Will access to medical information over the Internet increase the demand for health care and thus its cost? Certainly manufacturers of drugs, medical products, and technologies think so, as they have moved aggressively to create Web sites and to advertise in emerging e health venues on the Internet. However, it remains to be seen if advertising on the Internet will generate sufficient measurable returns to justify large advertising expenditures for pharmaceutical and product companies. Unlike with passive media such as radio and television, consumers can simply click past Internet advertising to the content they seek.
The Internet's potential to create demand for medical services will be closely studied in the next few years. in my opinion, these studies will find that in a consumer guided search for solutions, self care and alternative medicine will be given equal standing with invasive, high cost solutions to health conditions. Many consumers whose encounters with mainstream medical care yield only expensive options may find less invasive, less risky solutions to their health problems.
The Internet will also provide disease-specific consumer feedback on new treatments that may dampen demand. The Internet is a superb medium for gathering and monitoring information on adverse reactions to newly released drugs or therapies. As discussed earlier, the combination of Internet connectivity with institutional (enterprise-level) electronic monitoring of the prescribing process also has strong potential for lowering the number of adverse drug events and the associated cost.
Overall, the cost impact of the Internet may be closer to neutral than most people suspicious of technology's impact on health costs believe. Network computing may save as much money by eliminating middlemen, clerical costs, redundant processes, and medical error as it generates in increased demand for care. Interactive disease management for patients with chronic diseases may yield significant savings in the costs of avoidable care.
The Internet has a greater potential to fundamentally transform both the structure and the core processes of medicine than any new technology we have seen in the past fifty years. Professional resistance to adoption of the technology and political problems associated with protecting the confidentiality of patient records pose the two biggest hurdles to fully realizing this potential. I see the Internet generating some demand for new products and services. However, that demand is likely to be counterbalanced by a more careful weighing of potential benefits, reduction in medical errors, and the elevation of less expensive substitute therapies to parity with traditional invasive medicine, as well as savings from improved disease management. As a consequence, the Internet's impact on health care costs may be surprisingly benign. The most important effect of the Internet will be to strengthen the consumer's role in relation to practitioners and health care institutions, and to create a powerful new tool to help people manage their own health risks more effectively.
Jeff Goldsmith, a health care forecaster and strategist, is president of Health Futures, Inc., in Charlottesville, Virginia. He is a member of the board of directors of the Cerner Corporation, a health care informatics company, and a director of the Essent Corporation, an investor-owned hospital management firm.