eHealth as new bag of physician tools, poised to transform economics of health care

Rochester 14 November 2001The latest issue of Harris Interactive Health Care News focuses on a report by the Boston Consulting Group (BCG), titled "Vital Signs Update: Doctors Say eHealth Delivers". The report is based on newly released data from a nationwide survey of a cross section of 400 practising physicians which takes a closer look at how the Internet is influencing the physician's behaviour. With ehealth startups floundering, many health care players have been quick to discount the viability of ehealth. This recent survey of physicians, however, indicates that ehealth has quietly become a vibrant medium for reaching the medical community, and promises to gain even greater acceptance in the near future.


The proprietary study by BCG, conducted by Harris Interactive, was based on interviews of 400 United States physicians by telephone in February and March of 2001. Of the 400 physicians surveyed, 356 or 89 percent were using the Internet. The findings show that not only has the Internet already had a considerable impact on physician behaviour, but they strongly suggest that the influence of the Internet is likely to increase. In the study, BCG defines two areas of ehealth which increasingly attract physicians to the Internet, being knowledge enrichment and patient care.

The study reveals that doctors are using the Internet in force for gathering medical knowledge and that they are beginning to embrace on-line tools that enhance patient care, such as electronic prescribing, on-line communication with patients, and electronic medical records. Even more importantly, doctors are reporting that the information they find on-line is influencing, for some, in a major way, the types of diagnoses they make and the prescriptions they write. This has significant implications for the pharmaceutical companies, managed care organisations, and health care delivery systems that seek to influence physician behaviours. Those firms that re-evaluate and realign their mix of investments in off-line and on-line marketing will enjoy significant competitive advantage.

The 89 percent of doctors on-line in the BCG survey are spending an average of three hours each week to medical activities on the Internet. In fact, fully 90 percent of this category reported that they research clinical information on the Web, while about 80 percent stated that they read journal articles on-line. Also gaining acceptance are interactive ways of sharing information with colleagues, such as on-line conferences and courses for continuing medical education, with adoption rates ranging from 31 to 45 percent. Of the high-volume care providers or the busiest practitioners, who spend 65 or more hours a week with patients, two-third responded that they are searching for medical information on the Web, whereas only half of their counterparts, who dedicate 20 to 34 hours a week to patient care, do so. The former group constitutes an interesting target for any organisation aiming to influence the delivery of health care, according to BCG.

In stark contrast to patients, most physicians on-line concentrate on a handful of Web sites, to which they return faithfully, making these doctors easy to find in cyberspace for health care players, such as managed care organisations (MCOs) and pharmaceutical companies. On the other hand, the sites to which doctors return most frequently place strict limits on sponsorship and content, making it very difficult for players to use them to their advantage. Therefore, organisations will need to focus on devising unique and customised ways to reach doctors, as the study points out, by providing appropriate knowledge-building tools on the Web.

Also, electronic tools which help physicians with their daily patient care have the potential to deliver additional value but inhibiting factors including cost, reimbursement, and privacy issues have to be resolved first. In spite of this, already 26 percent of the physicians in the survey are communicating with their patients over the Internet, and 22 percent are relying on electronic medical records to store and track information about their patients. Currently, remote disease monitoring and electronic prescribing are yet being applied on a smaller scale: 11 percent of doctors reported that they prescribe drugs electronically, and 5 percent that they tele-monitor their patients' health. However, planned adoption would roughly triple the percentage of doctors turning to e-prescribing and remote disease monitoring in the next 18 months.

The majority of physicians in the BCG survey reported that on-line patient-care tools have improved their overall efficiency, enabled them to deliver better care, increased patient satisfaction, and, in some cases, saved their practices money. The growth in delivering ehealth will also result from the "virtuous circle" of adoption: as users experience positive outcomes with one on-line mechanism, they will become more open to others. In any case, the BCG research shows that different types of tools are attractive to physicians with different workloads and areas of focus. Thus, health care players must carefully segment the heterogeneous group of physicians, first identifying and then targeting the primary causes of inefficiency and the opportunities to improve patient care for different doctors and practices.

In conclusion, the BCG researchers suggest that once companies identify which on-line tools offer them the greatest strategic advantage, and how they can tailor them to the specific audience they are aiming to influence, the best approach for introducing those tools mirrors one that is already proven among physicians: the drug launch process. Even MCOs and health care delivery systems will find this strategy useful because it engages the forces that move doctors to trial, which are: demonstrated efficacy; personal testimony and professional recommendation from peers acting as key opinion leaders; and targeted marketing.

A complete downloadable pdf version of Harris Interactive Health Care News, Volume 1, Issue 31, with the report on physicians' behaviour towards ehealth, including graphs and charts, is available. To know more about the patients' attitude versus ehealth, you can read the VMW August 2001 article Internet has an impact on patients but how on earth do you reach them? which deals with another BCG/Harris Interactive study, titled "Vital Signs Update: The E-Health Patient Paradox".

Leslie Versweyveld

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