HEALTH AND THE INTERNET: Goldmine on the Web?
A study in this week's issue of the Journal of the American Medical Association says computer systems that help physicians diagnose patients' conditions could be helpful in training medical students, but produce limited improvements in diagnostic accuracy for experienced doctors. A team led by University of Pittsburgh researchers evaluated the usefulness of two commercially available computer-based decision support systems (DSSs) used in "diagnostically challenging" cases by 216 doctors at three academic medical institutions. The researchers compared the percentage of cases diagnosed correctly with and without the aid of a DSS for each of the three groups. Medical students showed the most improvement in diagnostic accuracy when aided by the systems (9.1% improvement), while senior residents and faculty members showed relatively small improvements (5.4% and 3.3%, respectively). The study's authors noted that, while DSSs can be helpful to any doctor in the diagnosis of difficult cases, their usefulness is dependent upon factors such as the physician's own medical knowledge and skill in using the system. Due to the larger effects seen for students, the researchers conclude that current DSSs may be better suited for use in undergraduate medical education than in clinical practice by experienced doctors (Friedman, et al, 11/17). Noting the study results showing that without the help of a computer, the most experienced doctors arrived at the correct diagnosis only 52% of the time, University of Pittsburgh associate vice chancellor for biomedical information and lead study author Dr. Charles Friedman said, "The public should not be scared by the fact that the faculty and residents got only half the cases right. It (the study) involved an artificial structure using very, very hard cases. No conclusions should be drawn from this about the capabilities of the doctors" (Wilson, Pittsburgh Tribune-Review, 11/17).
McKesson HBOC Joins the Race
In a move that could put it "squarely into competition with Atlanta-based Healtheon/WebMD," San Francisco-based McKesson HBOC on Monday announced a "multimillion-dollar" licensing deal with a claims processing firm and acquisition of a separate physician services firm. McKesson's three-year licensing deal with Dallas, TX-based Claimsnet.com gives the nation's no. 1 drug wholesaler (McKesson), which earlier this year acquired "the market leader in health care software and services" (HBOC), a foothold in online claims processing. And its purchase of privately held Abaton.com, based in Minneapolis, MN, marks entry into the field of electronic prescriptions and other online clinical services for physicians. Financial terms were not disclosed for either arrangement. McKesson spokesman Larry Kurtz said the company aims to provide doctors with "everything they need within the next year." Services would include online business applications for practice management, claims processing, laboratory and pharmacy interfaces, and supply management (Miller,Atlanta Journal-Constitution, 11/16).
e Is for Ethics
The not-for-profit Internet Healthcare Coalition (IHC) has announced a "high-level working summit" Feb. 1-2, 2000, in Washington, D.C., to craft a set of ethical principles for health-related Internet sites. The "e-Health Ethics Summit" will examine advertising practices, disclaimers, privacy and content sponsorship on Web health information sites, among other issues. The summit hopes to bring together "key stakeholders" including public health policy and ethics academics, pharma and biotech industry reps, Internet-based health providers and commercial developers, medical libraries, database providers and medical specialty societies. Medscape editor-in-chief and former JAMA editor Dr. George Lundberg said in a keynote address at IHC's annual meeting in October, "I call upon the Internet Healthcare Coalition to no set international standards that can become commonly accepted." IHC chair Dr. Helga Rippen said, "Ethical conduct does not happen by accident. It requires leadership, vision and integrity. The IHC is ideally suited to lead the debate as one of the most diverse and experienced independent, international organizations involved in quality information online" (IHC release, 10/27). The challenge comes on the heels of recent allegations of profiteering aimed at former surgeon general Dr. C. Everett Koop, conflict-of-interest allegations aimed at a member of the overseeing board of the New England Journal of Medicine, as well as vast discrepancies in information presented on various sites.
What's .0002% of Nothing?
DoctorSurf.com, a Florida-based Internet start-up company that plans to offer doctors online access to everything from clinical guidelines and news to job-placement and "concierge" services, is offering them something else: free stock in the company. DoctorSurf has received SEC approval to give 100 shares of stock to each of the first 250,000 doctors who sign up for free membership at its Web site, www.doctorsurf.com. DoctorSurf's founder, a Largo, FL, cardiologist, hopes that giving away half of the company's 50 million shares before its expected IPO in September will win doctors away from established competitors such as Healtheon/WebMD. True, doctors may not be wowed by the offer of 100 shares of stock that's currently worthless in a company whose prospectus projects "losses for the foreseeable future." But in today's tech-crazed market, who knows? (Hundley, St. Petersburg Times, 11/17)