5 Ways the Internet is Changing Health Care





OK, so maybe you haven’t friended your doctor on Facebook. But if you’re like most Americans, the Internet has become your new best friend in health care.


According to the Pew Research Center’s Internet & American Life Project, 61 percent of U.S. adults go online for health information. What’s more, nearly all (60 percent) say their findings have influenced a decision about how to treat an illness and that the advice they found was helpful—a pretty strong indicator that, when used with requisite caution, the Internet can (and does) play a positive and vital role in health care.


The marriage of the Internet and health care is nothing new; scheduling appointments online, listening to podcasts and e-mailing your doctor are so five minutes ago. But as technology evolves, new applications are constantly emerging. Here are five.


1.The social media surge.


Were you born, or did you give birth, at Sutter Memorial? Are you a Mercy Mom? There’s a Facebook or Twitter page for you.


The Sacramento region’s health care providers are plugging in to the power of social media, and in a big way. All of the major medical groups—Sutter Health, UC Davis, Kaiser Permanente and CHW/Mercy—have Facebook pages (multiple pages, in some cases), sprinkled with a smattering of Twitter, YouTube and iTunes accounts and blogs. The most effective, experts say, are sites with specificity; a page called “integrative therapies for fibromyalgia” is more meaningful to most than an institutional site whose agenda is promotional or generic (i.e., “It’s flu season! Time for your vaccine.”).


“Connecting individuals with a clear mutual interest is really important,” says Peter Yellowlees, M.D., professor of psychiatry and director of the Health Informatics Graduate Program at UC Davis. The best sites, Yellowlees says, not only bring together people who have a shared medical interest—online communities for rare diseases are particularly useful, he notes—but also get experts involved so patients can connect with physicians who treat the condition or read posts from, say, the nation’s top 10 specialists.


Education and communication are among the main benefits of social media sites, says Sutter’s Michael Chez, M.D., who enthusiastically contributes to the Facebook page for Sutter’s Autism Treatment Center. “It’s a great educational tool for patients and a really nice community resource—more interactive than your old-fashioned website,” says Chez, medical director of pediatric neurology for Sutter Neuroscience Medical Group. A recent check of the page revealed 285 fans, with posts ranging from “autistic student’s inspirational graduation speech” to the latest autism research findings to patient questions, such as “Anyone willing to share their experiences with Dr. Khan?” Chez says he frequently responds to posts, sometimes doing damage control. “One person recently posted a question about prenatal sonograms as a cause of autism, and I weighed in by saying there is no evidence to support this. There’s a lot of misinformation out there.”


Some patients post happy-ending stories, providing hope to others. When 10-year breast cancer survivor Stephanie Pill was approached by a friend who works at UC Davis Cancer Center to post on its Facebook page, she was only too happy to oblige. “Social media is a way to reach out to people and share your experiences,” says Pill, who lives in Fair Oaks. “It’s a way to learn about something and also to have a support network or be a mentor. A lot of people who have cancer don’t want to go out, or physically can’t go out, so the Internet is a handy way to connect.”


2. Rate your doctor.  


 “If you have health problems like your arm is visibly falling off, then he’ll fix ya right up,” wrote one snarky reviewer on RateMDs.com. I took offense: He was writing about my primary care physician, whom I happen to like. I rose immediately to my M.D.’s defense with a positive post and a smiley face, marking my first and only foray into the world of doctor-rating websites. The Yelp of health care, these sites invite real people to write doctor reviews and rate physicians on such matters as punctuality, listening skills, ease of scheduling appointments and knowledge. Their popularity seems to be growing: Even angieslist.com, better known as a place to find a plumber, now includes physicians on its consumer-rating hit list.


But with so many—there’s DrScore.com, vitals.com, physicianreports.com and dozens more—how do you choose? One local user (we’ll call her Michelle) who has tried several says she prefers RateMDs.com because it’s more than just a place to rate doctors; it’s a community.  


“It’s a place for patients to go, grieve, heal, get support,” says Michelle, who routinely hops onto the website’s forum section “like it’s my morning coffee. I go online and see ‘Who’s on?’” While her original impetus was to see if any of her doctors were listed on the site—“I had an unnecessary mastectomy and believed I had been mistreated,” says Michelle—she wound up finding “a lot of friends and some brilliant people on there who are just loaded with information.”


Some doctors are not quite so enamored, fearing their reputations will be smudged and, in some cases, asking patients to sign a waiver prohibiting them from posting negative comments on the sites. But not everybody is out to doctor-bash. According to a study of 33 physician-rating websites published earlier this year in the online Journal of General Internal Medicine, the overwhelming majority of reviews (88 percent) are positive.


3. Build a bridge.  


Jeff Working had been fighting epilepsy since he was a baby. But when Working, now in his late 40s, began having grand mal seizures on a frighteningly frequent basis, he temporarily moved from Sacramento to Santa Barbara to live with his elderly parents. Meanwhile, the rest of the family—two brothers in Sacramento, one in Chicago and another in Cleveland—did their best to rally around him. But staying connected isn’t easy when there are so many miles in between, so the Workings decided to try CaringBridge.org. “Connecting family and friends when health matters most” is CaringBridge’s slogan, and that’s exactly what it’s about, providing users free, personalized websites on which to post updates and photos during (and, presumably, before and after) a health event. The sites also feature a guestbook for stoppers-by.


“It (CaringBridge) seemed like a good forum for people to know what’s going on, even though they’re in Cleveland or Chicago or whatever,” says Jeff’s brother Tom Working, who lives in Sacramento. “We’re the kind of family that would be writing lots of letters if the Internet weren’t around.” As Jeff’s condition worsened and plans were put into place for brain surgery, the need for frequent communication grew more critical. Brother Russell, in Chicago, took charge of providing regular updates on the CaringBridge site. “He’s a good writer, so he was able to convey the updates vividly,” says Working. Many, he says, stopped by to jot words of support and encouragement in the guestbook—aunts, uncles and family friends, especially friends of Jeff’s.


This is exactly what founder Sona Mehring had in mind, she says, when she started the site. “My goal and dream is that CaringBridge can be there for the millions of people and their friends and family who are faced everyday with a serious health challenge,” says Mehring. Apparently, her dream has come true: According to the CaringBridge website, more than 1 billion visits have been logged.


4. Face-to-face, but not in person.


With all the hype about Skype, you’d think it was being used in the medical world. But no—at least not in the main, says UCD’s Peter Yellowlees. “Some physicians do use it, but they probably shouldn’t because Skype can potentially have some security issues,” he explains.


Maybe we’ll be Skyping with doctors down the road. But until then, we’ve got telemedicine, which serves the same purpose minus the security issues, says Yellowlees, enabling patients and doctors to see and talk to one another from a distance via teleconferencing. He certainly would know: Yellowlees is one of the top telemedicine experts at UC Davis, whose program is nationally renowned. As a psychiatrist, Yellowlees has been consulting with patients via live videoconferencing for years. But now, he says, there’s something even more cutting edge. Called store and forward, this approach allows a provider to gather diagnostic information via digital images and forward it elsewhere for assessment. It’s frequently used in dermatology and diabetic retinopathy screenings, but rarely used in psychiatry; Yellowlees says UCD is the first. “What we do is record the patient interviews, then send videos of the interviews to psychiatrists, who do assessments,” he says. The obvious advantage: No face-to-face visit is necessary. Telemedicine is a great thing, Yellowlees says, “in any situation where it’s inconvenient for a patient to travel, or when specialty services aren’t locally available.”


“Wonderful things are going on” in telemedicine, says Christine Martin, executive director of the California Telemedicine and eHealth Center in Sacramento. She bubbles with enthusiasm about a number of local programs—Tele-ICU at Sutter, telemedicine at the Mercy Stroke Center, a Kaiser home monitoring project (in which a patient’s vital signs are monitored at home and transmitted to health-care providers)—and says she wants to see telemed everywhere.




“If things continue to move in the direction they’re going in, I think we’re going to see that technology-assisted health care is going to be in all parts of our lives,” says Martin. It’s certainly starting to look that way.


5. Online Diagnoses. Go online, fill out a short survey, wait about an hour


and bam—you’re given a diagnosis and a treatment plan, all for a mere $25. Sound too good to be true? Some critics say so. But Jon Pearce, a co-founder of zipnosis.com, believes in his product. “We’ve had phenomenal feedback from the patients who use it, and I can honestly tell you we lower the cost of health care,” says Pearce. “We cut out the middle man between you and the provider.”


Launched in May 2010, Zipnosis services currently are only available in Minnesota, where the company is based. But Pearce’s goal is to spread to 15 states by fall 2011, and he’d like one of those states to be California. “California is high on our priority list,” says Pearce.


Zipnosis knows its limits. This is not where you go to have cancer or lupus diagnosed. But if your symptoms suggest something minor—sinusitis or a bladder infection, for instance—it’s a cheap, convenient way to confirm a hunch and, if needed, get a prescription. (Zipnosis clinicians can prescribe only basic meds, no narcotics or opioids, according to the official website.) The service is especially appropriate for the “younger, healthier” consumer whose health-care needs tend to be minimal, says Pearce.


Pearce, who was an M.B.A. student when he decided to put his degree on hold to launch the company, says the idea for Zipnosis was “borne out of my own experiences of being underinsured or uninsured and wanting to lower the cost of health care. Spending $220 to go to urgent care with a plugged-up ear and have them give me some saline was not my idea of a happy experience.”