superior to laptop LCDs. The Finnish students are submitted to severe controls for carrying mobile phones instead of weapons, in order to prevent them from cribbing. In addition, application service providers, such as SAP, HP, and McKessonHBOC, will offer software-on-demand to hospitals. Keen's scenario anticipates that hospitals will not pay for the software package anymore but instead will contribute an amount per bed on a monthly base, or per hour of usage. Software thus will turn into a variable cost.

Mr. Keen expects that leading Internet providers in particular will come up with crucial innovations in the medical record area instead of the traditional hospital software suppliers. Electronic patient and insured person records will be managed by application and Internet service providers. The nature of Internet technology enables to implement applications which the patient has always wanted. As an example, Peter Keen mentioned the Scottish insurance company Provident, that from now on exclusively covers personal risks, such as health.

The insured person and his family have a right to all sorts of services, even a nurse if needed, in exchange for the on-line delivery of medical data. In this regard, the insurer expects the patient to be willing to cooperate and as such be submitted to free medical check-ups, which offer useful advise on weight, obesity or cholesterol level. If a patient suffering from overweight, succeeds in losing five pounds, this may lead to a lower premium. Both parties have an interest in this collaboration, which means a vital key to success for each company, including health organisations and medical insurers, according to Mr. Keen.

The Internet will equally solve the issue of legacy systems within the health care sector. Advanced application programming interfaces (APIs) allow to approach a legacy system as an object, suitable to encapsulate. The user is no longer troubled by the confusing tangle of different data formats and structures, because the latest web technology enables him to shield off the concerned object. Peter Keen anticipates that web portals will clean up all logistic waste. Hospital information systems providers should be urged to offer software support to the chain health care delivery to avoid any logistic waste.

Mr. Keen also predicts a rapid growth in the sale of pharmaceuticals over the Internet as well as in on-line medical consultancy. Internet is a pre-eminent tool for expensive products and services which can be cheaply shipped, such as books, air travel tickets, and medical advice. Even if the market share is small, the trade is economically viable. According to Peter Keen, 60% of the Internet users regularly searches for information on medical web sites. This ushers in a whole new relationship between the doctor and his patient, who knows a lot more about health and disease. In turn, the Internet can become a paradise for the hypochondric person, constantly in search of proof for the terrible diseases which are threatening him.

Peter G.W. Keen has served on the faculties of Harvard, MIT, and Stanford, with visiting positions at universities abroad. Being a prolific writer, Keen has strongly influenced the business-technology dialogue. His latest books include The Business Internet (1998), The Process Edge: Creating Value Where It Counts (1997), Every Manager's Guide to Multimedia (1997), and On-Line Profits: A Manager's Guide to Electronic Commerce (1997). His Every Manager's Guide to Information Technology (1995), currently in its second edition, offers business managers a succinct overview of the key IT concepts and terms. The Automatisering Gids has served as a major news source for this article.

Leslie Versweyveld

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