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Crossing the Quality Chasm: A New Health System for the 21st Century
useful in selecting a health plan or provider, and to participate in formal and informal support groups. Comparative performance data are available on the Internet for many health plans (National Committee for Quality Assurance, 2000), and depending on the geographic area of interest, there may be relevant information on hospitals and providers. The Internet can also be used to post customized health education messages according to a person’s profile and needs (Kendall and Levine, 1997).
Clinical Care. The Internet has the potential to make health care delivery more timely and responsive to consumer preferences. As discussed in Chapter 6, the Internet is playing an increasingly critical role in making scientific publications, syntheses of the evidence, practice guidelines, and other tools required to support evidence-based practice available to both patients and clinicians. Examples of information technologies that are of growing importance in the health care arena are reminder systems (Alemi et al., 1996); telemedicine applications, such as teleradiology and e-mail; and online prescribing (National Health Policy Forum, 2000; Schiff and Rucker, 1998).
Administrative and Financial Transactions. To date, the area in which information systems have been used most extensively in health care has been to improve the service and efficiency of various administrative and financial transactions (Starr, 1997; Turban et al., 1996). In 1999, almost 65 percent of the 4.6 billion medical claims processed by private and public health insurance plans were transmitted electronically (Goldsmith, 2000).
Public Health. IT can be used to improve the quality of health care at the population level. Applications include incident reporting, videoconferencing among public health officials during emergency situations, disease surveillance, transfer of epidemiology maps and other image files for monitoring of the spread of disease, delivery of alerts and other information to clinicians and health workers, and maintenance of registries.
Professional Education. The Internet can be a powerful tool for undergraduate, graduate, and continuing medical education for all types of health professionals. A variety of Internet-based educational programs have made their curricula and training materials available on the Web. There are also educational videos, lectures, virtual classrooms, and simulation programs to teach surgical skills.
Research. The Internet opens up many options for improving researchers’ access to databases and literature, enhancing collegial interaction, and shortening the time required to conduct certain types of research and disseminate results to the field. These applications are already gaining widespread acceptance.
Of course, not all computer health applications are Internet-based. There are computerized order entry systems, reminder systems, and other applications that run on legacy systems (older IT systems, often built around mainframes, owned