The Internet's high-speed reach and anticipated cost efficiencies are prompting disease management firms to use point-and-click methods to target chronically ill
populations. Although health plans and pharmaceutical companies are just beginning to get their feet wet with online disease management programs, these efforts are expected to
grow dramatically over the next few years, says Russell Jackson, contributing editor of Disease Management News and editor of the 2000 Guide to Disease Management on the Internet.
Last month, for instance, eMD.com secured contracts with 42 managed care companies to provide password-protected applications for electronic prescribing, online medical
charting and other pharmaceutical services for monitoring chronic disease patients. The services will be available to more than 100 million health plan members.
While online disease management efforts have immeasurable potential for reaching certain Internet-savvy healthcare targets, it's important to manage expectations on the Web's
effectiveness for achieving overall compliance among the chronically ill.
Traditional disease management outreach still rules the day when it comes to reaching low-income populations, certain Medicare audiences and those who will never feel
comfortable sharing healthcare information online. The latter group defies demographic categorization, spanning across ethnic groups and income/educational status.
Given the undeniable appeal of the Internet, Bob Stone, executive VP of American Health Pathways, a disease management firm in Nashville, offers healthcare strategic planners
this advice: "Ignore the Web at your peril; depend on the Web at your peril."
Until some of the online barriers to disease management are resolved - including prohibitive provider IT systems, physician hesitancy toward online patient programs and limited
Internet access among chronically ill patients - the best way to use the Internet is as a complement to existing disease management efforts.
We're not yet in a position to replace traditional disease management campaigns like direct mail and telemarketing programs with the Internet, says Stone.
Reeling in the Net
Given how fast e-healthcare is evolving to provide more customized methods for chronic disease management, the pros seem to outweigh the cons for taking the online plunge. For
instance, the online menu of personalized disease management offerings can run the gamut from prescription email reminders and customized patient education to "e-checkups" that
keep doctors updated on patient compliance.
But in order for these efforts to realize their full potential, physicians have to become more convinced that the programs will save them additional money and time. "Physicians
are using the Internet for research, professional education and financial planning. But they are not using it to help them deliver healthcare because it's too cumbersome," says
Stone.
This physician hesitancy is one of the reasons AHP has taken a conservative approach to incorporating the Internet into its disease management offerings.
Another roadblock is the relatively conservative online interest among AHP's audience of 160,000 patients who receive traditional disease management services in key areas like
diabetes and cardiac care. Thirty percent of its members have Web access and only 10% have expressed an interest in online disease management. But given how costly traditional
disease management outreach is, which can average $10 per member/per month, online disease management to this small target can represent steep savings since direct mail and
telemarketing efforts can be significantly minimized.
To target this Web-savvy group, plans are under way to provide individualized health portals that will empower patients to self-manage their disease using a combination of
education, e-reminders and online clinical support.
The ultimate opportunity for online disease management is developing case management software and tools that will respond not just to the medical condition of a chronic disease
sufferer but important lifestyle issues as well. "If information were going to solve the disease management dilemma, it would have done so 20 years ago," says Stone.
(Disease Management News, Russell Jackson, 301/289-8742; eMD.com, Wayne Roberts, 770/246-2024; American Health Pathways, Bob Stone, 615/665-7760)
Health Plan Uses Takes Online Plunge
Unlike American Health Pathways' cautious approach to online disease management, One Health Plans, a national managed care organization, is using the Internet to replace and
expand its once fragmented traditional disease management programs to HMO members.
The online disease management program, called CareResults, was launched last month and is available to One Health's PPO, POS and HMO members with chronic conditions like
asthma, diabetes and heart conditions. Of the 200,000 health plan members with chronic conditions, the voluntary online program has generated participation from 100,000 members,
says Wally Gomaa, One Health Plan's VP of network development.
The cornerstones of the program are:
- a 10- to 20-minute risk assessment survey that health plan members are encouraged to take online; and
- consistent physician communication on the health status of chronic patients.
The program was designed by ProMedex, a provider of disease intervention programs.
From the survey information, members develop a care plan with physicians with specific disease management goals. The survey information also helps the health plan develop
individual health profiles that take into consideration an individual's risk level and ability to manage his or her condition.
For instance, high-risk members receive more aggressive online follow-up that promote monitoring key health indicators like weight and blood pressure. Moderate-risk members are
targeted on a quarterly basis with health quizzes and less aggressive health interventions.
To complement the online offerings, a direct mail campaign promotes the Web site and provides customized booklets on disease management.
Other offline disease management marketing materials include videos, books and cassette tapes.
(One Health Plan, Wally Gomaa, 314/982-1792)